The anti-PD-L1/CTLA-4 bispecific antibody KN046 plus lenvatinib in advanced unresectable or metastatic hepatocellular carcinoma: a phase II trial

New insights into cancer immune checkpoints landscape from single-cell RNA sequencing

Immune checkpoint blockade (ICB) therapy represents a pivotal advancement in tumor immunotherapy by restoring the cytotoxic lymphocytes' anti-tumor activity through the modulation of immune checkpoint functions. Nevertheless, many patients experience suboptimal therapeutic outcomes, likely due to the immunosuppressive tumor microenvironment, drug resistance, and other factors. Single-cell RNA sequencing has assisted to precisely investigate the immune infiltration patterns before and after ICB treatment, enabling a high-resolution depiction of previously unrecognized functional interaction among immune checkpoints. This review addresses the heterogeneity between tumor microenvironments that respond to or resist ICB therapy, highlighting critical factors underlying the variation in immunotherapy efficacy and elucidating treatment failure. Furthermore, a comprehensive examination is provided of how specific ICBs modulate immune and tumor cells to achieve anti-tumor effects and generate treatment resistance, alongside a summary of emerging immune checkpoints identified as promising targets for cancer immunotherapy through single-cell RNA sequencing applications.

Harnessing immunotherapy for hepatocellular carcinoma: Principles and emerging promises

HCC is considered as one of the leadin causes of death worldwide, with the ability of resistance towards therapeutics. Immunotherapy, particularly ICIs, have provided siginficant insights towards harnessing the immune system. The present review introduces the concepts and possibilities of immunotherapy for HCC treatment, emphasizing its underlying mechanisms and capacity to enhance patient results, focusing on both pre-clinical and clinical insights. The functions of TME and immune evasion mechanisms typical of HCC would be evaluated along with how contemporary immunotherapeutic approaches are designed to address these challenges. Furthermore, the clinical application of immunotherapy in HCC is discussed, emphasizing recent trial findings demonstrating the effectiveness and safety of drugs. In addition, the problems caused by immune evasion and resistance would be discussed to increase potential of immunotherapy along with combination therapy.

Efficacy and safety of radiotherapy combined with immune checkpoint inhibitors for advanced or unresectable hepatocellular carcinoma: A systematic review and meta-analysis

BACKGROUND

To evaluate the efficacy and safety of radiotherapy with immune checkpoint inhibitors (ICIs), with or without anti-vascular endothelial growth factor (anti-VEGF) agents, in the treatment of advanced or unresectable hepatocellular carcinoma (HCC).

METHODS

Databases including Web of Science, PubMed, Embase, Cochrane Library databases, American Society of Clinical Oncology, and European Society for Medical Oncology were systematically searched. The search included publications up to August 31, 2024. Primary outcome measures included objective response rate (ORR), disease control rate (DCR), incidence of treatment-related adverse events (TRAEs), and TRAEs (grade ≥3).

RESULTS

Twenty-one articles were included in this study (927 participants). Following RECIST 1.1, for external radiotherapy combined with ICIs, the ORR and DCR were 56 % (95 % CI 0.48-0.64, I2=65.91 %) and 88 % (95 % CI 0.77-0.96, I2=87.19 %), respectively; for yttrium-90 combined with ICI, they were 31 % (95 %CI 0.20-0.43, I2=0 %) and 73 % (95 %CI 0.48-0.92, I2=75.23 %), respectively. According to CTCAE criteria, for external radiotherapy combined with ICIs, the incidence of TRAEs (all grades) was 95 % (95 % CI 0.89-0.98, I2=70.79 %), and the incidence of TRAEs (grades ≥3) was 35 % (95 % CI 0.23-0.48, I2=87.54 %); for yttrium-90 combined with ICIs, they were 78 % (95 %CI 0.48-0.98, I2=88.15 %) and 22 % (95 %CI 0.04-0.47, I2=83.69 %), respectively. Subgroup analyses indicated that sequential therapy demonstrated a higher DCR than concurrent therapy, while the combination of intensity-modulated radiotherapy, ICIs, and anti-VEGF agents showed improved efficacy but was associated with increased toxicity.

CONCLUSIONS

Radiotherapy combined with ICI demonstrates substantial efficacy and manageable safety in advanced or unresectable HCC. Sequential therapy may enhance therapeutic effectiveness while reducing TRAEs.

The role of TRAF2 in pan-cancer revealed by integrating informatics and experimental validation

Background

Tumor necrosis factor (TNF) receptor associated factor-2 (TRAF2) is an E3 ubiquitin ligase and scaffolding protein that contribute to the progression of various malignant tumors. However, the role of TRAF2 expression in epigenetic, cancer prognosis, and immune responses in tumor microenvironment is unclear.

Methods

We used The Human Protein Atlas (HPA) database, TIMER 2.0 database, and TCGA database to evaluate TRAF2 expression in human normal and tumor tissues. Correlation of TRAF2 expression with mutations and epigenetic in tumors was evaluated using the cBioPortal platform and the GSCA database. To assess the prognostic value of TRAF2, we performed Kaplan-Meier plots and Cox regression analysis. LinkedOmics database was used for PANTHER Pathways enrichment analysis. The relationship between TRAF2 expression and immune checkpoint genes, as well as immune cell infiltration, was examined using TIMER 2.0 and the R language. Single-cell sequencing data and multiple immunofluorescence staining were used to observe the co-expression of TRAF2 on hepatocellular carcinoma cells and immune cells. Furthermore, using siRNA-mediated knockdown, we explored the potential role of TRAF2 in liver cancer cell biology.

Results

Our findings indicate that TRAF2 is frequently mutated and significantly overexpressed in various types of cancers, and this overexpression is linked to a poor prognosis. The epigenetic alterations in TRAF2 was significant across various types of cancers. TRAF2 is associated with the levels of various immune checkpoint genes and multiple tumor-infiltrating immune cells, suggesting its potential involvement in tumor microenvironment. Of note, enrichment analysis revealed a significant correlation between TRAF2 and T cell activation, and single-cell sequencing indicated that TRAF2 was overexpressed in malignant cells and T cells. In vivo results demonstrated that TRAF2 was closely associated with T lymphocytes in hepatocellular carcinoma. The results of our in vitro experimental studies confirmed that the loss of TRAF2 function inhibits the malignant behavior of HepG2 cells in hepatocellular carcinoma.

Conclusion

TRAF2 represents a potential prognostic biomarker and therapeutic target for cancer immunotherapy, particularly in patients with hepatocellular carcinoma.