Methods of predicting and preventing cancer in patients having premalignant lesions

Abstract

As advanced cancer has poor prognosis, its detection and treatment at the earliest stages is critical to increase cancer survival rate. Therefore, elucidating the determinants of the intra-lesion immune reaction during cancer's developments is critical for moving into precision medicine and immunotherapy-based cancer prevention. Adaptive immune response within tumors was shown to be the strongest at the earliest stage of carcinoma. Thus, the inventors hypothesized that the immune microenvironment and adaptive immunity were first established at early stage of lung carcinogenesis. Here they identified changes in the tumor molecular profile and its microenvironment during the successive steps of lung squamous carcinogenesis, using gene expression profiling and multispectral imaging. A unique and invaluable dataset of (9) morphological stages of development was analyzed, including (122) well-annotated biopsies from (77) patients. In particular, the inventors show that immune activation and immune escape occur before tumor invasion, and that immunosuppressive cytokines and checkpoint receptors immune escape mechanisms are concomitant with anti-tumor immunity in high-grade dysplasia. Thus, the present invention relates to methods of predicting and preventing cancer in subjects having premalignant lesions.

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