![]() The complex role of TME makes it possible to classify cancer immunologically in terms of prognosis, chemotherapy, and immunotherapy response prediction. Various tumor-infiltrating immune cells make TME a double-edged sword, exhibiting an ability to either arrest or support malignancy ( 15). The infiltrating immune cells are composed of multiple immune cell types, such as T cells, macrophages, and neutrophils ( 14). The primary composition of TME includes infiltrating immune cells, mesenchymal cells, and extracellular matrix ( 13). Meanwhile, increasing evidence demonstrates that the tumor microenvironment (TME) plays a crucial role in tumorigenesis and tumor progression ( 12). These include changes in the cellular microenvironment associated with growth and development ( 7), the microenvironment in which tumors occur, and the impact of gastrointestinal tumors and tumors outside the gastrointestinal tract, such as colon cancer ( 8), lung cancer ( 9), and prostate cancers ( 10, 11). Currently, some studies have reported some factors that affect the occurrence and development of colorectal cancer. Therefore, it is necessary to screen out patients who have good response to fluorouracil-based combination chemotherapy, making personalized treatment possible.Ĭolorectal cancer has a complex pathogenesis, and many potential factors have an important impact on the occurrence and development of colorectal cancer. Studies have shown that adjuvant chemotherapy improves survival rate by only 3% in patients with stage II CRC, and increases by 15% to 20% for stage III CRC ( 6). However, the occurrence of resistance often makes patients benefit less in the course of treatment ( 5). As first-line agents, fluorouracil-based combination chemotherapy includes FOLFOX, CapeOX, and FOLFIRI ( 4). Fluorouracil-based combination chemotherapy is recommended for all patients with stage II or III ( 3). In order to avoid recurrence and prolong OS, neoadjuvant or adjuvant chemotherapy is often required for surgical patients. In recent years, radical resection has been the mainstay of treatment for CRC. Our findings suggested that the high TMERSS subtype may have a higher proportion of respondents to Cetuximab agent and immunotherapy, while the low TMERSS subtype may be more suitable for treatment with FOLFOX and FOLFIRI regimens.ĭiscussion: In conclusion, the TMERSS model may provide a partial reference for the prognosis evaluation of patients, the prediction of drug sensitivity, and the implementation of clinical decision-making.Ĭolorectal cancer (CRC) represents the third most common malignancy and the second leading cause of cancer death worldwide ( 1, 2). Results: Compared with low TMERSS subtype, high TMERSS subtype has a better outcome, which may be associated to higher abundance of antitumor immune cell in high TMERSS subtype. In addition, patients sensitive to the therapy were screened out by correlation analysis between TMERSS subtypes and drug responses. Simultaneously, we compared the clinicopathological factors, antitumor immune activity, immune cell abundance and differences of cell states in different TMERSS subtypes. Methods: We analyzed the expression profiles and 197 TME-related signatures of 1775 patients using ssGSEA, univariate Cox proportional risk model and LASSO-Cox regression model, and defined a novo molecular subtype (TMERSS) of CRC. Therefore, it is necessary to define novo molecular subtypes of CRC based on TME immune components, and screen patients who are sensitive to the treatments, to make personalized therapy possible. There has been increasing evidence that immune components of TME can affect the sensitivity of patients to drugs. However, the drug sensitivity of patients to regimens is different. Introduction: As the top 3 cancer in terms of incidence and mortality, the first-line treatment for CRC includes FOLFOX, FOLFIRI, Cetuximab or immunotherapy. 2Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.1Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. ![]() Xiang Jun 1, Shengnan Gao 2, Lei Yu 1* and Guiyu Wang 1*
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