Abstract PO1-14-06: Integrated analysis reveals the impact of obesity on triple-negative breast cancer

Abstract Background: Obesity and overweight status, which has been growing rapidly over the past few decades, is considered as a risk factor for many types of cancers including breast cancer. Despite the multi-omics profile of triple-negative breast cancer (TNBC) has been comprehensively characterized, the impact of obesity on molecular features of TNBC is not fully appreciated. Methods: We applied an integrative analysis on clinicopathological data and molecular data (including genomic, transcriptomic, proteomic and metabolomic profiling) using the multi-omics database of TNBC (N = 465) from Fudan University Shanghai Cancer Center (FUSCC) for associations with patient body mass index (BMI). Patients were categorized into overweight/obese (OW/OB, BMI ≥ 24 kg/m2) and normal (NL, BMI < 24 kg/m2) group according to the Chinese criteria of BMI. The clinical and molecular differences between OW/OB and NL patients were systematically explored. We also constructed high-fat diet (HFD)-induced obese mouse tumor models and used single-cell RNA sequencing to investigate the impact of obesity on the tumor microenvironment. Furthermore, we analyzed the efficacy of anti-PD-1 immunotherapy on TNBC tumors in both obese and normal mice. Results: OW/OB patients exhibited higher proportion of metabolic syndrome, more adipose tissue in the breast and worse survival than NL patients. Among most frequently mutated genes, OBSCN showed statistically significantly less mutated in the OW/OB group (3.2% vs 9.6%), while TP53 (68.3% vs 76.9%) and PIK3CA (21.4% vs 14.1%) had tendency to be different. In terms of copy number alterations, we found OW/OB patients had a higher amplified or gained frequency of 13q14.11 (FOXO1) and a lower frequency of deletion or loss of chromosomal region 7p22.1 (FOXK1). We further dissect the expression profile of TNBC. Differentially expressed gene analysis and pathway enrichment analysis demonstrated that immune and metabolic pathways were the major distinction between OW/OB and NL tumors. OW/OB tumors were characterized with elevated inflammation of tumor microenvironment, as well as higher expression of immune checkpoints. Moreover, analyses focusing on metabolic heterogeneity using transcriptomic, proteomic and metabolomic data revealed upregulation of lipid metabolism and reactive oxygen species pathway in OW/OB group. In addition, our in vivo experiments demonstrated that TNBC in the obese mice displayed faster growth rates. Flow cytometry analysis and single-cell RNA sequencing showed that higher proportion of immunosuppressive myeloid cells and exhausted CD8+ T cells and upregulation of lipid metabolism in HFD group. Applying anti-PD-1 immunotherapy in both obese and normal mice displayed that tumors in the obese mice showed more sensitive to anti-PD-1 immunotherapy. Conclusion: Our study systematically revealed that obesity might play a significant role in the molecular heterogeneity of TNBC and showed distinct sensitivities to immunotherapy, which should be taken in account in the field of precision medicine. Keywords: triple-negative breast cancer, obesity, immune, tumor microenvironment, metabolism Citation Format: Yue Gong, Peng Ji, Huai-liang Wu, Li-Hua He, Ming-Liang Jin, Xin Hu, Yi-Zhou Jiang, Zhiming Shao. Integrated analysis reveals the impact of obesity on triple-negative breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-14-06.