Treating sex and gender differences as a continuous variable can improve precision cancer treatments

© 2024. The Author(s)..

BACKGROUND: The significant sex and gender differences that exist in cancer mechanisms, incidence, and survival, have yet to impact clinical practice. One barrier to translation is that cancer phenotypes cannot be segregated into distinct male versus female categories. Instead, within this convenient but contrived dichotomy, male and female cancer phenotypes are highly overlapping and vary between female- and male- skewed extremes. Thus, sex and gender-specific treatments are unrealistic, and our translational goal should be adaptation of treatment to the variable effects of sex and gender on targetable pathways.

METHODS: To overcome this obstacle, we profiled the similarities in 8370 transcriptomes of 26 different adult and 4 different pediatric cancer types. We calculated the posterior probabilities of predicting patient sex and gender based on the observed sexes of similar samples in this map of transcriptome similarity.

RESULTS: Transcriptomic index (TI) values were derived from posterior probabilities and allowed us to identify poles with local enrichments for male or female transcriptomes. TI supported deconvolution of transcriptomes into measures of patient-specific activity in sex and gender-biased, targetable pathways. It identified sex and gender-skewed extremes in mechanistic phenotypes like cell cycle signaling and immunity, and precisely positioned each patient's whole transcriptome on an axis of continuously varying sex and gender phenotypes.

CONCLUSIONS: Cancer type, patient sex and gender, and TI value provides a novel and patient- specific mechanistic identifier that can be used for realistic sex and gender-adaptations of precision cancer treatment planning.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:15

Enthalten in:

Biology of sex differences - 15(2024), 1 vom: 15. Apr., Seite 35

Sprache:

Englisch

Beteiligte Personen:

Yang, Wei [VerfasserIn]
Rubin, Joshua B [VerfasserIn]

Links:

Volltext

Themen:

Bayesian analyses
Cancer
Cell cycle regulation
Hallmark pathways
Inflammation/immunity
Journal Article
Personalized medicine
Sex and gender differences

Anmerkungen:

Date Completed 17.04.2024

Date Revised 25.04.2024

published: Electronic

Citation Status MEDLINE

doi:

10.1186/s13293-024-00607-1

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM371118611