Heterogeneity, crosstalk, and targeting of cancer-associated fibroblasts in cholangiocarcinoma

Abstract

Cholangiocarcinoma (CCA) comprises diverse tumors of the biliary tree and is characterized by late diagnosis, short-term survival, and chemoresistance.CCAs are mainly classified according to their anatomical location and include diverse molecular subclasses harboring inter-tumoral and intratumoral heterogeneity. Besides the tumor cell component, CCA is also characterized by a complex and dynamic tumor microenvironment where tumor cells and stromal cells crosstalk in an intricate network of interactions. Cancer-associated fibroblasts, one of the most abundant cell types in the tumor stroma of CCA, are actively involved in cholangiocarcinogenesis by participating in multiple aspects of the disease including extracellular matrix remodeling, immunomodulation, neo-angiogenesis, and metastasis. Despite their overall tumorpromoting role, recent evidence indicates the presence of transcriptional and functional heterogeneous CAF subtypes with tumor-promoting and tumorrestricting properties. To elucidate the complexity and potentials of cancerassociated fibroblasts as therapeutic targets in CCA, this review will discuss the origin of cancer-associated fibroblasts, their heterogeneity, crosstalk, and role during tumorigenesis, providing an overall picture of the present and future perspectives toward cancer-associated fibroblasts targeting CCA.

Commentary: Machine learning developed an intratumor heterogeneity signature for predicting prognosis and immunotherapy benefits in cholangiocarcinoma

“…The lower the IRS score, the lower the tumor immune dysfunction and rejection score, the lower the tumor microsatellite instability score, the lower the immune escape score, the lower the MATH score, and the higher the mutation burden score in patients with cholangiocarcinoma. This is consistent with previous findings [ [8] , [9] , [10] ] reported in related studies. Single-cell sequencing and in vitro cell assays were used to validate the large database cholangiocarcinoma prognostic model.…”