Analyzing single-cell transcriptome and TCR sequences from 12 colorectal cancer patients, Zhang, Yu, Zheng, and Zhang et al. categorized T cell subsets by unbiased clustering and phenotyping by localization, migration, and proliferation. A TCR clonotype-dependent developmental lineage linked CD8+ effector memory cells to recently activated effector memory and exhausted T cells (TEX). Microsatellite-unstable tumors were enriched in a clonally expanded and proliferative CXCL13+ BHLHE40+ Th1-like CD4+ T cell subset with upregulated IGFLR1, which was also upregulated in TEX . In vitro experiments suggested a role of IGFLR1 in TCR costimulation.
T cells are key elements of cancer immunotherapy(1), but certain fundamental properties, such as development and migration of T cells within tumours, remain elusive. The enormous T cell receptor (TCR) repertoire, which is required for recognising foreign and self-antigens(2), could serve as lineage tags to track these T cells in tumours(3). Here, we obtained transcriptomes of 11,138 single T cells from 12 patients with colorectal cancer (CRC) and developed STARTRAC (single T-cell analysis by RNA-seq and TCR tracking) indices to quantitatively analyse dynamic relationships among 20 identified T cell subsets with distinct functions and clonalities. While both CD8(+) effector and "exhausted" T cells exhibited high clonal expansion, they were independently connected with tumour-resident CD8(+) effector memory cells, implicating a TCR-based fate decision. Of the CD4(+) T cells, the majority of tumour-infiltrating Tregs showed clonal exclusivity, whereas certain Treg clones were developmentally linked to multiple TH clones. Notably, we identified two IFNG(+) TH1-like clusters in tumours, the GZMK(+) TEM and CXCL13(+)BHLHE40(+) TH1-like clusters, which were associated with distinct IFN-gamma-regulating transcription factors, EOMES/RUNX3 and BHLHE40, respectively. Only CXCL13(+)BHLHE40(+) TH1-like cells were preferentially enriched in tumours of microsatellite-instable (MSI) patients, which might explain their favourable responses to immune-checkpoint blockade. Furthermore, IGFLR1 was highly expressed in both CXCL13(+)BHLHE40(+) TH1-like and CD8(+) exhausted T cells and possessed co-stimulatory functions. Our integrated STARTRAC analyses provide a powerful avenue to comprehensively dissect the T cell properties in CRC, which could provide new insights into the dynamic relationships of T cells in other cancers.