Schwarz et al. sequenced and performed HLA-ligandome analysis of two patient-derived, microsatellite instability colorectal cancer (CRC) lines, identifying 97 tumor-associated cryptic peptides (produced via non-canonical translation) and 3 neoantigens (from somatic mutations). Peripheral (primarily CD8+ Tcm/Tscm) and tumor-isolated (equal or predominantly CD4+) T cells from the same patients degranulated and secreted IFNγ in response to both cryptic and neoantigen peptides, confirmed with tetramer staining. Certain immunogenic cryptic peptides were shared among additional CRC and melanoma patients, suggesting broad relevance.

Contributed by Alex Najibi

Background: Patients with cancers that exhibit extraordinarily high somatic mutation numbers are ideal candidates for immunotherapy and enable identifying tumor-specific peptides through stimulation of tumor-reactive T cells (Tc).

Methods: Colorectal cancers (CRC) HROC113 and HROC285 were selected based on high TMB, microsatellite instability and HLA class I expression. Their HLA ligandome was characterized using mass spectrometry, compared with the HLA ligand atlas and HLA class I-binding affinity was predicted. Cryptic peptides were identified using Peptide-PRISM. Patients' Tc were isolated from either peripheral blood (pTc) or tumor material (tumor-infiltrating Tc, TiTc) and expanded. In addition, B-lymphoblastoid cells (B-LCL) were generated and used as antigen-presenting cells. pTc and TiTc were stimulated twice for 7 days using peptide pool-loaded B-LCL. Subsequently, interferon gamma (IFNγ) release was quantified by ELISpot. Finally, cytotoxicity against autologous tumor cells was assessed in a degranulation assay.

Results: 100 tumor-specific candidate peptides-97 cryptic peptides and 3 classically mutated neoantigens-were selected. The neoantigens originated from single nucleotide substitutions in the genes IQGAP1, CTNNB1, and TRIT1. Cryptic and neoantigenic peptides inducing IFNγ secretion of Tc were further investigated. Stimulation of pTc and TiTc with neoantigens and selected cryptic peptides resulted in increased release of cytotoxic granules in the presence of autologous tumor cells, substantiating their improved tumor cell recognition. Tetramer staining showed an enhanced number of pTc and TiTc specific for the IQGAP1 neoantigen. Subpopulation analysis prior to peptide stimulation revealed that pTc mainly consisted of memory Tc, whereas TiTc constituted primarily of effector and effector memory Tc. This allows to infer that TiTc reacting to neoantigens and cryptic peptides must be present within the tumor microenvironment.

Conclusion: These results prove that the analyzed CRC present both mutated neoantigenic and cryptic peptides on their HLA class I molecules. Moreover, stimulation with these peptides significantly strengthened tumor cell recognition by Tc. Since the overall number of neoantigenic peptides identifiable by HLA ligandome analysis hitherto is small, our data emphasize the relevance of increasing the target scope for cancer vaccines by the cryptic peptide category.

Author Info: (1) Department of General Surgery, Molecular Oncology and Immunotherapy, Rostock University Medical Center, Rostock, Germany. (2) Department of General Surgery, Molecular Oncology

Author Info: (1) Department of General Surgery, Molecular Oncology and Immunotherapy, Rostock University Medical Center, Rostock, Germany. (2) Department of General Surgery, Molecular Oncology and Immunotherapy, Rostock University Medical Center, Rostock, Germany. (3) Department of General, Visceral and Transplant Surgery, Universitätsklinikum, Tübingen, Tubingen, Germany. Department of Immunology, University of Tübingen, Tubingen, Germany. German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ) Partner Site Tübingen, University of Tübingen, Tübingen, Germany. Cluster of Excellence iFIT (EXC2180) 'Image-Guided and Functionally Instructed Tumor Therapies', University of Tübingen, Tübingen, Germany. Department of Clinical Pharmacology, University Hospital Tübingen, Tübingen, Germany. (4) Department of Immunology, University of Tübingen, Tubingen, Germany. (5) Department of Immunology, University of Tübingen, Tubingen, Germany. German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ) Partner Site Tübingen, University of Tübingen, Tübingen, Germany. (6) Miltenyi Biotec BV & Co KG, Bergisch Gladbach, Germany. (7) Miltenyi Biotec BV & Co KG, Bergisch Gladbach, Germany. (8) Miltenyi Biotec BV & Co KG, Bergisch Gladbach, Germany. (9) Miltenyi Biotec BV & Co KG, Bergisch Gladbach, Germany. (10) Centogene GmbH, Rostock, Germany. (11) Centogene GmbH, Rostock, Germany. (12) Centogene GmbH, Rostock, Germany. (13) Centogene GmbH, Rostock, Germany. (14) Centogene GmbH, Rostock, Germany. (15) Department of General Surgery, Molecular Oncology and Immunotherapy, Rostock University Medical Center, Rostock, Germany. (16) Center for Integrative and Translational Bioimaging, Rudolf-Virchow Center, University of Würzburg, Würzburg, Germany. (17) Department of General Surgery, Molecular Oncology and Immunotherapy, Rostock University Medical Center, Rostock, Germany michael.linnebacher@med.uni-rostock.de.