Xu et al. demonstrated heterogeneity in T cell distribution and density in RCC, and identified local antigen-experienced clonally expanded T cells and shared populations among PBMC and/or normal adjacent tissue (NAT). Tumor restricted T cell clones displayed a Tem phenotype, with the highest expression of antigen-activation, exhaustion, and proliferation markers of any T cell subset within the TME. A subset of the Tem clones comprised CD4+CD8+ double positive T cells with a similar antigen-experienced phenotype. The clonotypes shared among tumor, NAT, and PBMC displayed a Teff phenotype with higher cytotoxic markers and lower activation and exhaustion markers.

Contributed by Shishir Pant

ABSTRACT: Objective responses of metastatic renal cell carcinoma (RCC) associated with systemic immunotherapies suggest the potential for T-cell-mediated tumor clearance. Recent analyses associate clonally expanded T cells present in the tumor at diagnosis with responses to immune checkpoint inhibitors (ICIs). To identify and further characterize tumor-associated, clonally expanded T cells, we characterized the density, spatial distribution, T-cell receptor (TCR) repertoire, and transcriptome of tumor-infiltrating T cells from 14 renal tumors at the time of resection and compared them with T cells in peripheral blood and normal adjacent kidney. Multiplex immunohistochemistry revealed that T-cell density was higher in clear cell RCC (ccRCC) than in other renal tumor histologies with spatially nonuniform T-cell hotspots and exclusion zones. TCR repertoire analysis also revealed increased clonal expansion in ccRCC tumors compared with non-clear cell histologies or normal tissues. Expanded T-cell clones were most frequently CD8(+) with some detectable in peripheral blood or normal kidney and others found exclusively within the tumor. Divergent expression profiles for chemokine receptors and ligands and the Ki67 proliferation marker distinguished tumor-restricted T-cell clones from those also present in blood suggesting a distinct phenotype for subsets of clonally expanded T cells that also differed for upregulated markers of T-cell activation and exhaustion. Thus, our single-cell level stratification of clonally expanded tumor infiltrating T-cell subpopulations provides a framework for further analysis. Future studies will address the spatial orientation of these clonal subsets within tumors and their association with treatment outcomes for ICIs or other therapeutic modalities.

Author Info: (1) Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States. (2) Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States

Author Info: (1) Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States. (2) Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States. (3) Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States. (4) Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States. Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States. (5) Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States. Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States. (6) Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States. Department of Medicine, Division of Medical Oncology, University of Washington School of Medicine, Seattle, WA, United States. (7) Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, United States. Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States. Department of Medicine, Division of Medical Oncology, University of Washington School of Medicine, Seattle, WA, United States.