Tumor transcriptional state predicts survival in immune-checkpoint-blockade-treated glioblastoma
(1) Ghannam JY (2) Bryan J (3) Weiss J (4) Kovarsky D (5) Merrell D (6) Messer C (7) Schlueter-Kuck K (8) Fell GG (9) Lim-Fat MJ (10) Youssef G (11) Rahman R (12) Qin L (13) Young GS (14) Janes JT 3rd (15) Van Orden M (16) Pfaff KL (17) Gans A (18) Lin ES (19) Huang RY (20) Danysh BP (21) Parida L (22) Li S (23) Wen PY (24) Chiocca EA (25) Neuberg D (26) Ligon KL (27) Tirosh I (28) Reardon DA (29) Getz G (30) Wu CJ
Using bulk DNA/RNA sequencing and single-nucleus RNAseq, Ghannam et al. profiled 181 ICB-treated glioblastomas, benchmarking against standard-of-care cohorts, to define genomic correlates of ICB response. At baseline, an mesenchymal (MES) transcriptional subtype with high HLA class I expression and increased T cell infiltration was predictive of improved survival after ICB, but not chemoradiation, whereas non-MES-linked lesions were associated with worse ICB outcomes. TMB was not predictive of outcomes, and a longitudinal analysis showed ICB selected for subclones with non-MES features as a trajectory of acquired ICB resistance in GBM.
Contributed by Shishir Pant
(1) Ghannam JY (2) Bryan J (3) Weiss J (4) Kovarsky D (5) Merrell D (6) Messer C (7) Schlueter-Kuck K (8) Fell GG (9) Lim-Fat MJ (10) Youssef G (11) Rahman R (12) Qin L (13) Young GS (14) Janes JT 3rd (15) Van Orden M (16) Pfaff KL (17) Gans A (18) Lin ES (19) Huang RY (20) Danysh BP (21) Parida L (22) Li S (23) Wen PY (24) Chiocca EA (25) Neuberg D (26) Ligon KL (27) Tirosh I (28) Reardon DA (29) Getz G (30) Wu CJ
Using bulk DNA/RNA sequencing and single-nucleus RNAseq, Ghannam et al. profiled 181 ICB-treated glioblastomas, benchmarking against standard-of-care cohorts, to define genomic correlates of ICB response. At baseline, an mesenchymal (MES) transcriptional subtype with high HLA class I expression and increased T cell infiltration was predictive of improved survival after ICB, but not chemoradiation, whereas non-MES-linked lesions were associated with worse ICB outcomes. TMB was not predictive of outcomes, and a longitudinal analysis showed ICB selected for subclones with non-MES features as a trajectory of acquired ICB resistance in GBM.
Contributed by Shishir Pant
ABSTRACT: The determinants of immune checkpoint blockade (ICB) response in glioblastoma (GBM) with wild-type isocitrate dehydrogenase remain poorly understood. Here we profiled 181 ICB-treated GBM cases using bulk DNA sequencing, bulk RNA sequencing and single-nucleus RNA sequencing to investigate the genomic features associated with ICB outcomes. Baseline tumor transcriptional subtype was predictive of overall survival following ICB, with mesenchymal (MES) GBM associated with improved outcomes to ICB but not standard chemoradiation. Non-MES-associated genetic lesions, including those in PDGFRA and CDKN2A, were associated with worse survival following ICB but not standard therapy. Tumor mutational burden was not predictive of outcomes. Survival was associated with pre-ICB enrichment for MES-like malignant cells, marked by high human leukocyte antigen class I expression and greater T cell infiltration. Paired tumor analyses linked ICB exposure to outgrowth of subclones harboring lesions associated with non-MES subtypes, supporting MES-to-non-MES transition as a common trajectory of acquired resistance to ICB, distinct from standard chemoradiation.
Author Info:
(1) Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. Harvard Medical School, Boston, MA, USA. Broad Institute of MIT and Harvard, Cambridge, MA, USA.
Harvard/MIT MD-PhD Program and Harvard Immunology PhD Program, Harvard Medical School, Boston, MA, USA. (2) Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. Harvard Medical School, Boston, MA, USA. Broad Institute of MIT and Harvard, Cambridge, MA, USA. Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Molecular Diagnostics Laboratory, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. (3) Broad Institute of MIT and Harvard, Cambridge, MA, USA. (4) Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel. (5) Broad Institute of MIT and Harvard, Cambridge, MA, USA. (6) Broad Institute of MIT and Harvard, Cambridge, MA, USA. (7) Broad Institute of MIT and Harvard, Cambridge, MA, USA. (8) Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA. (9) Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. (10) Harvard Medical School, Boston, MA, USA. Center for Neuro-Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. (11) Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, USA. (12) Department of Imaging, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, USA. (13) Departments of Radiology, Mass General Brigham, Brigham and Women's Hospital, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, USA. (14) Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. Translational Immunogenomics Laboratory, Dana-Farber Cancer Institute, Boston, MA, USA. (15) Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. Translational Immunogenomics Laboratory, Dana-Farber Cancer Institute, Boston, MA, USA. (16) Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. (17) Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. (18) Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. (19) Departments of Radiology, Mass General Brigham, Brigham and Women's Hospital, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, USA. (20) Broad Institute of MIT and Harvard, Cambridge, MA, USA. (21) IBM Research, Yorktown Heights, NY, USA. (22) Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. Broad Institute of MIT and Harvard, Cambridge, MA, USA. Translational Immunogenomics Laboratory, Dana-Farber Cancer Institute, Boston, MA, USA. (23) Center for Neuro-Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. (24) Center for Tumors of the Nervous System, Mass General Brigham Cancer Institute & Department of Neurosurgery, Mass General Brigham, Boston, MA, USA. (25) Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA. (26) Broad Institute of MIT and Harvard, Cambridge, MA, USA. Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Department of Pathology, Dana-Farber Cancer Institute, Boston, MA, USA. (27) Department of Molecular Cell Biology, Weizmann Institute of Science, Rehovot, Israel. (28) Center for Neuro-Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. (29) Harvard Medical School, Boston, MA, USA. Broad Institute of MIT and Harvard, Cambridge, MA, USA. Cancer Center and Department of Pathology, Massachusetts General Hospital, Boston, MA, USA. (30) Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. catherine_wu@dfci.harvard.edu. Harvard Medical School, Boston, MA, USA. catherine_wu@dfci.harvard.edu. Broad Institute of MIT and Harvard, Cambridge, MA, USA. catherine_wu@dfci.harvard.edu.
