Acquired cancer resistance to combination immunotherapy from transcriptional loss of class I HLA.
K G PaulsonV VoilletM S McAfeeD S HunterF D WagenerM PerdicchioW J ValenteS J KoelleC D ChurchN VandevenH ThomasA G ColungaJ G IyerC YeeR KulikauskasDavid M KoelleR H PierceJ H BielasP D GreenbergS BhatiaRaphaël GottardoPaul T NghiemA G ChapuisPublished in: Nature communications (2018)
Understanding mechanisms of late/acquired cancer immunotherapy resistance is critical to improve outcomes; cellular immunotherapy trials offer a means to probe complex tumor-immune interfaces through defined T cell/antigen interactions. We treated two patients with metastatic Merkel cell carcinoma with autologous Merkel cell polyomavirus specific CD8+ T cells and immune-checkpoint inhibitors. In both cases, dramatic remissions were associated with dense infiltration of activated CD8+s into the regressing tumors. However, late relapses developed at 22 and 18 months, respectively. Here we report single cell RNA sequencing identified dynamic transcriptional suppression of the specific HLA genes presenting the targeted viral epitope in the resistant tumor as a consequence of intense CD8-mediated immunologic pressure; this is distinguished from genetic HLA-loss by its reversibility with drugs. Transcriptional suppression of Class I loci may underlie resistance to other immunotherapies, including checkpoint inhibitors, and have implications for the design of improved immunotherapy treatments.
Keyphrases
- single cell
- rna seq
- genome wide
- gene expression
- transcription factor
- cell therapy
- high throughput
- heat shock
- bone marrow
- sars cov
- dna damage
- papillary thyroid
- quantum dots
- stem cells
- squamous cell carcinoma
- platelet rich plasma
- young adults
- single molecule
- newly diagnosed
- squamous cell
- genome wide identification
- bioinformatics analysis
- living cells
- monoclonal antibody