EMT- and stroma-related gene expression and resistance to PD-1 blockade in urothelial cancer

Nature Communications
Li WangMatthew D Galsky

Abstract

Cancers infiltrated with T-cells are associated with a higher likelihood of response to PD-1/PD-L1 blockade. Counterintuitively, a correlation between epithelial-mesenchymal transition (EMT)-related gene expression and T-cell infiltration has been observed across tumor types. Here we demonstrate, using The Cancer Genome Atlas (TCGA) urothelial cancer dataset, that although a gene expression-based measure of infiltrating T-cell abundance and EMT-related gene expression are positively correlated, these signatures convey disparate prognostic information. We further demonstrate that non-hematopoietic stromal cells are a major source of EMT-related gene expression in bulk urothelial cancer transcriptomes. Finally, using a cohort of patients with metastatic urothelial cancer treated with a PD-1 inhibitor, nivolumab, we demonstrate that in patients with T-cell infiltrated tumors, higher EMT/stroma-related gene expression is associated with lower response rates and shorter progression-free and overall survival. Together, our findings suggest a stroma-mediated source of immune resistance in urothelial cancer and provide rationale for co-targeting PD-1 and stromal elements.

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Methods Mentioned

BETA
xenograft
RNA-seq
EdgeSeq
dissection
RNAseq
flow cytometry

Clinical Trials Mentioned

NCT02387996

Software Mentioned

ESTIMATE
immune
EdgeSeq
stromal
FeatureCounts
TopHat

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