Clear cell renal cell carcinoma (ccRCC) is an immunologically vulnerable tumor entity, and immune checkpoint inhibitors are now widely used to treat patients with advanced disease. Whether and to what extent immune responses in ccRCC are shaped by genetic alterations, however, is only beginning to emerge. In this proof-of-concept study, we performed a detailed correlative analysis of the mutational and immunological landscapes in a series of 23 consecutive kidney cancer patients. We discovered that a high infiltration with CD8 + T cells was not dependent on the number of driver mutations but rather on the presence of specific mutational events, namely pathogenic mutations in PTEN or BAP1. This observation encouraged us to compare mechanisms of T cell suppression in the context of four different genetic patterns, i.e., the presence of multiple drivers, a PTEN or BAP1 mutation, or the absence of detectable driver mutations. We found that ccRCCs harboring a PTEN or BAP1 mutation showed the lowest level of Granzyme B positive tumor-infiltrating lymphocytes (TILs). A multiplex immunofluorescence analysis revealed a significant number of CD8 + TILs in the vicinity of CD68 + macrophages/monocytes in the context of a BAP1 mutation but not in the context of a PTEN mutation. In line with this finding, direct interactions between CD8 + TILs and CD163 + M2-polarized macrophages were found in BAP1-mutated ccRCC but not in tumors with other mutational patterns. While an absence of driver mutations was associated with more CD8 + TILs in the vicinity of FOXP3 + Tregs and CD68 + monocytes/macrophages, the presence of multiple driver mutations was, to our surprise, not found to be strongly associated with immunosuppressive mechanisms. Our results highlight the role of genetic alterations in shaping the immunological landscape of ccRCC. We discovered a remarkable heterogeneity of mechanisms that can lead to T cell suppression, which supports the need for personalized immune oncological approaches.
Cancer immunology, immunotherapy : CII. 2022 Dec 23 [Epub ahead of print]
Jana Friedhoff, Felix Schneider, Christina Jurcic, Volker Endris, Martina Kirchner, Angela Sun, Iulia Bolnavu, Laura Pohl, Miriam Teroerde, Maximilian Kippenberger, Constantin Schwab, Adam Kaczorowski, Stefanie Zschäbitz, Dirk Jäger, Markus Hohenfellner, Albrecht Stenzinger, Anette Duensing, Stefan Duensing
Department of Urology, Molecular Urooncology, University Hospital Heidelberg, Im Neuenheimer Feld 517, 69120, Heidelberg, Germany., Institute of Pathology, University Hospital Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany., Cancer Therapeutics Program, UPMC Hillman Cancer Center, 5117 Centre Avenue, Pittsburgh, PA, 15213, USA., Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany., Department of Urology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany., Department of Urology, Molecular Urooncology, University Hospital Heidelberg, Im Neuenheimer Feld 517, 69120, Heidelberg, Germany. .