Abstract

Activation of natural killer (NK) cell function is regulated by cytokines, such as IL-2, and secreted factors upregulated in the tumor microenvironment, such as platelet-derived growth factor D (PDGF-DD). In order to elucidate a clinical role for these important regulators of NK cell function in antitumor immunity, we generated transcriptional signatures representing resting, IL-2-expanded, and PDGF-DD-activated, NK cell phenotypes and established their abundance in The Cancer Genome Atlas bladder cancer (BLCA) dataset using CIBERSORT. The IL-2-expanded NK cell phenotype was the most abundant in low and high grades of BLCA tumors and was associated with improved prognosis. In contrast, PDGFD expression was associated with numerous cancer hallmark pathways in BLCA tumors compared with normal bladder tissue, and a high tumor abundance of PDGFD transcripts and the PDGF-DD-activated NK cell phenotype were associated with a poor BLCA prognosis. Finally, high tumor expression of transcripts encoding the activating NK cell receptors, KLRK1 and the CD160–TNFRSF14 receptor–ligand pair, was strongly correlated with the IL-2-expanded NK cell phenotype and improved BLCA prognosis. The transcriptional parameters we describe may be optimized to improve BLCA patient prognosis and risk stratification in the clinic and potentially provide gene targets of therapeutic significance for enhancing NK cell antitumor immunity in BLCA.

Highlights

  • Bladder cancer (BLCA) is a disease of the elderly in the developed world [1, 2]

  • We found that a high tumor abundance of the IL-2expanded NK cells (IL2NK) phenotype was associated with improved BLCA prognosis, but not the resting NK cells (ReNK) or signature of PDGF-DDactivated NK cells (SPANK)

  • Since all three natural killer (NK) cell phenotypes were detected in BLCA tumors, we speculated that PDGF-DD-activated NK cells might counterbalance the effect of PDGFD expression on BLCA prognosis

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Summary

Introduction

Bladder cancer (BLCA) is a disease of the elderly in the developed world [1, 2]. The first-line management of high-grade non-muscleinvasive BLCA involves transurethral resection of the bladder tumor [3] and administration of an induction course of intravesical bacille Calmette–Guerin (BCG) vaccine. Transition to a BCG-refractory high-grade BLCA is associated with poor survival outcomes [8], and radical cystectomy (RC) for patients that fail intravesical immunotherapy is the current gold standard treatment [9]. Limited therapeutic options beyond systemic chemotherapy have resulted in dire outcomes for patients with metastatic BLCA disease [11, 13]. There is an urgent need for less invasive, tolerable, and durable alternatives for intractable BLCA

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