Abstract

BackgroundPatient derived organoids (PDOs) can be established from colorectal cancers (CRCs) as in vitro models to interrogate cancer biology and its clinical relevance. We applied mass spectrometry (MS) immunopeptidomics to investigate neoantigen presentation and whether this can be augmented through interferon gamma (IFNγ) or MEK-inhibitor treatment.MethodsFour microsatellite stable PDOs from chemotherapy refractory and one from a treatment naïve CRC were expanded to replicates with 100 million cells each, and HLA class I and class II peptide ligands were analyzed by MS.ResultsWe identified an average of 9936 unique peptides per PDO which compares favorably against published immunopeptidomics studies, suggesting high sensitivity. Loss of heterozygosity of the HLA locus was associated with low peptide diversity in one PDO. Peptides from genes without detectable expression by RNA-sequencing were rarely identified by MS. Only 3 out of 612 non-silent mutations encoded for neoantigens that were detected by MS. In contrast, computational HLA binding prediction estimated that 304 mutations could generate neoantigens. One hundred ninety-six of these were located in expressed genes, still exceeding the number of MS-detected neoantigens 65-fold. Treatment of four PDOs with IFNγ upregulated HLA class I expression and qualitatively changed the immunopeptidome, with increased presentation of IFNγ-inducible genes. HLA class II presented peptides increased dramatically with IFNγ treatment. MEK-inhibitor treatment showed no consistent effect on HLA class I or II expression or the peptidome. Importantly, no additional HLA class I or II presented neoantigens became detectable with any treatment.ConclusionsOnly 3 out of 612 non-silent mutations encoded for neoantigens that were detectable by MS. Although MS has sensitivity limits and biases, and likely underestimated the true neoantigen burden, this established a lower bound of the percentage of non-silent mutations that encode for presented neoantigens, which may be as low as 0.5%. This could be a reason for the poor responses of non-hypermutated CRCs to immune checkpoint inhibitors. MEK-inhibitors recently failed to improve checkpoint-inhibitor efficacy in CRC and the observed lack of HLA upregulation or improved peptide presentation may explain this.

Highlights

  • Immunotherapy with immune-checkpoint inhibitors (ICIs) is highly efficacious in microsatellite unstable (MSI) colorectal cancers (CRCs) but ineffective in microsatellite stable (MSS) Colorectal Cancer (CRC) [1, 2]

  • mass spectrometry (MS) has sensitivity limits and biases, and likely underestimated the true neoantigen burden, this established a lower bound of the percentage of non-silent mutations that encode for presented neoantigens, which may be as low as 0.5%

  • This could be a reason for the poor responses of non-hypermutated CRCs to immune checkpoint inhibitors

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Summary

Introduction

Immunotherapy with immune-checkpoint inhibitors (ICIs) is highly efficacious in microsatellite unstable (MSI) colorectal cancers (CRCs) but ineffective in microsatellite stable (MSS) CRCs [1, 2]. In contrast to a mean of 1158 non-silent mutations in MSI CRCs, MSS tumors only harbor 123 mutations on average [3] which may explain poor ICI sensitivity. Computational algorithms that consider the binding strength of mutated peptides to HLA Class I (HLA-I) molecules predicted that many MSS CRCs harbor over 100 mutated neoantigens [4]. This high number of predicted neoantigens contrasts with the poor senstivity of MSS CRCs to ICIs. Patient derived organoids (PDOs) can be established from colorectal cancers (CRCs) as in vitro models to interrogate cancer biology and its clinical relevance. We applied mass spectrometry (MS) immunopeptidomics to investigate neoantigen presentation and whether this can be augmented through interferon gamma (IFNγ) or MEKinhibitor treatment

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