Poster Presentation 35th Lorne Cancer Conference 2023

Uncovering subtype specific intra-tumoural heterogeneity in brain cancer (#252)

Joel JD Moffet 1 , J Jones 2 , S Roberts-Thomson 3 , A Pavenko 4 , D Scoville 4 , A Venschoiack 4 , A Morokoff 2 , James R Whittle 1 5 6 , Saskia Freytag 1 5 , Sarah A Best 1 5
  1. Personalised Oncology Division, WEHI, Melbourne, Victoria, Australia
  2. Department of Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  3. Department of Anatomical Pathology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  4. NanoString Technologies Inc., Seattle, Washington, USA
  5. Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia
  6. Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia

Brain cancer is a deadly disease with a treatment regime that remains unchanged for decades. In brain cancer biology, intra-tumoural heterogeneity (ITH) is fast becoming an essential element to understand the complex nature of solid tumours. With the advent of single cell sequencing, tumours that appear homogenous by pathology are revealing unforeseen heterogeneity in the tumour sample. Indeed, in high-grade glioma (i.e., glioblastoma, GBM), increased ITH is associated with more aggressive disease. The next step in investigating ITH is to spatially discern these clusters of transcriptionally distinct cell types to identify specific niches in which they reside and cells they associate with. In order to investigate spatial ITH of high grade glioma, we have obtained surgical samples from Anaplastic Astrocytoma (AA, IDH1-mutant) and Glioblastoma (GBM, IDH1-wt) patients. Though routine histological analysis of these samples indicates IDH1-mutant AA are homogenous, we have evaluated spatial regions of interest with increased cycling cells (Ki67 staining) and immune infiltrate (CD45 staining) by spatial whole transcriptome analysis. Individual copy-number alterations and transcriptional profiles suggest that there are deeper levels of heterogeneity in these samples than initially appreciated, likely driven by cycling cells and involving cell-to-cell communication with spatial significance. Indeed, the localisation of different immune cell types and tumour subtypes across the tumour border reveals enrichment of macrophages along the edge and within the tumour, whereas CD4 T cells are enriched in regions immediately outside the tumour. Leveraging matched tumour and immune regions to determine correlated signatures, we also observe increased macrophages in the presence of astrocytic GBM samples. Together, this primary study reveals high levels of ITH in high-grade glioma, and a diverse immune landscape between glioma subtypes, likely impacting response to immunotherapy treatments.