Immune Characteriza/on of Basal- like Bladder Cancer
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1 Immune Characteriza/on of - like Bladder Cancer William Y. Kim, M.D. Departments of Medicine and Gene2cs Lineberger Comprehensive Cancer Center University of North Carolina Chapel Hill, NC
2 5 year survival rates Stage 5 year survival* 0 98% I 88% II 63% III 46% IV 15% * American Cancer Society Wong-You Cheong J J et al. Radiographics 2006;26:
3 Are there intrinsic subtypes of high-grade bladder cancer?
4 Can we define subtypes of bladder cancer focusing exclusively on high grade tumors? Normal urothelium FGFR3 RAS PTEN RB1 Recurrence LG papillary Progression PTEN RB1 HG muscle-invasive -like
5 Consensus Clustering identifies 2 subtypes of high grade UC MSKCC (n=58) Meta-dataset (n=262) TCGA (n=131) Meta K1 Meta K K1 K2 K1 K2 MSKCC TCGA Damrauer et al., PNAS, 2014
6 Significance Analysis of Microarrays (SAM) determines differences in gene expression Meta-dataset (n=262) K1 vs- K2, FDR = 0 SAM K1 KRT5 KRT6A CD44 K2 PPARG GATA3 KRT20 UPK2
7 Normal urothelium is characterized by different differentiation states HMWK LMWK Umbrella cells Uroplakin KRT 20 (Castillo-Martin 2010) -like cells KRT 14 KRT 5
8 Development of the BASE47 (Bladder cancer Analysis of Subtype by gene Expression)
9 BASE47 can accurately classify basal and luminal bladder cancers Centroid Centroid BASE47 Prediction Training CCP Meta BASE Predictor Generation by PAM Validation MSKCC CCP p< BASE Consensus Clustering of Meta Dataset Validation CCP TCGA p< BASE p< Damrauer et al., PNAS, 2014
10 bladder cancer has a relatively poor prognosis MSKCC TCGA Overall Survival Overall Specific Survival in Choi Overall Survival Probability Log Rank p= Months Overall Survival Log Rank p= Days Overall Survival Probability Months Log Rank p= Damrauer et al., PNAS, 2014 Choi et al., Cancer Cell, 2014 TCGA, Nature, 2014
11 Intrinsic subtypes of bladder cancer reflect breast cancer biology
12 Breast cancer related genes are coregulated with urothelial specific genes K1 K2 CYP2J2 DHRS2 FXYD3 CROT GPX2 MECOM MAOA RAPGEFL 1 S100P MGST2 ICA1 CNGA1 MCCC1 IFNA14 ATP8B1 ACSF2 CYP4F12 TJP3 CYP4B1 ELF3 FOXA1 HMGCS2 FAM174B BCAS1 CYB5A GPD1L GATA3 EPN3 ERBB3 EVPL BCAT2 ADIRF CAPN5 PPFIBP2 UPK1A PLCE1 UPK2 TRAK1 SCNN1B SCNN1G TMPRSS2 TLE2 TBX2 TMEM97 ZBTB7C TOP2B RAB15 NR2F6 TM7SF2 PIK3C2B PLEKHG6 SUOX SNCG RAB11A VIPR1 VGLL1 SH3GLB2 ZNF443 TBX3 SLC9A2 SPINK1 SLC29A3 PSCA PPARG Text Color Breast Cancer Related Urothelial Related Breast Bladder Breast Damrauer et al., PNAS, 2014
13 bladder cancer is enriched for signatures related to basal breast cancer PAM50 Calls LumA LumB Her2 Normal Bladder Subtypes Breast Signatures Cluster PMID: GATA3 PMID: GATA3 PMID: Estrogen Reg. PMID: Cluster PMID: Breast Signatures Mature Down PMID: Progenitor PMID: Metaplastic PMID: MaSC PMID: Pathway Signatures Myc Targets PMID: Oncogenic E2F3 PMID: Her2 Amplicon PMID: Damrauer et al., PNAS, 2014
14 Breast and Bladder subtypes Damrauer et al., PNAS, 2014
15 Intrinsic subtypes defined by MDACC and TCGA
16 Intrinsic subtypes defined by MDACC Choi et al., Cancer Cell, 2014
17 Intrinsic subtypes defined by TCGA TCGA, Nature, 2014
18 Subtype summary McConkey, Eur Urol, 2014
19 Proposed model for intrinsic bladder subtypes Recurrence FGFR3 RAS LG papillary Normal urothelium BC BC PTEN RB1 TP53 BC PTEN RB1 TP53 HG non-papillary UC urothelial cells increased TICs Squamous differentiation RB pathway alterations Female gender HG papillary UC Umbrella urothelial cells Papillary features FGFR3 alterations Damrauer et al., PNAS, 2014
20 Intrinsic bladder cancer subtypes express different markers of immune infiltration
21 Gene expression pathways in basal-bladder Ingenuity Pathway Analysis (IPA) migration of cells cell movement homing homing of cells chemotaxis cell movement tumor cell lnes chemotaxis of cells leukocyte migration cell movement of blood cells migration of tumor cell lines adhesion of immune cells homing of leukocytes adhesion of blood cells chemotaxis of leukocytes development of blood cells development of leukocytes homing of blood cells inflammatory response organization of cytoplasm chemotaxis of phagocytes z - activation score
22 Gene expression pathways in basal-bladder Gene Set Enrichment Analysis (GSEA) Functional*Annotation*Clusters*Enriched*in** Cluster(Rank( Representative(Pathway( Enrichment(Score( PValue( FDR( 1( IPR007110:ImmunoglobulinClike( 16.04( 1.76EC13( 3.10EC10( 2( GO: ~leukocyte(activation( 13.74( 2.44EC14( 4.62EC11( 3( GO: ~chemotaxis( 13.05( 4.15EC16( 8.44EC13( 4( GO: ~cell(migration( 9.93( 3.62EC12( 6.84EC09( 5( GO: ~regulation(of(cell(motion( 8.98( 3.42EC10( 6.47EC07( 6( GO: ~regulation(of(apoptosis( 8.86( 1.04EC09( 1.96EC06( 7( GO: ~regulation(of(T(cell(activation( 8.80( 1.35EC08( 2.56EC05( 8( GO: ~glycosaminoglycan(binding( 8.64( 8.88EC10( 1.47EC06( 9( GO: ~vasculature(development( 8.04( 1.90EC09( 3.59EC06( 10( GO: ~chemokine(activity( 7.97( 1.22EC08( 2.03EC05( 11( hsa05332:graftcversuschost(disease( 7.81( 4.78EC10( 5.91EC07( 12( GO: ~negative(regulation(of(apoptosis( 7.38( 2.46EC08( 4.66EC05( 13( GO: ~positive(regulation(of(cell(motion( 6.99( 7.35EC08( 1.39EC04( 14( GO: ~immune(system(development( 6.53( 6.95EC07( ( 15( hydroxylysine( 6.50( 5.37EC08( 8.16EC05(
23 Immune signatures are enriched in basal bladder A TCGA Bladder RNA seq B_Cell signature Mac_CSF1 T_Cell_cluster T test p value: 1.89e T test p value: 1.44e T test p value: 5.82e 06 B MAC_CSF1 CD68_CLUSTER enrichment score: 0.71 p-value = 0.04 enrichment score: 0.92 p-value = 0.0
24 Immunecheckpoint genes are enriched in basal bladder cancer CTLA4 FOXP3 IDO1 Log2 Median Centered Expression p = 2.63e p = 1.28e p = 4.28e 14 PD1 PDL1 IL10 Log2 Median Centered Expression p = 2.74e p = 8.3e p = 8.42e 08
25 PD-L1 highly expressed in basal bladder cancer Log2 Median Centered Expression PD L1 Expression By Tumor Type Her2 LumA LumB COAD GBM KIRC LAML LUAD LUSC OV READ UCEC Bladder Breast
26 Row Z Score A subset of basal bladder tumors have clonal expansion of B cells B
27 Conclusions Intrinsic subtypes of HG bladder cancer exist and have similari2es to breast cancer. - like and luminal subtypes are associated with specific molecular altera2ons and clinico- pathologic characteris2cs. bladder tumors have increased immune infiltrates and a subset of tumors may have clonal expansion of B cells.
28 Acknowledgements Kim Lab Jeff Damrauer Sara Wobker Ryoichi Saito David Chism Bhavani Krishnan Bing Zhou Sean Bailey Janet Leung HyoJin Lee Harper Wilson Jonathan Serody Ben Vincent Chuck Perou Ka2e Hoadley Joel Parker Chris Fan Gopa Iyer FUNDING SOURCES NIH/NCI Department of Defense Damon Runyon Founda2on University Cancer Research Fund (UCRF) AACR Kure It
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