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Immuno and Epigenetic Therapies Xiaole Shirley Liu STAT115, STAT215, BIO298, BIST520 Using Single Agent to Treat Cancer Cancer Immunology • Would tumor grow in another individual? Effector Lympocytes • Lymphocytes express highly specific antigen receptors on their surface, recognize specific structural (AA) motif • Usually CD8+ cells which kill target cells by recognizing foreign peptide-MHC molecules on the target cell membrane. • Cancer cells express neoantigen from mutations that are recognizable and accessible to the immune system -- tumor-specific “antigenicity” • The immune system is able to mount a response against cells bearing such antigens Cytokines • Low molecular weight protein mediators involved in cell growth, inflammation, immunity, differentiation and repair • Production triggered by presence of foreign particles • Interleukins (ex. IL-2) and interferons • Acts as a potent immunomodulator and antitumor element, but might have extensive multiorgan toxicity Active Immonotherapy • High dose IL-2 (FDA approved for kidney cancer and melanoma) • Boost overall immune cells inside the patient body CAR • Chimeric antigen receptors: proteins that allow the T cells to recognize specific antigen (e.g. CD19 on lymphoma) on tumors • Side effects: rapid and massive release of cytokines into the bloodstream Using Antibodies to Boost Immune Systems • Checkpoint blockade antibodies can activate Tcell and boost immune to kill tumor Adoptive Immunotherapy • Isolate tumor-infiltrating lymphocytes (TILs) • Expand their number artificially in cell culture to recognize the tumor-specific neoantigens • Infuse TIL back into the bloodstream, recognize and destroy the tumor cells • Find mutations from exome sequencing • Use bioinformatics program to find mutations that might be immunogenic • Create vectors expressing the small peptides containing the mutations • Co-culture to activate TIL Personalized ImmunoTherapy • Great for melanoma, lung and colon cancer • Immunotherapy specific to each patients’ tumor mutations Bioinformatics of Immunotherapy • How much of different immune cells are around each tumor • Which peptide will be presented on the cell surface • Which mutations are immunogenic • How does tumor evade immune system • How do the patient T-cells respond to the tumor (TCR) • Biomarkers of immunotherapy response Deconvolve Tumor Immune Infiltrates 1111 LogR LogR LogR LogR Ratio Ratio Ratio Ratio LRR LRR LRR LRR aa 000 0 0.5 0.5 0.5 0.5 111 1 -1 -1 -1-100001111 Figure Figure 11 0000 LRR LRR LRR LRR Index Index Index Index -1 -1 -1-1 BAF BAF BAF BAF BBAllele B Allele Allele B Allele Frequency Frequency Frequency Frequency Genomic estimates Genomic Genomic estimates estimates of tumor purity can beobtained using referencedataset or of of tumor purity or of tumor tumor purity purity can can beobtained beobtained using using referencedataset referencedataset or p=0.7 p=0.7 log transformation on both sides of Eq.(1) p=0.7 log transformation on both sides of Eq.(1) p=0.7 p=1.0 log transformation on both sides of Eq.(1) p=1.0 p=1.0 0 0 0.25 0.25 DNA-based estimation of tumor purity from from external external sources. sources. Taking Taking from external sources. Taking and (2) leads to: and to: leadsto: and (2) (2) leads 0.5 0.5 KIRP HNSC CESC KIRC LUAD SKCM LUSC OV LIHC BRCA UCEC BLCA GBM STAD ACC UCS KICH COAD THCA READ PRAD LGG DLBC Odds Odds Odds Odds Ratio Ratio Ratio Ratio g 00 0.25 0.5 s s s 0.25g 0.5 g g g g g log(Y log(⌃ RRr= ⇥ µ e R gsss )) = gsss R 1ff r,i gsss )) + rg ii g Y log(Y = log(⌃ ⇥ µ + e r,i r= 1 r Y log(Y ) = log(⌃ f ⇥ µ ) + e r,i r= rr ii Immune Y b r= 1 1 r,i YR Immune b g s Immune R g b ⌃ ⇥ µ ss Cell R R g rg = ssff r,i ⌃ ⇥ µ g s Merge Cell g s TCGA tumor r,i Cell= log{f ⇥ µggsss ⇥ (1+ ⌃ r6 r r6 = f ⇥ µ g r,i ss r r6 = s r,i g + e r r6 = s g s,i g s gs )} sss ⇥ (1+ Y s,i = log{f ⇥ µ )} + e g Y ss s,i g f ⇥ µ s Y s,i s g s Y Batch effect removal ff s,i ⇥µ s,i Batch µssss g s,i Batch effect effect removal removal Tumor s,i ⇥ expression with reference Tumor R s Tumor R g ⌃ ff r,i ⇥ µ ss R g R g r r6 = s ⌃ ⇥ µ g s g s r,i s r6 = g = r,i ⇥gµrrr + eg g '' log(µ )) + gs ) + r6 = sssf r,i gsss Y + log(f log(f + ⌃ r6 + e s immune dataset s,i g Y ss s,i ' log(µ log(µsgsssss )) + log(f s,i + e g ff s,i ⇥ µ Y s,i ) + s g Y s ⇥ µ sss s,i f ⇥ µ s,i s,i gs g s g ss ) + log(f s,i ) + ∆ s,i + eg g = log(µ (3) g gsss ccc sg Y = log(µ + log(f ) + ∆ + e (3) s,i s,i ssss )) + Y s,i s,i = log(µ log(f ) + ∆ + e (3) Y s,i s,i Y g g g s s s g Select genes overexpressed in g g R≤ -0.2 ss g s s log(X ) = log(µ ) + e (4) g g s s g R≤ s ssgs ) = log(µsg X log(X (4) Purity based gene R≤ -0.2 -0.2 ssss )) + e X log(X log(µ e (4) R> -0.2 ss ) X Purity based gene X R> -0.2 Purityselection based gene R> -0.2 selection the microenvironment selection In theaboveequations, new error terms follow normal distributions with In new error terms follow normal distributions with In theaboveequations, theaboveequations, new error terms follow normal distributions g g s s with gs g g s s g g zero means. Let Y denotethelog-transformed observation of Y and Xsgggsss s s g g s s ii denotethelog-transformed zero zero means. means. Let Let Y Y denotethelog-transformed observation observation of of Y Yiii and and X Xsss i g s denotefor log(X Thejoint likelihood of observations regarding geneset g gsss ). ssg denotefor log(X ). Thejoint likelihood of observations regarding geneset denotefor log(Xss ). Thejoint likelihood of observations regarding geneset d * * d {G bewritten as: Filter in purity-selected genes d ss}} 9can * * * {G can bewritten as: {Gss} can bewritten as: * * * * 6 g s * * * g s g for immune g * *1 (Y log(µ )) − ∆ ))222signature ss ) − log(f * * * * * gsss − s,i Select immune sg iig 1 (Y − log(µ − ∆ s ) − log(f s,i s,i s,i Select immune s s,i s,i 1 (Y − log(µ ) − log(f ) − ∆ * p 3 L = ⇧ exp{− ss ii s,i s,i ) }} ii ⇧ Select immune {{ g * * s 2G gs }} p L = ⇧ ⇧ exp{− 2 g signature genes * ss 2G g L = ⇧ ⇧ exp{− } ss } p 2⇡ σ2 2 g 2σ i { g 2G signature genes g 2 s g 1 s s g 2σ signature genes 2 0 2σYYY2 gggsss 2⇡⇡ σ σYYY2 gggssss gs g s 2 g 1 (X log(µ ss ))2 gsss − rrg rg s ))2 1 (X − log(µ r 1 (X − log(µ )) }} q ⇥ ⇧ ⇧ exp{− (5) rr ⇧{{ g r r 2G } s g q ⇥ ⇧ exp{− (5) s 2 } g q ⇥ ⇧r ⇧{ ggsss 2G exp{− } (5) s 2 g 2 2σ gs 2Ggss } 2 2 2σ g 2 ⇡ σ X gs s g r s 2 2σ gs 2 ⇡ σ X g X s r r g s r 2⇡ σXX rrrgs X r Linearly deconvolve six e ee Constrained least square fit Constrained Constrained least least square square fit fit Statistical Statistical Statistical deconvolution deconvolution deconvolution 6 X X 6 6 X X g g X X g g 2 2 ffˆˆˆ = argmin (Y − ff rr X g− rrg))2 = argmin (Y X f = argmin (Y − f X r r) 8rf r > 0 8rf G} 8rf rrr > >0 0 g2{ g2{ g2{ G} G} Inlinemode: max r= 1 r= 1 r= 1 , max . immune cells: B cell, CD4 T cell, CD8 T cell,(6) neutrophil, (6) (6) macrophage and dendritic cell 13 TIL Association With Survival TIL • Adjusted for age, gender, tumor stage and viral infection status • CD8 T cell with better survival and macrophage with worse outcome • Single cell analysis? 14 CYT: Rooney et al, Cell 2015 MHC Presentation • MHC presents peptides (~9 aa) in the cell to the surface for immune examination (self vs non-self), important for transplanation • MHC presents tumor neoantigen for immune elimination • Different HLA have different affinity to different peptides • Immune evasion: HLA mutation, antigen mutation NetMHC: Predict HLA / peptide affinity • Predict which peptide in the cell will be presented on the cell surface by which HLA • There are 2500 different HLA alleles • ~70 HLA alleles are characterized by binding data • Reliable MHC class I binding predictions for ~50 HLA A and B molecules HLA-A*3001 HLA-A*3002 Polysolver HLA Somatic Mutations Shukla et al, NBT 2015 T-Cell Repertoire and VDJ Recombination • Assembled α- (light) and β- (heavy) chains form the αβTCR expressed on T cells • Traditional TCR repertoire: PCR amply and sequence the rearranged VDJ region in the T cells 18 Infer T-Cell Repertoire and CDR3 Sequence from Tumor RNA-seq Figure 2 V region (i) J region s1 s2 s1 (ii) (iii) CDR3 s2 s1 s2 19 Response BioMarkers • High CD8 T-cell infiltrates • High immune checkpoint gene expression • High tumor mutation load Epigenetic Drugs • HDAC inhibitor to delay drug resistance • Minimum 5-aza (DNA demethylation) 21 Treat Cell Lines Directly Treating Mice Effect of 5-aza • Minimum dosage and toxicity, well tolerated • Activate suppressed immune genes • Can use DNA methylation status at these immune genes to predict patient response • Small % of patients directly cured. • Others re-sensitized for chemotherapy • Can be used with other drugs? Targeted Epigenetic Drug • DOT1L inhibitor for MLL Leukemia Meyer et al, Nat 2013 Targeted Epigenetic Drug • EZH2 inhibitors • Diffuse large B-cell lymphoma • Rhabdoid tumor with SNF5 mutation • Hormone independent prostate cancer Martinez-Garcia & Licht, Nat Genetics 2010 Targeted Epigenetic Drug • JQ1 as a BET domain inhibitor, also works on MLL leukemia Summary • Immunotherapy: a living drug! • Different immunotherapy options • Bioinformatics challenges of immunotherapy – Immune infiltrate – MHC presentation and HLA typing – T-cell receptor repertoire • Epigenetic therapy: 5-aza immune response • Targeted epigenetic therapy: DOT1L, EZH2, BRD4