Abstract PR002: Single-cell spatial analysis reveals microenvironmental features that contribute to immune discrepancies between adult and pediatric nasopharyngeal carcinomas
Authors: Gong Lanqi , Zhang Yu , Guan Grace , Ru Beibei , Jiang Peng 
Published: December 2023

Background: Nasopharyngeal carcinoma (NPC) is an EBV-positive malignancy with high immune infiltrates but also high immunosuppressive activities. Pediatric NPC only constitutes 0.1-1% of the total NPC incidences and exhibits superior treatment responses and prognosis compared to adult NPC. Clinically, we consider that the differences in the tumor landscape between adult and pediatric NPC patients are the vital driver of such immune discrepancies. Therefore, we apply scRNA-seq and Visium spatial sequencing to primary pediatric NPC tissues and paired peripheral blood samples, and integrate our data with multiple independent adult NPC scRNA-seq cohorts. Furthermore, we establish a bioinformatics analysis pipeline that can calculate spatial cellular compositions and biological activities. Here, we demonstrate that low lipid metabolism, disrupted interactions between NPC cells and regulatory T cells (Tregs)/CD8+ T cells, and high infiltration of central stem memory T cells, contribute to more potent and enduring anti-tumor immunity in pediatric NPC patients, and these microenvironmental features might serve as new immunotherapeutic vulnerabilities.

Method: 5' scRNA-seq coupled with TCR/BCR profiling was performed on 5 primary and treatment-naïve pediatric NPC tissues with 5 paired peripheral blood samples. Visium spatial-seq was performed on 4 paired pediatric and 7 adult NPC tissues. We incorporated our scRNA-seq cohort with three independent adult NPC cohorts. Our computational framework was integrated with existing analysis packages, including Seurat, Spacexr, and SpaCET, to analyze single-cell-referenced spatial data. The key results in our study were validated by multiplex IHC staining and flow cytometry on patient samples.

Results: We established a multi-center NPC scRNA spatial cohort containing 503,021 cells from 69 samples, and 15,222 spatial spots from 11 samples. We developed a computational framework to calculate spatial co-localization and biological activities. We unveiled that lipid metabolism was elevated in the tumor-T cell core in adult NPC. Strong co-localizations between NPC cells and Tregs/CD8+ T cells were found in adult NPC, with spatially enriched CD70-CD27 and LGALS9-TIM3 interactions. This finding was corroborated by multiplex IHC staining of KRT19+ NPC cells, CD4+/FOXP3+ Tregs, and CD8+/PD-1/TIM-3+ exhausted T cells. We also identified and characterized novel IL7R+ central stem memory T cells in pediatric NPC tissues and blood, with strong resilience to immunosuppressive cues, including TGF-β, PEG2, and cyclic AMP, and could lead to enduring immunity and anti-PD-1/PD-L1 responses.

Conclusion: We demonstrate that higher T-cell immunosuppression and exhaustion caused by aberrant lipid metabolism, tumor-T interactions, and a lower age-associated central stem memory T-cell pool, are vital drivers of immune discrepancies in adult and pediatric NPC patients. Thus, screening and targeting these molecular microenvironmental characteristics might help stratify immunotherapy responders and generate therapeutic benefits in NPC patients.

Citation Format: Lanqi Gong, Yu Zhang, Grace Guan, Beibei Ru, Peng Jiang. Single-cell spatial analysis reveals microenvironmental features that contribute to immune discrepancies between adult and pediatric nasopharyngeal carcinomas [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2023 Oct 11-15; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2023;22(12 Suppl):Abstract nr PR002.