The glycosphingolipid GD2 as an effective but enigmatic target of passive immunotherapy in children with aggressive neuroblastoma (HR-NBL)

Genetic insights into neuroblastoma: the role of immune cell features

OBJECTIVE

To elucidate the causal relationship between immune cells and neuroblastoma, we conducted a two-sample Mendelian randomization (MR) analysis.

MATERIALS AND METHODS

The exposure and outcome data for the genome-wide association study (GWAS) used in this research were sourced from an open-access database. The study utilized two-sample MR analysis to evaluate the causal relationship between 731 immune cell features and neuroblastoma. The main approach to explore this relationship is to apply the inverse variance weighting (IVW) method. In addition, sensitivity analyses including leave-one-out analysis, Cochran's Q test, Mendelian randomization Egger method (MR-Egger) intercept test and Mendelian randomization pleiotropy residual sum and outlier test (MR-PRESSO) were performed to verify the reliability of the MR results.

RESULTS

The study identifies five immune cell traits as causally contributing to neuroblastoma risk, including CD3- lymphocyte (% of leukocytes) (IVW: OR[95 % CI] 0.65[0.42-0.99], P = 0.0469), CD86 on granulocyte (IVW: OR[95 % CI] 0.61[0.41-0.92], P = 0.0167), FSC-A on granulocyte(IVW: OR[95 % CI] 0.73[0.57-0.93], P = 0.0117), HLA DR+ CD8+ T cell Absolute Count(IVW: OR[95 % CI]: 1.38[1.01-1.88], P = 0.0408), IgD- CD38+ B cell Absolute Count(IVW: OR[95 % CI] 0.42[0.27-0.66], P = 0.0002). The results of sensitivity analyses were consistent with the main findings.

CONCLUSION

We demonstrated a close causal relationship between specific types of immune cells and neuroblastoma by genetic methods, offering valuable guidance for future clinical studies.

Multiomics Analysis Reveals Neuroblastoma Molecular Signature Predicting Risk Stratification and Tumor Microenvironment Differences

Neuroblastoma (NB) remains associated with high mortality and low initial response rate, especially for high-risk patients, thus warranting exploration of molecular markers for precision risk classifiers. Through integrating multiomics profiling, we identified a range of hub genes involved in cell cycle and associated with dismal prognosis and malignant cells. Single-cell transcriptome sequencing revealed that a subset of malignant cells, subcluster 1, characterized by high proliferation and dedifferentiation, was strongly correlated with the hub gene signature and orchestrated an immunosuppressive tumor microenvironment (TME). Furthermore, we constructed a robust malignant subcluster 1 related signature (MSRS), which was an independent prognostic factor and superior to other clinical characteristics and published signatures. Besides, TME differences conferred remarkably distinct therapeutic responses between high and low MSRS groups. Notably, polo-like kinase-1 (PLK1) was one of the most crucial contributors to MSRS and remarkably correlated with malignant subcluster 1, and PLK1 inhibition was effective for NB treatment as demonstrated by in silico analysis and in vitro experiments. Overall, our study constructs a novel molecular model to further guide the clinical classification and individualized treatment of NB.

GD2-targeted theranostics of neuroblastoma with [64Cu]Cu/[177Lu]Lu-hu3F8

PURPOSE

Neuroblastoma (NB) is a malignant embryonic tumour with poor prognosis and high mortality rate. The antigen gisialoganglioside (GD2), which is highly expressed on the surface of NB cells, is an effective target for therapy. This study aims to evaluate the GD2 expression with [64Cu]Cu-NOTA-hu3F8 positron emission tomography (PET) imaging and explore the radioimmunotherapy (RIT) effect of [177Lu]Lu-DOTA-hu3F8 in NB tumour models.

METHODS

The in vitro validation of the binding ability of anti-GD2 humanised monoclonal antibody (hu3F8) to GD2 was achieved via flow cytometry, cell immunofluorescence, and cell uptake test. Hu3F8 were conjugated with p-SCN-Bn-NOTA (NOTA) and p-SCN-Bn-DOTA (DOTA) for 64Cu- and 177Lu- radiolabelling. PET imaging and RIT studies were conducted using [64Cu]Cu-NOTA-hu3F8 and [177Lu]Lu-DOTA-hu3F8 in subcutaneous NB tumour models.

RESULTS

The Institute for Medical Research-32 (IMR32) cell line exhibited a specific binding ability of hu3F8. PET imaging demonstrated a specific accumulation of [64Cu]Cu-NOTA-hu3F8 in IMR32 tumour models, with a maximum tumour uptake of 23.73 ± 2.29%ID/g (n = 3) at 72 h post-injection (p.i.), outperforming other groups significantly (P < 0.001). The high dose [177Lu]Lu-DOTA-hu3F8 group (11.1MBq) showed the most potent tumour suppression, with a standardised tumour volume of about 20.47 ± 6.32% at 30 days p.i., significantly smaller than other groups (n = 5, P < 0.05).

CONCLUSION

This study demonstrated that 64Cu-/177Lu- labelled hu3F8 could noninvasively evaluate the GD2 expression and effectively inhibit tumour growth in NB tumour models. The excellent therapeutic efficacy of [177Lu]Lu-DOTA-hu3F8 may be helpful for the clinical translation of this GD2-targeted theranostics approach in GD2-positive tumours.

Molecular profiling of core immune-escape genes highlights TNFAIP3 as an immune-related prognostic biomarker in neuroblastoma

BACKGROUND

Neuroblastoma (NB) is the most prevalent and deadliest pediatric solid tumor. With of over 50% of high-risk neuroblastoma cases relapse, the imperative for novel drug targets and therapeutic strategies is accentuated. In neuroblastoma, the existence of tumor-associated macrophages (TAMs) correlates with an unfavorable patient prognosis. However, the clinical relevance and prognostic implications of regulatory genes linked to TAMs infiltration in neuroblastoma remain unclear, and further study is required.

METHODS

We conducted a comprehensive analysis utilizing transcriptome expression profiles from three primary datasets associated with neuroblastoma (GSE45547, GSE49710, TARGET) to identify hub genes implicated in immune evasion within neuroblastoma. Subsequently, we utilized single-cell RNA sequencing analysis on 17 clinical neuroblastoma samples to investigate the expression and distribution of these hub genes, leading to the identification of TNFAIP3. The above three public databases were merged to allowed for the validation of TNFAIP3's molecular functions through GO and KEGG analysis. Furthermore, we assessed TNFAIP3's correlation with immune infiltration and its potential immunotherapeutic impact by multiple algorithms. Our single-cell transcriptome data revealed the role of TNFAIP3 in macrophage polarization. Finally, preliminary experimental verifications to confirm the biological functions of TNFAIP3-mediated TAMs in NB.

RESULTS

A total of 6 genes related to immune evasion were screened and we found that TNFAIP3 exhibited notably higher expression in macrophages than other immune cell types, based on the scRNA-sequencing data. GO and KEGG analysis showed that low expression of TNFAIP3 significantly correlated with the activation of multiple oncogenic pathways as well as immune-related pathways. Then validation affirmed that individuals within the TNFAIP3 high-expression cohort could potentially derive greater advantages from immunotherapeutic interventions, alongside exhibiting heightened immune responsiveness. Deciphering the pseudotime trajectory of macrophages, we revealed the potential of TNFAIP3 in inducing the polarization of macrophages towards the M1 phenotype. Finally, we confirmed that patients in the TNFAIP3 high expression group might benefit more from immunotherapy or chemotherapy as substantiated by RT-qPCR and immunofluorescence examinations. Moreover, the role of TNFAIP3 in macrophage polarization was validated. Preliminary experiment showed that TNFAIP3-mediated TAMs inhibit the proliferation, migration and invasion capabilities of NB cells.

CONCLUSIONS

Our results suggest that TNFAIP3 was first identified as a promising biomarker for immunotherapy and potential molecular target in NB. Besides, the presence of TNFAIP3 within TAMs may offer a novel therapeutic strategy for NB.

Identification of a Glycosyltransferase Signature for Predicting Prognosis and Immune Microenvironment in Neuroblastoma

Neuroblastoma (NB) is one of the most common solid tumors in children. Glycosyltransferases (GTs) play a crucial role in tumor development and immune escape and have been used as prognostic biomarkers in various tumors. However, the biological functions and prognostic significance of GTs in NB remain poorly understood. The expression data from Gene Expression Omnibus (GEO) and Therapeutically Applicable Research to Generate Effective Treatments (TARGET) were collected as training and testing data. Based on a progression status, differentially expressed GTs were identified. We constructed a GTscore through support vector machine, least absolute shrinkage and selection operator, and Cox regression in NB, which included four prognostic GTs and was an independent prognostic risk factor for NB. Patients in the high GTscore group had an older age, MYCN amplification, advanced International Neuroblastoma Staging System stage, and high risk. Samples with high GTscores revealed high disialoganglioside (GD2) and neuron-specific enolase expression levels. In addition, a lack of immune cell infiltration was observed in the high GTscore group. This GTscore was also associated with the expression of chemokines (CCL2, CXCL9, and CXCL10) and immune checkpoint genes (cytotoxic T-lymphocyte–associated protein 4, granzyme H, and granzyme K). A low GTscore was also linked to an enhanced response to anti–PD-1 immunotherapy in melanoma patients, and one type of tumor was also derived from neuroectodermal cells such as NB. In conclusion, the constructed GTscore revealed the relationship between GT expression and the NB outcome, GD2 phenotype, and immune infiltration and provided novel clues for the prediction of prognosis and immunotherapy response in NB.