Neoantigenic potential of complex chromosomal rearrangements in mesothelioma

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Introduction: Malignant pleural mesothelioma is a disease primarily associated with exposure to the carcinogen asbestos. Whereas other carcinogen-related tumors are associated with a high tumor mutation burden, mesothelioma is not. We sought to resolve this discrepancy. Material and Methods: We used mate-pair (n=22), RNA (n=28) and T cell receptor sequencing along with in silico predictions and immunologic assays to understand how structural variants of chromosomes affect the transcriptome. Results: We observed that inter- or intra-chromosomal rearrangements were present in every specimen and were frequently in a pattern of chromoanagenesis such as chromoplexy or chromothripsis. Transcription of rearrangement-related junctions was predicted to result in many potential neoantigens, some of which were proven to bind patient-specific MHC molecules and to expand intratumoral T cell clones. T cells responsive to these predicted neoantigens were also present in a patient’s circulating T cell repertoire. Analysis of genomic array data from the mesothelioma cohort in The Cancer Genome Atlas suggested that multiple chromothriptic-like events negatively impact survival. Discussion: Our findings represent the discovery of potential neoantigen expression driven by structural chromosomal rearrangements. These results may have implications for the development of novel immunotherapeutic strategies and the selection of patients to receive immunotherapies.

Division of Medical Oncology, Mayo Clinic, Rochester, MN Division of Pulmonary Medicine and Critical Care, Mayo Clinic, Rochester, MN Center for Individualized Medicine, Biomarker Discovery Group, Mayo Clinic, Rochester, MN Center for International Blood and Marrow Transplant Research, Mayo Clinic, Minneapolis, MN nference, Cambridge, MA 02142 Department of Immunology, Mayo Clinic, Rochester, MN Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN Medical Genome Facility, Mayo Clinic, Rochester, MN Department of Urology, Mayo Clinicc, Rochester, MN