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  • Liu, David; Schilling, Bastian; Liu, Derek; Sucker, Antje; Livingstone, Elisabeth; Jerby-Arnon, Livnat; Zimmer, Lisa; Gutzmer, Ralf; Satzger, Imke; Loquai, Carmen; Grabbe, Stephan; Vokes, Natalie; Margolis, Claire A; Conway, Jake; He, Meng Xiao; Elmarakeby, Haitham; Dietlein, Felix; Miao, Diana; Tracy, Adam; Gogas, Helen; Goldinger, Simone M; Utikal, Jochen; Blank, Christian U; Rauschenberg, Ricarda; von Bubnoff, Dagmar; Krackhardt, Angela; Weide, Benjamin; Haferkamp, Sebastian; Kiecker, Felix; Izar, Ben; Garraway, Levi; Regev, Aviv; Flaherty, Keith; Paschen, Annette; Van Allen, Eliezer M; Schadendorf, Dirk

    Nature medicine, 12/2019, Volume: 25, Issue: 12
    Journal Article

    Immune-checkpoint blockade (ICB) has demonstrated efficacy in many tumor types, but predictors of responsiveness to anti-PD1 ICB are incompletely characterized. In this study, we analyzed a clinically annotated cohort of patients with melanoma (n = 144) treated with anti-PD1 ICB, with whole-exome and whole-transcriptome sequencing of pre-treatment tumors. We found that tumor mutational burden as a predictor of response was confounded by melanoma subtype, whereas multiple novel genomic and transcriptomic features predicted selective response, including features associated with MHC-I and MHC-II antigen presentation. Furthermore, previous anti-CTLA4 ICB exposure was associated with different predictors of response compared to tumors that were naive to ICB, suggesting selective immune effects of previous exposure to anti-CTLA4 ICB. Finally, we developed parsimonious models integrating clinical, genomic and transcriptomic features to predict intrinsic resistance to anti-PD1 ICB in individual tumors, with validation in smaller independent cohorts limited by the availability of comprehensive data. Broadly, we present a framework to discover predictive features and build models of ICB therapeutic response.