||1R21CA230486-01A1 Interpret this number
||Fred Hutchinson Cancer Research Center
||Germline Genetic Factors Regulating Immune Response to Tumors and Their Contribution to Colorectal Cancer Risk and Prognosis
Despite advances in precision oncology, cancer remains a leading cause of death around the world.
Immunotherapies, including checkpoint blockade inhibitors and adoptive T cell therapy, are transforming
cancer care and hold great promise in delivering cure for many cancer patients. Yet, only a proportion of
patients responds to immunotherapy, and underlying factors are incompletely understood. Treatment success
has been associated to the presence of tumor infiltrating lymphocytes (TILs) which lie at the heart of cancer
immunotherapies. TILs abundance has also been associated with good clinical outcome in many different
cancers, regardless of treatment. To date, most efforts to elucidate factors that contribute to the observed
variability in immune response against cancers, and its associated clinical outcome, have focused on the role
of tumor characteristics and the cancer genome. Very little attention has been paid to the role of germline
genetic factors in the immune response to cancers, or clinical outcomes, and, therefore, their role is poorly
understood. The overarching goal of this study is to identify germline genetic factors associated with tumor
immune profile within and across solid tissue cancers, and to examine their role in colorectal cancer (CRC) risk
and survival outcomes. To achieve this, we propose to leverage transcriptome data from primary, untreated
solid tumors (n=8,578) and matched germline genome-wide single nucleotide variant data generated by The
Cancer Genome Atlas (TCGA) project. Using state-of-the-art imputation reference panels and statistical
algorithms, we will perform in silico genotyping of nearly all common variants, many rare variants with a minor
allele frequency as low as 0.1% in the population, and human leukocyte antigen (HLA) and killer cell
immunoglobulin-like receptor (KIR) types. We propose to perform an agnostic genome-wide association study
(GWAS) of TIL subpopulations in solid tumors from TCGA (Aim 1). We present strong preliminary results
demonstrating that our approach works. As part of this aim, we will also perform a more focused investigation
of known variants that have been robustly associated with immune-related phenotypes. Next, we will evaluate
whether newly identified loci associated with tumor immune profile are contributing to colorectal cancer (CRC)
risk and survival outcomes (Aim 2). To investigate this, we will leverage GWAS data from over 125,000 CRC
cases and controls to examine association with cancer risk, and ~20,000 CRC cases to examine association
with CRC disease-free and overall survival. The results yielded by this project will be among the first reporting
germline genetic variants associated with tumor immune response, and colorectal cancer survival. Discoveries
will have high translational potential. Not only will new findings contribute to improved understanding of the
cellular and molecular basis of established associations between presence of TILs and clinical outcomes, new
discoveries can also lead to improved prediction of treatment response, and may suggest new drug targets to
promote immunity in immunotherapy nonresponders, and, ultimately, decrease cancer mortality.
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