# Proteomic determinants of response to checkpoint blockade in malignant pleuralmesothelioma

> **NIH NIH R37** · BAYLOR COLLEGE OF MEDICINE · 2022 · $508,688

## Abstract

PROJECT SUMMARY / ABSTRACT
Malignant pleural mesothelioma (MPM) is a fatal cancer of the lining of the lungs that has defeated standard
therapies for decades. Immune checkpoint inhibitors (ICIs) are revolutionizing cancer treatment, and tumor-
specific neoantigens are critical components of the vigorous anti-tumor T cell responses possible from these
agents. Emerging clinical data show that ICIs result in meaningful extension of life in half of patients with MPM
but are associated with immune-related side effects. There is no reliable biomarker for identifying MPM patients
who will respond to ICIs. Such a test would avoid unnecessary toxicity, triage non-responders to potentially more
effective treatment, and could even extend long-term survival. Our preliminary data show that MPM tumors from
patients that respond favorably to ICIs are rich in 1) distinct cellular and tissue architectural features of MPM's
unique immune contexture, and 2) abundant tumor neoantigens that are detected at the peptide level and
expressed concomitantly with the specific HLA proteins that are required for their presentation to T cells. Our
central hypothesis is that response to PD-1 blockade in MPM can be predicted by a clinically-applicable
biomarker of its immunologic organization and requires neoantigen:MHC concordance. In Aim 1, we will apply
the high dimensional platforms of time-of-flight mass cytometry (CyTOF) and imaging mass cytometry (IMC) to
dissect the cellular networks and immuno-architectural features of MPM that govern response to nivolumab.
Based on these features, we derived a novel score that predicts response to nivolumab in MPM and we have
developed an innovative bioinformatics platform to abstract this score from standard formalin-fixed paraffin-
embedded (FFPE) clinical tissue sections. In Aim 1, we will optimize and prospectively validate this score in
patients with MPM. In Aim 2, we will perform mass spectrometry (MS) on HLA-typed tumors to investigate
neoantigen biology and challenge the prevailing biomarker of neoantigen burden that is used clinically to predict
response to ICIs in other tumors, but with low accuracy. This biomarker has relied exclusively on neoantigens
predicted in silico and does not directly measure neoantigens in tumors. We found that high quantities of MHC-
I and MHC-II neoantigens detected by MS in MPM tumors (termed neoantigen abundance) correlated with
sensitivity to nivolumab. More interestingly, we found that the MPM tumors most likely to respond had high
peptide level expression of neoantigens concordant with high protein level expression of the specific HLA
proteins required for their presentation (termed neoantigen:MHC concordance). These novel metrics will be
tested prospectively in Aim 2 where we will also validate the immunogenicity of MS-detected neoantigens and
determine the phenotype of neoantigen-reactive T cells. Our results will define core elements of the
immunoproteomic structure of MPM and result in th...

## Key facts

- **NIH application ID:** 10321963
- **Project number:** 5R37CA248478-02
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** Bryan Michael Burt
- **Activity code:** R37 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $508,688
- **Award type:** 5
- **Project period:** 2021-01-01 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10321963

## Citation

> US National Institutes of Health, RePORTER application 10321963, Proteomic determinants of response to checkpoint blockade in malignant pleuralmesothelioma (5R37CA248478-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10321963. Licensed CC0.

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