Glossary TermMeaning ELS Epitope likelihood score GELS General epitope likelihood score IRS Immune relevance score, based on the mutation frequency (ReFrame) and the GELS M1Reading frame resulting from the deletion of one nucleotide or insertions of two nucleotides M2Reading frame resulting from the deletions of two nucleotides or insertion of one nucleotide m1, m2, m3, etc.Minus one, two, three base pair deletions p1, p2, p3, etc.Plus one, two, three base pair insertions ReFrameREgression-based FRAMEshift quantification Abbreviations B2M Beta2-microglobulin cMS Coding microsatellites CRC Colorectal cancer MMR Mismatch repair EC Endometrium cancer FSP neoantigens Frameshift peptide neoantigens HLA Human leukocyte antigen ICB Immune checkpoint blockade MSI Microsatellite instability, microsatelliteunstable NGSNext generation sequencing Abstract:The immune system can recognize and attack cancer cells, especially those with a high load of mutation-induced neoantigens. Such neoantigens are particularly abundant in DNA mismatch repair (MMR)-deficient, microsatellite-unstable (MSI) cancers. MMR deficiency leads to insertion/deletion (indel) mutations at coding microsatellites (cMS) and to neoantigen-inducing translational frameshifts. The abundance of mutational neoantigens renders MSI cancers sensitive to immune checkpoint blockade. However, the neoantigen landscape of MMR-deficient cancers has not yet been systematically mapped. In the present study, we used a novel tool to monitor neoantigen-inducing indel mutations in MSI colorectal and endometrial cancer. Our results show that MSI cancers share several highly immunogenic neoantigens that result from specific, recurrent indel mutation events.Notably, the frequency of such indel mutations was negatively correlated to the predicted immunogenicity of the resulting neoantigens. These observations suggest continuous immunoediting of emerging MMR-deficient cells during tumor evolution.
Main text:DNA MMR deficiency is a major mechanism causing genomic instability in human cancer. MMR-deficient cancers accumulate an exceptionally high number of somatic mutations. These mutations encompass certain types of single nucleotide alterations, but mostly insertion/deletion (indel) mutations at repetitive sequence stretches termed microsatellites (microsatellite instability, MSI) (1, 2). About 15% of colorectal cancers (CRC), up to 30% of endometrial cancers (EC) and multiple other tumors display the MSI phenotype (3). MSI tumors can develop sporadically or in the context of Lynch syndrome, the most common inherited cancer predisposition syndrome. Due to this very specific process of genomic instability, the pathogenesis of MSI cancers can be precisely dissected (4): Indel mutations affecting coding microsatellites (cMS), predominantly coding mononucleotide repeats, in genomic regions encoding tumor suppressor genes are considered major drivers of MSI tumorigenesis (5-7). Importantly, the same indels that inactivate tumor suppressor genes simultaneously cause translational frameshi...