AUTHOR=Yu Guangyang , Butler Madison K. , Abdelmaksoud Abdalla , Pang Ying , Su Yu-Ting , Rae Zachary , Dadkhah Kimia , Kelly Michael C. , Song Young K. , Wei Jun S. , Terabe Masaki , Atony Ramya , Mentges Kelly , Theeler Brett J. , Penas-Prado Marta , Butman John , Camphausen Kevin , Zaghloul Kareem A. , Nduom Edjah , Quezado Martha , Aldape Kenneth , Armstrong Terri S. , Gilbert Mark R. , Gulley James L. , Khan Javed , Wu Jing TITLE=Case Report: Single-Cell Transcriptomic Analysis of an Anaplastic Oligodendroglioma Post Immunotherapy JOURNAL=Frontiers in Oncology VOLUME=10 YEAR=2021 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.601452 DOI=10.3389/fonc.2020.601452 ISSN=2234-943X ABSTRACT=

Glioma is the most common primary malignant brain tumor with a poor prognosis. Immune checkpoint inhibitors have been of great interest in investigation of glioma treatments. Here, we report single-cell transcriptomic analyses of two tumor areas from an oligodendroglioma taken from a patient who had multiple tumor recurrences, following several chemotherapies and radiation treatments. The patient subsequently received nivolumab and was considered have disease progression based on conventional diagnostic imaging after two cycles of treatment. He underwent a debulking surgical resection and pathological diagnosis was recurrent disease. During the surgery, tumor tissues were also collected from the enhancing and non-enhancing areas for a scRNAseq analysis to investigate the tumor microenvironment of these radiographically divergent areas. The scRNAseq analysis reveals a plethora of immune cells, suggesting that the increased mass observed on MRI may be partially a result of immune cell infiltration. The patient continued to receive immunotherapy after a short course of palliative radiation and remained free of disease progression for at least 12 months after the last surgery, suggesting a sustained response to immunotherapy. The scRNAseq analysis indicated that the radiological progression was in large part due to immune cell infiltrate and continued immunotherapy led to a positive clinical outcome in a patient who would have otherwise been admitted to hospice care with halting of immunotherapy. Our study demonstrates the potential of scRNAseq analyses in understanding the tumor microenvironment, which may assist the clinical decision-making process for challenging glioma cases following immunotherapy.