Predicting immunotherapy response of advanced bladder cancer through a meta-analysis of six independent cohorts

Abstract Advanced bladder cancer patients show very variable responses to immune checkpoint inhibitors (ICIs) and effective strategies to predict response are still lacking. Here we integrate mutation and gene expression data from 707 advanced bladder cancer patients treated with anti-PD-1/anti-PD-L...

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Main Authors: Lilian Marie Boll, Sergio Vázquez Montes de Oca, Marta E. Camarena, Robert Castelo, Joaquim Bellmunt, Júlia Perera-Bel, M. Mar Albà
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-56462-0
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author Lilian Marie Boll
Sergio Vázquez Montes de Oca
Marta E. Camarena
Robert Castelo
Joaquim Bellmunt
Júlia Perera-Bel
M. Mar Albà
author_facet Lilian Marie Boll
Sergio Vázquez Montes de Oca
Marta E. Camarena
Robert Castelo
Joaquim Bellmunt
Júlia Perera-Bel
M. Mar Albà
author_sort Lilian Marie Boll
collection DOAJ
description Abstract Advanced bladder cancer patients show very variable responses to immune checkpoint inhibitors (ICIs) and effective strategies to predict response are still lacking. Here we integrate mutation and gene expression data from 707 advanced bladder cancer patients treated with anti-PD-1/anti-PD-L1 to build highly accurate predictive models. We find that, in addition to tumor mutational burden (TMB), enrichment in the APOBEC mutational signature, and the abundance of pro-inflammatory macrophages, are major factors associated with the response. Paradoxically, patients with high immune infiltration do not show an overall better response. We show that this can be explained by the activation of immune suppressive mechanisms in a large portion of these patients. In the case of non-immune-infiltrated cancer subtypes, we uncover specific variables likely to be involved in the response. Our findings provide information for advancing precision medicine in patients with advanced bladder cancer treated with immunotherapy.
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spelling doaj-art-de643bae1db5451f80ea886473b900ba2025-08-20T03:10:52ZengNature PortfolioNature Communications2041-17232025-02-0116111510.1038/s41467-025-56462-0Predicting immunotherapy response of advanced bladder cancer through a meta-analysis of six independent cohortsLilian Marie Boll0Sergio Vázquez Montes de Oca1Marta E. Camarena2Robert Castelo3Joaquim Bellmunt4Júlia Perera-Bel5M. Mar Albà6Hospital del Mar Research Institute (HMRIB)Hospital del Mar Research Institute (HMRIB)Hospital del Mar Research Institute (HMRIB)Department of Medicine and Life Sciences, Universitat Pompeu Fabra (UPF)Hospital del Mar Research Institute (HMRIB)Hospital del Mar Research Institute (HMRIB)Hospital del Mar Research Institute (HMRIB)Abstract Advanced bladder cancer patients show very variable responses to immune checkpoint inhibitors (ICIs) and effective strategies to predict response are still lacking. Here we integrate mutation and gene expression data from 707 advanced bladder cancer patients treated with anti-PD-1/anti-PD-L1 to build highly accurate predictive models. We find that, in addition to tumor mutational burden (TMB), enrichment in the APOBEC mutational signature, and the abundance of pro-inflammatory macrophages, are major factors associated with the response. Paradoxically, patients with high immune infiltration do not show an overall better response. We show that this can be explained by the activation of immune suppressive mechanisms in a large portion of these patients. In the case of non-immune-infiltrated cancer subtypes, we uncover specific variables likely to be involved in the response. Our findings provide information for advancing precision medicine in patients with advanced bladder cancer treated with immunotherapy.https://doi.org/10.1038/s41467-025-56462-0
spellingShingle Lilian Marie Boll
Sergio Vázquez Montes de Oca
Marta E. Camarena
Robert Castelo
Joaquim Bellmunt
Júlia Perera-Bel
M. Mar Albà
Predicting immunotherapy response of advanced bladder cancer through a meta-analysis of six independent cohorts
Nature Communications
title Predicting immunotherapy response of advanced bladder cancer through a meta-analysis of six independent cohorts
title_full Predicting immunotherapy response of advanced bladder cancer through a meta-analysis of six independent cohorts
title_fullStr Predicting immunotherapy response of advanced bladder cancer through a meta-analysis of six independent cohorts
title_full_unstemmed Predicting immunotherapy response of advanced bladder cancer through a meta-analysis of six independent cohorts
title_short Predicting immunotherapy response of advanced bladder cancer through a meta-analysis of six independent cohorts
title_sort predicting immunotherapy response of advanced bladder cancer through a meta analysis of six independent cohorts
url https://doi.org/10.1038/s41467-025-56462-0
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