TMIC-80. HIGH-DIMENSIONAL HISTOPATHOLOGIC EVALUATION OF THE HYPOXIC TUMOR MICROENVIRONMENT IN GLIOBLASTOMA

Abstract Gliobastoma (GBM) is a highly aggressive solid tumor of the brain, characterized by a hypoxic tumor microevironment (TME) leading to histopathological features of necrosis, microvascular proliferation and deregulated hypervascularization. The heterogeneous nature of GBM results in a gradient of intra-tumoral hypoxia that causes molecular changes to specific cell populations within the bulk of the tumor. Our study is the first clinical study to utilize the exogenous oxygen-independent marker pimonidazole (PIMO) to identify the hypoxic TME using high-dimensional spatial and single-cell proteomics of specific cell populations within GBM. A cohort of 35 patients with primary GBM, recurrent GBM or IDH-mutant glioma were administered PIMO prior to surgical resection of tumor tissue for downstream bulk proteomic analysis of bulk tissue by serial immunohistochemistry and imaging mass cytometry (IMC) and single-cell analysis of dissociated tissue by Cytometry by time-of-flight (CyTOF). We utilized high-resolution imaging analyses to validate PIMO as a sensitive and stable marker for hypoxia against a panel of transiently expressed HIF-target genes and examine the inter- and intra-tumoral heterogeneity of hypoxia within each tumor subtype. A custom CyTOF marker panel was developed for further single-cell analyses of T-cell subsets and their functional states, myeloid cell subpopulations, natural killer cells, glial cells, and tumor cells in the hypoxic TME. We demonstrate the utility of PIMO to effectively study the hypoxic TME through spatial and single cell methods and further elucidate mechanisms of hypoxia-driven treatment resistance.