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Single-cell spatial atlas of high-grade serous ovarian cancer unveils MHC class II as a key driver of spatial tumor ecosystems and clinical outcomes

Perez-Villatoro, F.; van Wagensveld, L.; Shabanova, A.; Junquera, A.; Kang, Z.; Niemiec, I.; Falco, M. M.; Anttila, E.; Casado, J.; Marcus, E.; Kahelin, E.; Chamchougia, F.; Salko, M.; Shah, S.; Russo, S.; Chiaro, J.; Gronholm, M.; Sonke, G. S.; Van de Vijver, K. K.; Kruitwagen, R. F.; van der Aa, M.; Virtanen, A.; Cerullo, V.; Vaharautio, A.; Sorger, P. K.; Horlings, H. M.; Farkkila, A.

2024-12-03 cancer biology
10.1101/2024.11.29.626039 bioRxiv
Show abstract

The tumor microenvironment (TME) is a complex network of interactions between malignant and host cells, yet its orchestration in advanced high-grade serous ovarian carcinoma (HGSC) remains poorly understood. We present a comprehensive single-cell spatial atlas of 280 metastatic HGSCs, integrating high-dimensional imaging, genomics, and transcriptomics. Using 929 single-cell maps, we identify distinct spatial domains associated with phenotypically heterogeneous cellular compositions, and demonstrate that immune cell co-infiltration at the tumor-stroma interface significantly influences clinical outcomes. To uncover the key drivers of the tumor ecosystem, we developed CEFIIRA (Cell Feature Importance Identification by RAndom forest), which identified tumor cell-intrinsic MHC-II expression as a critical predictor of prolonged survival, independent of clinicomolecular profiles. Validation with external datasets confirmed that MHC-II-expressing cancer cells drive immune infiltration and orchestrate spatial tumor-immune interactions. Our atlas offers novel insights into immune surveillance mechanisms across HGSC clinicomolecular groups, paving the way for improved therapeutic strategies and patient stratification.

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