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ResearchIn-Press PreviewCell biologyImmunologyNeuroscienceOncology Open Access | 10.1172/JCI195189

Mismatch repair deficiency drives malignant progression and alters the tumor immune microenvironment in glioblastoma models

Montserrat Puigdelloses Vallcorba,1 Nishant Soni,2 Seung-Won Choi,3 Kavita Rawat,1 Tanvi Joshi,1 Sam Friedman,4 Alice Buonfiglioli,1 Angelo Angione,1 Zhihong Chen,1 Gonzalo Piñero,1 Gabrielle Price,1 Mehek Dedhia,1 Raina Roche,5 Emir Radkevich,5 Anne M. Bowcock,6 Deepti Bhatt,4 Winfried Edelmann,7 Robert M. Samstein,6 Timothy E. Richardson,8 Nadejda M. Tsankova,8 Alexander M. Tsankov,2 Ranjit S. Bindra,9 Raul Rabadan,3 Juan C. Vasquez,10 and Dolores Hambardzumyan6

1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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1Departments of Oncological Sciences and Neurosurgery, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America

2Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America

3Departments of Systems Biology and Biomedical Informatics, Columbia University, New York, United States of America

4Yale Center for Research Computing, Yale University School of Medicine, New Haven, United States of America

5Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, United States of America

6Departments of Oncological Sciences and Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, United States of America

7Department of Cell Biology, Albert Einstein College of Medicine, New York, United States of America

8Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, United States of America

9Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, United States of America

10Department of Pediatrics, Yale University School of Medicine, New Haven, United States of America

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Published December 23, 2025 - More info

J Clin Invest. https://doi.org/10.1172/JCI195189.
Copyright © 2025, Puigdelloses Vallcorba et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published December 23, 2025 - Version history
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Abstract

Mutations in DNA mismatch repair (MMR) pathway genes (MSH2, MSH6, MLH1, and PMS2) are linked to acquired resistance to temozolomide (TMZ) and high tumor mutation burden (TMB) in high-grade gliomas (HGG), including glioblastoma (GBM). However, the specific roles of individual MMR genes in the initiation, progression, TMB, microsatellite instability (MSI), and resistance to TMZ in glioma remain unclear. Here, we developed de novo mouse models of germline and somatic MMR-deficient (MMRd) HGG. Surprisingly, loss of Msh2 or Msh6 does not lead to high TMB, MSI, nor confer response to anti-PD-1 in GBM. Similarly, human GBM shows discordance between MMR gene mutations and TMB/MSI.Germline MMRd leads to promoted progression from low-grade to HGG and reduced survival compared to MMR-proficient (MMRp) tumor-bearing mice. This effect is not tumor cell intrinsic but is associated with MMRd in the tumor immune microenvironment, driving immunosuppressive myeloid programs, reduced lymphoid infiltration, and CD8+ T cell exhaustion. Both MMR-reduced (MMRr) and MMRd GBM are resistant to temozolomide (TMZ), unlike MMRp tumors. Our study shows that KL-50, a imidazotetrazine-based DNA targeting agent inducing MMR-independent cross-link–mediated cytotoxicity, was effective against germline and somatic MMRr/MMRd GBM, offering a potential therapy for TMZ-resistant HGG with MMR alterations.

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