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Mismatch repair deficiency drives malignant progression and alters the tumor immune microenvironment in glioblastoma models
Montserrat Puigdelloses Vallcorba, Nishant Soni, Seung-Won Choi, Kavita Rawat, Tanvi Joshi, Sam Friedman, Alice Buonfiglioli, Angelo Angione, Zhihong Chen, Gonzalo Piñero, Gabrielle Price, Mehek Dedhia, Raina Roche, Emir Radkevich, Anne M. Bowcock, Deepti Bhatt, Winfried Edelmann, Robert M. Samstein, Timothy E. Richardson, Nadejda M. Tsankova, Alexander M. Tsankov, Ranjit S. Bindra, Raul Rabadan, Juan C. Vasquez, Dolores Hambardzumyan
Montserrat Puigdelloses Vallcorba, Nishant Soni, Seung-Won Choi, Kavita Rawat, Tanvi Joshi, Sam Friedman, Alice Buonfiglioli, Angelo Angione, Zhihong Chen, Gonzalo Piñero, Gabrielle Price, Mehek Dedhia, Raina Roche, Emir Radkevich, Anne M. Bowcock, Deepti Bhatt, Winfried Edelmann, Robert M. Samstein, Timothy E. Richardson, Nadejda M. Tsankova, Alexander M. Tsankov, Ranjit S. Bindra, Raul Rabadan, Juan C. Vasquez, Dolores Hambardzumyan
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Research Article Cell biology Immunology Neuroscience Oncology

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

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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 (HGGs), including glioblastomas (GBMs). However, the specific roles of individual MMR genes in the initiation, progression, TMB, microsatellite instability (MSI), and resistance to TMZ in gliomas remain unclear. Here, we developed de novo mouse models of germline and somatic MMR-deficient (MMRd) HGGs. Surprisingly, loss of Msh2 or Msh6 did not lead to high TMB, MSI, nor did it confer a response to anti–programmed cell death 1 (anti–PD-1) in GBM. Similarly, human GBM showed discordance between MMR gene mutations and the TMB and MSI. Germline MMRd promoted the progression from low-grade to HGG and reduced survival compared with MMR-proficient (MMRp) tumor–bearing mice. This effect was not tumor cell intrinsic but was 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 were resistant to TMZ, unlike MMRp tumors. Our study shows that N3-(2-fluoroethyl) imidazotetrazine (KL-50), an imidazotetrazine-based DNA targeting agent that induces MMR-independent cross-link–mediated cytotoxicity, was effective against germline and somatic MMRr and MMRd GBMs, offering a potential therapy for TMZ-resistant HGG with MMR alterations.

Authors

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

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Figure 6

Somatic MMRd does not lead to shortened survival in tumor-bearing mice.

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Somatic MMRd does not lead to shortened survival in tumor-bearing mice.
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(A) Schematic illustration for the generation of adult somatic Msh2 loss–induced MMRd GBM models utilizing PDGFB overexpression along with either shp53 or shPten across various genotypes. (B and C) Kaplan-Meier survival curves of tumors from mice of various genotypes. (D) Representative images and IHC quantification for MSH2 in somatic homozygous or heterozygous MMRd tumors. Scale bars: 100 μm and 50 μm (insets). (E) Illustration of the isolation and culturing of freshly dissociated primary tumors generated in germline Msh2, WT, and Msh2-deficient mice. (F) Illustration of the experimental setup and results for the MTS assay for MMRp and MMRd primary tumor cell cultures maintained in GSC conditions. The experiments included 3 replicates for each genotype, with primary cell lines derived from 3 different tumor-bearing mice. Experiments were repeated at least 3 times for each line at 24 hours, 48 hours, and 72 hours. MTS, 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium. Data are presented as the mean ± SD.(G) Schematic illustration showing the generation of adult Msh2 cell-specific depletion in GBM models utilizing PDGFB overexpression combined with shp53 across different genotypes. (H) Kaplan-Meier survival curves for tumor-bearing mice of various genotypes. The experiments included 3 replicates for each genotype, with primary cell lines derived from 3 different tumor-bearing mice. Experiments were repeated at least 3 times for each line at 24 hours, 48 hours, and 72 hours. MC and GBW test (B, C, and H). Panels A and E–G include illustrations created with BioRender.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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