- Arrieta, Víctor A;
- Chen, Andrew X;
- Kane, J Robert;
- Kang, Seong Jae;
- Kassab, Cynthia;
- Dmello, Crismita;
- Zhao, Junfei;
- Burdett, Kirsten B;
- Upadhyayula, Pavan S;
- Lee-Chang, Catalina;
- Shilati, Joseph;
- Jaishankar, Dinesh;
- Chen, Li;
- Gould, Andrew;
- Zhang, Daniel;
- Yuan, Jinzhou;
- Zhao, Wenting;
- Ling, Xiaoyang;
- Burks, Jared K;
- Laffleur, Brice;
- Amidei, Christina;
- Bruce, Jeffrey N;
- Lukas, Rimas V;
- Yamaguchi, Jonathan T;
- Cieremans, David;
- Rothschild, Gerson;
- Basu, Uttiya;
- McCord, Matthew;
- Brat, Daniel J;
- Zhang, Hui;
- Cooper, Lee AD;
- Zhang, Bin;
- Sims, Peter;
- Cloughesy, Tim F;
- Prins, Robert;
- Canoll, Peter;
- Stupp, Roger;
- Heimberger, Amy B;
- Horbinski, Craig;
- Iwamoto, Fabio M;
- Rabadan, Raul;
- Sonabend, Adam M
Only a subset of recurrent glioblastoma (rGBM) responds to anti-PD-1 immunotherapy. Previously, we reported enrichment of BRAF/PTPN11 mutations in 30% of rGBM that responded to PD-1 blockade. Given that BRAF and PTPN11 promote MAPK/ERK signaling, we investigated whether activation of this pathway is associated with response to PD-1 inhibitors in rGBM, including patients that do not harbor BRAF/PTPN11 mutations. Here we show that immunohistochemistry for ERK1/2 phosphorylation (p-ERK), a marker of MAPK/ERK pathway activation, is predictive of overall survival following adjuvant PD-1 blockade in two independent rGBM patient cohorts. Single-cell RNA-sequencing and multiplex immunofluorescence analyses revealed that p-ERK was mainly localized in tumor cells and that high-p-ERK GBMs contained tumor-infiltrating myeloid cells and microglia with elevated expression of MHC class II and associated genes. These findings indicate that ERK1/2 activation in rGBM is predictive of response to PD-1 blockade and is associated with a distinct myeloid cell phenotype.