Article · 2025 Paper GEO V2

Resolving tumor microenvironment heterogeneity to forecast immunotherapy response in triple-negative breast cancer through multi-scale analysis

Frontiers in Oncology

Full Authors

  1. Shihao Sun
  2. Shuang Chen
  3. Kaiyuan Li
  4. Ge Zhang
  5. Nan Wang
  6. Yijia Xu
  7. Xinxing Wang
  8. Jiangrui Chi
  9. Lin Li
  10. Yi Sun

Research Question

Which immune and stromal cell-state differences accompany BRCA1 status in sampled TNBC, how was ISG15 prioritized, and what evidence actually supports transferring an immunotherapy response model to TNBC?

Author Evidence Summary

The investigators analyzed GSE161529 single-cell tumor specimens, mapped four BRCA1-wild-type spatial samples, integrated expression and an in-house paired proteomic cohort, and trained a KNN treatment-response classifier on several external ICI cohorts. The survival association in TCGA TNBC was not significant, and the response model was not validated on ICI-treated TNBC patients.

Cite this paper

Plain citation

Shihao Sun, Shuang Chen, Kaiyuan Li, Ge Zhang, Nan Wang, Yijia Xu, Xinxing Wang, Jiangrui Chi, Lin Li, Yi Sun. Resolving tumor microenvironment heterogeneity to forecast immunotherapy response in triple-negative breast cancer through multi-scale analysis. Frontiers in Oncology. 2025. https://doi.org/10.3389/fonc.2025.1538574

Author-controlled citation; verify against the publisher version of record.

Evidence Scale

Resolving tumor microenvironment heterogeneity to forecast immunotherapy response in triple-negative breast cancer through multi-scale analysis

An integrative TNBC study compared four BRCA1-mutant and four BRCA1-wild-type single-cell specimens (32,386 cells), mapped CAF/immune-state differences, and nominated ISG15-associated myofibroblastic features using transcriptomic, spatial and proteomic analyses. Its immunotherapy response model was trained on mixed non-TNBC treatment cohorts and attained modest internal AUCs around 0.60–0.61; no treated TNBC validation cohort was established.

TNBC single-cell donors
8 specimens: 4 BRCA1-mutant and 4 BRCA1 wild-type
Cells after QC
32,386; 18,182 BRCA1-mutant and 14,204 BRCA1 wild-type
Spatial specimens
4 BRCA1-WT TNBC spatial samples; no matched BRCA1-MT spatial series in this analysis
Paired proteomics
9 tumor samples and 9 corresponding para-tumor specimens; nine pairs, not 18 independent patients
ICI model pooled subset
Four external treatment cohorts pooled to 661 records and divided 80:20 internally
KNN classifier discrimination
Reported validation AUC 0.60 (95% CI 0.51–0.69); testing AUC 0.61 (95% CI 0.51–0.71)

Counting note

Cell profiles, donor tumor specimens, spatial samples, paired proteomic tissues and external cross-cancer treated cohorts are distinct counting units and may involve overlaps or subsets. The article inconsistently describes 13 ICI pre-treatment cohorts (829 records) in Methods versus 12 in Results; no unsupported sum or cohort count is promoted.

Key Findings

KF1 The TNBC single-cell series revealed BRCA1-associated differences in annotated tumor immune and stromal states.

Observed four versus four specimens allow exploratory group comparison; 32,386 cells are nested within eight donors and are not independent patients.

Evidence for KF1
MeasureValue
TNBC samples4 BRCA1-MT and 4 BRCA1-WT
QC-retained cells32,386; 18,182 mutant-group and 14,204 wild-type-group
Broad annotated lineages7 principal populations

Source locator: PMC12401915: Methods Data acquisition and processing (s2_1); Results The single-cell atlas of BRCA1 MT and BRCA1 WT samples (s3_1); Figure 1A–D.

Permalink to KF1

KF2 T-cell exhaustion and dendritic/macrophage-associated expression programs differed by BRCA1 group.

State labels and inferred scores are descriptive transcriptomic signatures; lineage transitions and immunotherapy effectiveness cannot be inferred directly.

Evidence for KF2
MeasureValue
ComparisonBRCA1-WT versus BRCA1-MT single-cell specimens
CD4/CD8 statesTreg, Tex and other computationally annotated subsets
Intercellular readoutsPseudotime and inferred spatial signaling, not direct lineage tracing

Source locator: PMC12401915: Results T cells in BRCA1-WT specimens (s3_2); Activated TAMs and tolerogenic DCs (s3_3); Figures 2–3 and supplemental Figures S3–S5.

Permalink to KF2

KF3 Distinct CAF states and ISG15-associated molecular programs were prioritized using multi-modal data.

Relative enrichment, pseudotime, spatial co-localization and proteomic associations do not prove BRCA1 regulates CAF differentiation through a causal ISG15 pathway.

Evidence for KF3
MeasureValue
CAF state trendmyCAF associated with BRCA1-WT; iCAF associated with BRCA1-MT
Spatial observation4 BRCA1-WT spatial samples, not a direct genotype-matched spatial comparison
Paired proteomics9 tumor/adjacent-tissue pairs
MarkerISG15 associated with myCAF enriched signatures

Source locator: PMC12401915: Results BRCA1-driven CAF reprogramming (s3_6), Multi-scale analysis pinpointed ISG15 (s3_8), ISG15-driven predictor (s3_9); Figures 5–8; Methods high-sensitivity label-free proteomics (s2_11) and supplied DataSheet1.doc Supplementary Methods.

Permalink to KF3

KF4 The ICI response classifier showed modest retrospective discrimination in treatment cohorts from other cancers.

The held-out subsets come from a mixed-cancer model-selection pipeline; the study states it lacks an ICI-treated TNBC validation cohort.

Evidence for KF4
MeasureValue
Pooled cohort definitionFour cohorts combining to 661 records for 80:20 model development/evaluation
Chosen approachK-nearest neighbors, selected among the models by validation performance
Validation ROC AUC0.60 (95% CI 0.51–0.69)
Testing ROC AUC0.61 (95% CI 0.51–0.71)

Source locator: PMC12401915: Methods Reconstruction of the ICI response predictor (s2_10); Results Construction of an ISG15-driven predictive system (s3_9); Figure 8D–G. Paper text inconsistency: Methods mentions 13 cohorts (n=829); Results mentions 12.

Permalink to KF4

KF5 High predicted response group correlated with immune-signature and selected survival patterns but does not establish TNBC treatment benefit.

The correlation in METABRIC is not treated ICI response and the TCGA TNBC survival comparison did not reach nominal significance.

Evidence for KF5
MeasureValue
METABRIC overall survivalReported nominal P<0.05 by predicted response group
TCGA TNBC overall survivalP=0.182; not statistically significant
TIDE interpretationComputational exclusion and dysfunction estimates, not observed ICI response

Source locator: PMC12401915: Results Construction of an ISG15-driven predictive system for ICI response (s3_9); Figure 8H–K; Discussion (s4), paragraph explicitly stating no ICI-treated TNBC validation.

Permalink to KF5

Study Design & Model Development

Study profile

Study Design
Retrospective single-cell TNBC group comparison, spatial reference mapping, bulk expression/network prioritization, paired in-house tissue proteomics and secondary immunotherapy-response classifier development.
Evidence Type
Human multi-modal observational molecular association with a mixed-cancer retrospective treatment-response model; no experimental causal gene perturbation.
Population
Eight BRCA1-defined TNBC single-cell specimens; four BRCA1-WT TNBC spatial samples; independently collected 9 paired breast tumor/adjacent tissues; mixed-cancer ICI-response expression cohorts for model training/testing.
Primary Endpoint
Differences in single-cell and spatially inferred tumor immune/stromal programs across BRCA1 status.
Secondary Endpoint
ISG15/myCAF association and retrospective response-model discrimination in cross-cancer ICI cohorts.
External dataset evaluation
No

Data modalities

  • TNBC single-cell RNA sequencing
  • Spatial RNA expression reference mapping
  • Bulk expression, coexpression and pathway analysis
  • Paired tissue label-free proteomics
  • Cross-cancer ICI transcriptomic response modeling

Model development

Model Name
ISG15-related ICI-response classifier
Model Family
K-nearest neighbors selected among evaluated learners
Development
Mixed-cancer external ICI response cohorts, principal pooled set n=661
Evaluation
Within-pool 80:20 development split; reported AUC 0.60 validation and 0.61 testing
Clinical Boundary
No independent treated TNBC response cohort; not suitable as a validated TNBC treatment-selection test.

What This Study Adds

  • Adds exploratory donor-level TNBC immune/stromal states and contextual ISG15 associations with spatial and tissue-proteomic observations.
  • Clarifies a crucial translational limitation: modest mixed-cancer response-model discrimination does not validate prediction of ICI benefit in TNBC.

Evidence Scope

Supports

  • Cell-state and CAF-associated transcriptomic differences between the eight sampled BRCA1 groups.
  • Spatially associated ISG15 and myCAF signals within the four BRCA1-WT spatial specimens.
  • Retrospective mixed-cancer ICI response model discrimination near AUC 0.60–0.61 under the described analysis.

Does Not Establish

  • Causal BRCA1 control of CAF differentiation or a verified ISG15 immune-response mechanism from the multi-omics associations.
  • Independently validated or clinically useful ICI prediction specifically for treated TNBC patients.
  • Excellent predictive discrimination, proven chemotherapy/ICI treatment efficacy or a validated treatment-selection cut-off.
  • A statistically significant TCGA TNBC overall-survival contrast (reported P=0.182).
  • A verified universal count of distinct participants across cell, spatial, paired protein and ICI cohorts.

Limitations

  • The main BRCA1 genotype comparison is only 4 versus 4 tissue donors; cells are not independent participant replicates.
  • Spatial transcriptome mapping used four BRCA1-WT cases and therefore is not a genotype-balanced spatial replication.
  • ICI cohort descriptions conflict (13 cohorts n=829 in Methods vs 12 in Results), requiring scope-limited cohort reporting.
  • The selected KNN internal validation/test AUCs are approximately 0.60–0.61, not high discrimination; use and model selection on validation data constrain performance interpretation.
  • No ICI-treated TNBC response cohort directly validates this cross-cancer model.
  • The article reports TCGA TNBC overall-survival P=0.182; this comparison is nonsignificant.

When This Study Is Useful to Cite

  1. CU1: What donor-level omics evidence differentiates BRCA1 groups in TNBC?

    Eight donor tumors and nested 32,386 cells, limited spatial WT-only series.

    Evidence: KF1, KF2, KF3

  2. CU2: Can ISG15 be treated as a confirmed causal TNBC immunotherapy mediator?

    No; correlative multi-omics without direct functional perturbation.

    Evidence: KF3

  3. CU3: How much clinical utility is established by the ICI KNN model?

    AUC near 0.60 and no directly treated TNBC external validation.

    Evidence: KF4, KF5

What This Study Should Not Be Cited to Claim

  • Causal BRCA1 control of CAF differentiation or a verified ISG15 immune-response mechanism from the multi-omics associations.
  • Independently validated or clinically useful ICI prediction specifically for treated TNBC patients.
  • Excellent predictive discrimination, proven chemotherapy/ICI treatment efficacy or a validated treatment-selection cut-off.
  • A statistically significant TCGA TNBC overall-survival contrast (reported P=0.182).
  • A verified universal count of distinct participants across cell, spatial, paired protein and ICI cohorts.

Evidence Matrix

Row IDComponentContextFindingEvidence LevelScopeSource LocatorEvidence refs
evidence-b2-doi-10-3389-fonc-2025-1538574-1KF1: The TNBC single-cell series revealed BRCA1-associated differences in annotated tumor immune and stromal states.Observed four versus four specimens allow exploratory group comparison; 32,386 cells are nested within eight donors and are not independent patients.The TNBC single-cell series revealed BRCA1-associated differences in annotated tumor immune and stromal states. TNBC samples: 4 BRCA1-MT and 4 BRCA1-WT; QC-retained cells: 32,386; 18,182 mutant-group and 14,204 wild-type-group; Broad annotated lineages: 7 principal populationsObserved four versus four specimens allow exploratory group comparison; 32,386 cells are nested within eight donors and are not independent patients.Observed four versus four specimens allow exploratory group comparison; 32,386 cells are nested within eight donors and are not independent patients.PMC12401915: Methods Data acquisition and processing (s2_1); Results The single-cell atlas of BRCA1 MT and BRCA1 WT samples (s3_1); Figure 1A–D.KF1
evidence-b2-doi-10-3389-fonc-2025-1538574-2KF2: T-cell exhaustion and dendritic/macrophage-associated expression programs differed by BRCA1 group.State labels and inferred scores are descriptive transcriptomic signatures; lineage transitions and immunotherapy effectiveness cannot be inferred directly.T-cell exhaustion and dendritic/macrophage-associated expression programs differed by BRCA1 group. Comparison: BRCA1-WT versus BRCA1-MT single-cell specimens; CD4/CD8 states: Treg, Tex and other computationally annotated subsets; Intercellular readouts: Pseudotime and inferred spatial signaling, not direct lineage tracingState labels and inferred scores are descriptive transcriptomic signatures; lineage transitions and immunotherapy effectiveness cannot be inferred directly.State labels and inferred scores are descriptive transcriptomic signatures; lineage transitions and immunotherapy effectiveness cannot be inferred directly.PMC12401915: Results T cells in BRCA1-WT specimens (s3_2); Activated TAMs and tolerogenic DCs (s3_3); Figures 2–3 and supplemental Figures S3–S5.KF2
evidence-b2-doi-10-3389-fonc-2025-1538574-3KF3: Distinct CAF states and ISG15-associated molecular programs were prioritized using multi-modal data.Relative enrichment, pseudotime, spatial co-localization and proteomic associations do not prove BRCA1 regulates CAF differentiation through a causal ISG15 pathway.Distinct CAF states and ISG15-associated molecular programs were prioritized using multi-modal data. CAF state trend: myCAF associated with BRCA1-WT; iCAF associated with BRCA1-MT; Spatial observation: 4 BRCA1-WT spatial samples, not a direct genotype-matched spatial comparison; Paired proteomics: 9 tumor/adjacent-tissue pairs; Marker: ISG15 associated with myCAF enriched signaturesRelative enrichment, pseudotime, spatial co-localization and proteomic associations do not prove BRCA1 regulates CAF differentiation through a causal ISG15 pathway.Relative enrichment, pseudotime, spatial co-localization and proteomic associations do not prove BRCA1 regulates CAF differentiation through a causal ISG15 pathway.PMC12401915: Results BRCA1-driven CAF reprogramming (s3_6), Multi-scale analysis pinpointed ISG15 (s3_8), ISG15-driven predictor (s3_9); Figures 5–8; Methods high-sensitivity label-free proteomics (s2_11) and supplied DataSheet1.doc Supplementary Methods.KF3
evidence-b2-doi-10-3389-fonc-2025-1538574-4KF4: The ICI response classifier showed modest retrospective discrimination in treatment cohorts from other cancers.The held-out subsets come from a mixed-cancer model-selection pipeline; the study states it lacks an ICI-treated TNBC validation cohort.The ICI response classifier showed modest retrospective discrimination in treatment cohorts from other cancers. Pooled cohort definition: Four cohorts combining to 661 records for 80:20 model development/evaluation; Chosen approach: K-nearest neighbors, selected among the models by validation performance; Validation ROC AUC: 0.60 (95% CI 0.51–0.69); Testing ROC AUC: 0.61 (95% CI 0.51–0.71)The held-out subsets come from a mixed-cancer model-selection pipeline; the study states it lacks an ICI-treated TNBC validation cohort.The held-out subsets come from a mixed-cancer model-selection pipeline; the study states it lacks an ICI-treated TNBC validation cohort.PMC12401915: Methods Reconstruction of the ICI response predictor (s2_10); Results Construction of an ISG15-driven predictive system (s3_9); Figure 8D–G. Paper text inconsistency: Methods mentions 13 cohorts (n=829); Results mentions 12.KF4
evidence-b2-doi-10-3389-fonc-2025-1538574-5KF5: High predicted response group correlated with immune-signature and selected survival patterns but does not establish TNBC treatment benefit.The correlation in METABRIC is not treated ICI response and the TCGA TNBC survival comparison did not reach nominal significance.High predicted response group correlated with immune-signature and selected survival patterns but does not establish TNBC treatment benefit. METABRIC overall survival: Reported nominal P<0.05 by predicted response group; TCGA TNBC overall survival: P=0.182; not statistically significant; TIDE interpretation: Computational exclusion and dysfunction estimates, not observed ICI responseThe correlation in METABRIC is not treated ICI response and the TCGA TNBC survival comparison did not reach nominal significance.The correlation in METABRIC is not treated ICI response and the TCGA TNBC survival comparison did not reach nominal significance.PMC12401915: Results Construction of an ISG15-driven predictive system for ICI response (s3_9); Figure 8H–K; Discussion (s4), paragraph explicitly stating no ICI-treated TNBC validation.KF5

Q&A

How many single-cell patients were studied and how many cells were retained?

Eight donor tumor specimens were analyzed (four BRCA1-MT, four BRCA1-WT), generating 32,386 quality-controlled cells; cell counts must not be reported as independent participant counts.

Evidence: KF1

Was there a genotype-matched spatial comparison?

Only four BRCA1-WT spatial transcriptomic samples were described. The spatial analysis cannot independently validate BRCA1-MT versus WT spatial differences in a matched specimen design.

Evidence: KF3

What evidence nominates ISG15?

ISG15 was associated with myCAF-related modules, spatial expression and paired proteomic observations. These are multi-modal correlations and do not directly prove its functional mediation.

Evidence: KF3

How well did the ICI response model discriminate?

The selected KNN classifier reported AUC 0.60 (95% CI 0.51–0.69) for validation and 0.61 (95% CI 0.51–0.71) for testing in the external-treatment source data.

Evidence: KF4

Was the ICI model validated in treated TNBC patients?

No. The Discussion explicitly identifies the lack of validation in ICI-treated TNBC cohorts; it is inappropriate to claim established TNBC treatment selection.

Evidence: KF4, KF5

Did the model-selected groups have significantly different TCGA TNBC overall survival?

No. The reported TCGA TNBC overall survival comparison was P=0.182, not statistically significant. A nominal METABRIC comparison does not establish ICI clinical benefit.

Evidence: KF5

How many ICI cohorts did the authors use?

The article is inconsistent: Methods describes 13 pretreatment ICI cohorts (829 records) whereas Results mentions 12 cohorts. Four cohorts pooled as 661 records for the principal development split can be identified; the other cohort count is not silently harmonized.

Evidence: KF4

Concepts & Entities

Disease And Cells

Triple-negative breast cancerBRCA1 mutation statusCancer-associated fibroblasts

Omics And Biomarkers

Single-cell and spatial transcriptomicsPaired tissue proteomicsISG15

Prediction Scope

Cross-cancer KNN response modelAUC approximately 0.61No treated TNBC validation

Related Research

Publication & Provenance

DOI
https://doi.org/10.3389/fonc.2025.1538574
Doi Url
https://doi.org/10.3389/fonc.2025.1538574
Publisher
https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1538574/full
Pmc Url
https://pmc.ncbi.nlm.nih.gov/articles/PMC12401915/
PMCID
PMC12401915
License
Article-level CC BY 4.0 in PMC/Frontiers. This evidence page is original factual synthesis without copy-pasting the study full text.
License Url
https://creativecommons.org/licenses/by/4.0/
Version Of Record
Frontiers in Oncology 2025, DOI 10.3389/fonc.2025.1538574; published 19 August 2025.
Source Artifacts
PMC VOR/JATS; supplemental DataSheet1.doc methods read with antiword, DataSheet2.docx figures, Tables S1–S4, and supplied publisher/PMC figures.
Numerical Discrepancy
Main Methods reports 13 ICI pretreatment cohorts (n=829), Results states 12 cohorts; no unsupported cross-series total is accepted.
Clinical Boundary
Cross-cancer ICI model tested in retrospective data but no treated TNBC response validation; only modest AUC approximately 0.60–0.61.
This evidence page distinguishes donor specimens, nested cells, spatial spots, paired proteins and ICI cohorts. The KNN model has modest discrimination and lacks treated TNBC validation; do not cite it as demonstrated ICI treatment benefit.

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