Evidence map›Paper›PMID 41617396›Full record

ArticleJournal for immunotherapy of cancer2026

Single-cell spatial transcriptomics uncovers niches that govern response to PD-1/PD-L1 blockade in cutaneous squamous cell carcinoma.

Maxwell Y Lee, Alistaire R Sherman, Luis Martinez Ramirez, Mobeen Rahman, Sabrina Zdravkovic, June Ho Shin, Ivan Stepanek, Alexander Dimitrios Colevas, John B Sunwoo, Vasu Divi

Abstract read
In one paragraph

Article in Journal for immunotherapy of cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Maxwell Y LeeDepartment of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA.ORCID http://orcid.org/0000-0001-7226-4855
Alistaire R ShermanDepartment of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA.
Luis Martinez RamirezStanford Cancer Institute Clinical Trials Office, Stanford University School of Medicine, Palo Alto, California, USA.ORCID http://orcid.org/0000-0001-9619-1689
Mobeen RahmanDepartment of Pathology, Stanford University School of Medicine, Palo Alto, California, USA.
Sabrina ZdravkovicDepartment of Pathology, Stanford University School of Medicine, Palo Alto, California, USA.
June Ho ShinDepartment of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA.
Ivan StepanekDepartment of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA.
Alexander Dimitrios ColevasDepartment of Medicine, Division of Medical Oncology, Stanford University, Palo Alto, California, USA.
John B Sunwoo *Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA vdivi@stanford.edu sunwoo@stanford.edu.ORCID http://orcid.org/0000-0002-8393-4196
Vasu Divi *Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA vdivi@stanford.edu sunwoo@stanford.edu.

Funding

Reprogramming the Tumor-Immune Interface in Oral CancerR35DE030054 · NIDCR · STANFORD UNIVERSITY · PI JOHN B SUNWOO · 2020 to 2026
$6.7M
NIDCR NIH HHS R35 DE030054
6 · The paper itself

Abstract

backgroundNeoadjuvant PD-1/PD-L1 blockade yields robust efficacy in advanced cutaneous squamous cell carcinoma (cSCC), yet many patients fail to achieve a complete or major pathologic response. The reasons why some patients experience response but others do not are unclear.

methodsWe profiled cSCC specimens before, after 1 dose, and after 3-4 doses of PD-1/PD-L1 blockade to uncover resistance mechanisms and predict therapeutic response. In total, 27 patients across three cohorts, including two phase II trials, were studied. We created 1.7 mm tissue-core microarrays and performed single-cell spatial transcriptomics, including spatial clustering, gene-set enrichment, and spatial correlation analyses.

resultsAfter profiling all samples, six distinct spatial niches emerged, each differentially enriched in responders versus non-responders. A high antigen presentation niche, B/plasma cell enriched niche, and inflammatory keratinocyte niche were more frequent in responders, whereas proliferative keratinocyte, low antigen presentation myeloid, and fibroblast-rich epithelial-mesenchymal transition niches prevailed in non-responders. Notably, spatial niche profiling on pretreatment samples outperformed PD-L1 status in predicting pathologic response. Each niche displayed unique gene coexpression modules, suggesting niche-specific resistance mechanisms. Individual tumor analyses revealed varied immune evasion strategies, including defective interferon-induced antigen presentation, immunosuppressive myeloid environments, and epithelial-mesenchymal transition.

conclusionsOur single-cell spatial transcriptomic approach identifies six spatial niches that predict immunotherapy response better than PD-L1 status using only 1.7 mm tissue cores and may inform the development of biomarkers. Our results further underscore the heterogeneity of resistance mechanisms among cSCC patients, highlighting the need for tailored therapeutic strategies.

Indexed as

B7-H1 AntigenCarcinoma, Squamous CellCutaneous Squamous Cell CarcinomaImmune Checkpoint InhibitorsProgrammed Cell Death 1 ReceptorSkin NeoplasmsFemaleHumansMaleSingle-Cell Gene Expression AnalysisSpatial TranscriptomicsTumor MicroenvironmentB7-H1 AntigenCD274 protein, humanImmune Checkpoint InhibitorsPDCD1 protein, humanProgrammed Cell Death 1 ReceptorImmune Checkpoint InhibitorImmunotherapySkin Cancer

Identifiers

PMID41617396
PMCPMC12863322

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.