Distinct Tumor-Resident Memory HBV-Specific T Cell Responses Correlate with Relapse-Free Survival in Patients with HBV-Associated Hepatocellular Carcinoma

In the context of hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC), despite a range of possibilities, the antigen specificities of tumor-infiltrating T cells and their relevance to control of is largely unknown. Using highly multiplexed peptide-MHC tetramer staining of unexpanded cells from blood, liver and tumor tissues from 46 HCC patients, we detected 91 different CD8 T cell populations specific for epitopes derived from HBV, tumor-associated and neoantigens (NeoAg), as well as disease-unrelated antigens. Parallel high-dimensional analysis delineated distinct tissue-resident memory T cells (TRM) populations among other highly diverse lymphocytes profiles observed in these compartments. Intratumoral and intrahepatic HBV-specific T cells were particularly enriched for three TRM phenotypes and the majority expressed relatively low levels of PD-1 receptor and TOX gene, inconsistent with reported terminal exhausted T cells (TEX) despite being clonally expanded within tumors. High frequencies of terminal TEX in these tumors was uncommon, whereas patients who had detectable and less exhausted tumor-infiltrating HBV- or NeoAg-specific CD8 TRM had superior long-term relapse-free survival. Thus, non-terminally-exhausted tumor-resident HBV-specific CD8 TRM show hallmarks of active involvement and effective antitumor response, implying that these cells could be harnessed for therapeutic purposes.