Collagen Alignment and Spatial Transcriptomics Analysis (CASTA) reveals gene programs associated with collagen alignmet in colorectal cancer

The use of immune checkpoint blockade is limited to the minority of colorectal cancers that are highly infiltrated by CD8+ T cells. Therefore, a method to improve CD8+ T-cell infiltration has the potential to expand the use immune checkpoint blockade to more patients. Barriers of aligned collagen surrounding tumors have been proposed as one mechanisim of CD8+ T-cell exclusion. We use 5 colorectal cancer patient samples to examine the relationship between collagen alignment and gene expression. Overall design: Five CRC patient samples were collected and Visium v2 spatial transcriptomics was performed. Collagen was imaged in serial sections and spatially-resolved quantification of collagen alignment was integrated with the spatial transcriptomics data.