Multimodal single-cell analyses reveal distinct fusion-regulated transcriptional programs in Ewing sarcoma

Reviewer #1 (Public review):

The investigators elegantly utilized a single-cell co-assay of RNA and ATAC seq to unveil the heterogeneous gene regulatory networks in Ewing sarcoma. The authors should be commended on their ability to identify multiple unique modules of gene regulation of Ewing sarcoma utilizing complex computational methods between numerous Ewing sarcoma cell lines. Additionally, they complemented their single-cell findings with xenografts as well as primary Ewing sarcoma patient tumors - validating the intratumoral heterogeneous gene regulatory networks of Ewing sarcoma. More importantly, they have revealed that exogenous TGF-β may modify these distinct epigenetic and transcriptional signatures within Ewing sarcoma tumors. Overall, the manuscript highlights an important discovery of the heterogenous gene regulatory programming of Ewing sarcoma and further highlights the role that TGFB plays within the tumor microenvironment of Ewing sarcoma. There are some areas of ambiguity that require clarification to increase the impact of the manuscript.

Reviewer #2 (Public review):

Summary:

This work by Waltner et. al. provides a comprehensive single-cell multiomics analysis of plasticity in gene regulatory networks present in Ewing sarcoma using single-cell RNA-sequencing (scRNA-seq) and single-cell assay for transposase accessible chromatin with sequencing (scATAC-seq). They find that Ewing sarcoma cell line models have distinct patterns of chromatin accessibility compared to non-Ewing sarcoma models, and that there is significant variability across Ewing sarcoma cell lines, and sometimes within a single cell line. These differences across models are linked to 3 distinct gene regulatory modules, 2 of which are present across the range of model systems studied here. The first modules present across models are activated when the fusion is expressed and include genes enriched for the known EWSR1::FLI1 response element, GGAA microsatellites, along with other neural crest transcription factors. The other module primarily consists of genes repressed by EWSR1::FLI1, which are activated in EWSR1::FLI1-low states. Interestingly, EWSR1::FLI1-low cells have already been tied to more migratory and metastatic phenotypes, and the data here suggest these cells are more responsive to external signals from TGF-β, and this may be mediated through FOSL2-mediated gene regulation. While there are some minor additional validation studies that can be performed to strengthen a few individual analyses, this is a technically rigorous study, with a variety of different analytical techniques used to address similar questions, and this approach elevates confidence in the answers provided. This is further strengthened by the diverse set of model systems used, including patient-derived cell lines, cell line xenograft models, patient-derived xenografts, mining available single-cell data from patient samples, and validation of the gene modules identified in a larger set of patient microarray samples. In whole, this study provides a valuable resource for understanding heterogeneity, plasticity, and gene expression networks in Ewing sarcoma. This may be useful for future studies of metastatic disease and may also provide a framework for similar questions in other fusion-driven sarcomas.

Strengths:

There are a few core strengths in this study. First is the number and diversity of Ewing sarcoma models studied, spanning commonly used cell lines, patient-derived xenografts, and patient samples. The second is the large array of rigorous and orthogonal approaches used to uncover the identity and function of various gene modules. This includes an array of informatics techniques, as well as specific modulation of cell line models in culture. A third is confirmation that different gene expression programs are present in the same tumor using spatial transcriptomic analysis. Lastly, the authors have made all of their data and code accessible, enabling continued use of this dataset as a resource for others.

Weaknesses:

As highlighted by the authors, this study is somewhat limited by the small number of single-cell data from patient samples that are publicly available. Much of the analysis comes from cell lines. Additionally, they focus only on one type of signal that may modulate cell plasticity, and there are likely to be many others. Lastly, there are a few weak spots in the data. Some of this likely arises from the underlying complexity of the data, the generally sparse nature of scATAC data, and the biological heterogeneity present in the cell lines studied. The most pronounced weakness was in the analysis of transcription factors that dictate gene expression in the distinct modules, as well as the response to TGF-β. While some specific transcription factors showed module-specific expression consistent with the computational prediction in Figure 2, others did not likely due to additional factors not tested here. Likewise, the same transcription factors did not always show consistent enrichment in the gene modules that responded to TGF-β treatment when analyzed across cell lines. On the whole, these are relatively minor weaknesses and do not diminish the value of this study.