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Kim Blenman, PhD, MS

Assistant Professor of Medicine (Medical Oncology) and Assistant Professor of Computer Science

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Kim Blenman, PhD, MS

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Research Summary

To date, the major challenge in studies of the tumor microenvironment has been the lack of tools to interrogate the tumor microenvironment in situ. Major technical components of my research involve flow cytometry, histology, and creation of imaging software tools. Flow cytometry is an elegant quantitative approach to identifying the contents of the tumor microenvironment. However, to understand the spatial relationships of the cells and structures in the tumor microenvironment we must assess the space in situ by histology. One of our short-term goals is to change the way that we approach histology by making it fully quantitative and use the approach to generate clinically meaningful results for use in standard of care settings and clinical trials. Therefore, for the past several years we have been working on creating tools as part of our long-term research goal.

We create immune profiles using high dimensional multiplex histology (immunohistochemistry (IHC); immunofluorescence (IF)) assessment of cell characteristics, distributions, spatial relationships/interactions, and target antigen intensities at the single cell level as well as the global level. Our histology method allows for multiplexed staining of up to 8 biomarkers with chromogen-based IHC and at least 20 biomarkers with pure fluorochrome-based IF per tissue section through dye inactivation. Any entities that can be stained through histology can be evaluated using our method (e.g. proteins (secreted; membrane-bound), RNA, DNA, metabolites, etc.).

Quantitative imaging analysis can be performed successfully on any image taken from any standard microscopy system. However, quantitative imaging systems, such as the Vectra Multispectral Imaging System (CRi/Perkin Elmer) and the TissueFAXS RGB Imaging System (TissueGnostics), in which I am an expert and have helped to develop both, provide all-in-one tools for automated imaging and analysis. The quantitative analysis is performed using algorithms and scripts developed using commercial (InForm/Nuance; StrataQuest; MATLAB) software. The algorithms and scripts lead to identification and segmentation (e.g. nucleus, cytoplasm, and membrane) of each cell and/or tissue structure by target antigens tagged with chromogens/fluorochromes. From this data, we can enumerate each cell/structure type, calculate the cell/structure population distributions, determine target antigen intensities, identify spatial relationships between cells and/or structures, and correlate this information with clinical parameters/outcomes and therapeutic response.

Since the approval of the first checkpoint inhibitor in 2011, the interest in and value of the immune system in disease and treatment has skyrocketed. Approaches, such as the methods that we have created, that allows one to fully interrogate the relationships of components in disease microenvironments and use the knowledge to guide and/or create treatment are the future of medicine.

Extensive Research Description

Computational Histology and spatial analysis tools. As the number of visible objects in an image increases, the ability of the human brain to discern patterns in the image decreases. We endeavor to use our software tools to help the human brain identify patterns in high complexity microenvironments and link those patterns to the biology of disease, clinical data, therapeutic response, and health disparity.

Software tools for in silico analysis of images: We currently define the approach that we use to capture the in situ profiles of the tissue microenvironment as Computational Histology. We use standard microscopy to capture multiplexed histology images of up to 20 biomarkers per tissue slide. Since the biomarkers are imaged at different time periods, they can be recombined in silico to study any combination and/or coexpressions of the biomarkers.

To capture the profile of tissue microenvironments, we created algorithms that align the images into a composite image, isolate each cell in the composite image, and identify the positive cells in the composite image. The information collected is used for our recently developed novel image analysis tools for spatial relationships. The tools incorporate methods and metrics used in flow cytometry to create histograms, dot scatterplots, backgates, and cluster/pattern plots for isolation, identification, quantitation, and measurement of spatial relationships of single cells, cell populations, and clusters/patterns of cells. Our method and workflow were recently published in Cytometry A journal and received the honor of being featured on the cover of the journal.

Using some or all aspects of our Computational Histology approach we have found that B cells and neutrophils may have a role in tumor regression in melanoma and breast cancer. In melanoma, we used a mouse tumor regression model that consisted of implanting immunocompetent B6 mice with YUMMER1.7 melanoma cells. We found that B cells including plasmablasts and plasma cells and neutrophils were numerous and increased with the introduction of immunotherapy. Neutrophils were in direct contact with dead or dying melanoma cells and immunotherapy caused neutrophil extracellular traps (NETs)-like formations as well as geographic necrosis. In the clinic, we found that patients that were treated with anti-PD-1 (pembrolizumab; nivolumab) who had high levels of B cells had better progression-free survival.

In breast cancer, we found that sentinel lymph node B cells in patients could predict disease-free survival. Breast cancer patients with higher density of B cells had longer disease-free survival. This benefit was also seen in patients with the triple-negative subtype which is the breast cancer with pathologic complete response rates of 20% to 60% with chemotherapy treatment. Patients that achieve pathologic complete response are less likely to have a distant metastasis. It is also the breast cancer subtype that is more common in premenopausal women of African descent. Overall, our data suggests that B cells may protect against cancer recurrence and potentially distant metastasis.

Earlier Research in Autoimmunity

Generation and phenotypic characterization of a murine model of systemic lupus erythematosus (SLE). SLE is an autoimmune disease characterized by production of autoantibodies against self-nuclear proteins. In the most severe form of SLE, the autoantibody:antigen complexes bind to the basement membrane of kidneys initiating a cascade of events that lead to renal failure. We created congenic mouse strains of SLE-susceptibility genes from the SLE-prone NZM2410 mouse strain on a B6 background. We used a speed-congenic approach, which cut the development time in half. Each of the 4 congenic and multiple sub-congenic strains have unique phenotypes that when recombined together in bi- and tri- congenics was successful in partially or fully reconstituting the original disease. We bred the congenic strains, genotyped, and phenotyped them. The speed congenic approach is used by essentially all labs that are using genetics and mice to address their research questions. Our congenic mice are available to the research community through the Jackson Labs.

Cytokine modulation as a potential key to treatment of SLE. We and others have shown that cytokines are required to keep autoimmune cells alive by inhibition of apoptosis and perpetuation of inflammation. We have shown that there are defects in the TNFα/TNFR1 apoptotic signaling pathway in lupus-prone mice post binding of TNFα to TNFR1. We have also shown that gene-therapy treatment with IL-10 reduces inflammation and delays renal damage in lupus-prone mice.

Coauthors

Research Interests

Breast Neoplasms; Immunotherapy; Leukemia; Lymphoma; Melanoma; Multiple Myeloma; Clinical Trial

Public Health Interests

Health Equity, Disparities, Social Determinants and Justice

Research Images

Dr Blenman's Computational Histology Approach Featured on the Cover of Cytometry April 2019 Volume 95A Issue 4
Kim R.M. Blenman* and Marcus W. Bosenberg. Immune cell and cell cluster phenotyping, quantitation, and visualization using in silico multiplexed images and tissue cytometry. Cytometry A, 2019. PMID: 30468565. [*Corresponding Author].

Selected Publications

  • Pitfalls in assessing stromal tumor infiltrating lymphocytes (sTILs) in breast cancer.Kos Z, Roblin E, Kim RS, Michiels S, Gallas BD, Chen W, van de Vijver KK, Goel S, Adams S, Demaria S, Viale G, Nielsen TO, Badve SS, Symmans WF, Sotiriou C, Rimm DL, Hewitt S, Denkert C, Loibl S, Luen SJ, Bartlett JMS, Savas P, Pruneri G, Dillon DA, Cheang MCU, Tutt A, Hall JA, Kok M, Horlings HM, Madabhushi A, van der Laak J, Ciompi F, Laenkholm AV, Bellolio E, Gruosso T, Fox SB, Araya JC, Floris G, Hudeček J, Voorwerk L, Beck AH, Kerner J, Larsimont D, Declercq S, Van den Eynden G, Pusztai L, Ehinger A, Yang W, AbdulJabbar K, Yuan Y, Singh R, Hiley C, Bakir MA, Lazar AJ, Naber S, Wienert S, Castillo M, Curigliano G, Dieci MV, André F, Swanton C, Reis-Filho J, Sparano J, Balslev E, Chen IC, Stovgaard EIS, Pogue-Geile K, Blenman KRM, Penault-Llorca F, Schnitt S, Lakhani SR, Vincent-Salomon A, Rojo F, Braybrooke JP, Hanna MG, Soler-Monsó MT, Bethmann D, Castaneda CA, Willard-Gallo K, Sharma A, Lien HC, Fineberg S, Thagaard J, Comerma L, Gonzalez-Ericsson P, Brogi E, Loi S, Saltz J, Klaushen F, Cooper L, Amgad M, Moore DA, Salgado R. Pitfalls in assessing stromal tumor infiltrating lymphocytes (sTILs) in breast cancer. NPJ Breast Cancer 2020, 6:17.
  • Report on computational assessment of Tumor Infiltrating Lymphocytes from the International Immuno-Oncology Biomarker Working Group.Amgad M, Stovgaard ES, Balslev E, Thagaard J, Chen W, Dudgeon S, Sharma A, Kerner JK, Denkert C, Yuan Y, AbdulJabbar K, Wienert S, Savas P, Voorwerk L, Beck AH, Madabhushi A, Hartman J, Sebastian MM, Horlings HM, Hudeček J, Ciompi F, Moore DA, Singh R, Roblin E, Balancin ML, Mathieu MC, Lennerz JK, Kirtani P, Chen IC, Braybrooke JP, Pruneri G, Demaria S, Adams S, Schnitt SJ, Lakhani SR, Rojo F, Comerma L, Badve SS, Khojasteh M, Symmans WF, Sotiriou C, Gonzalez-Ericsson P, Pogue-Geile KL, Kim RS, Rimm DL, Viale G, Hewitt SM, Bartlett JMS, Penault-Llorca F, Goel S, Lien HC, Loibl S, Kos Z, Loi S, Hanna MG, Michiels S, Kok M, Nielsen TO, Lazar AJ, Bago-Horvath Z, Kooreman LFS, van der Laak JAWM, Saltz J, Gallas BD, Kurkure U, Barnes M, Salgado R, Cooper LAD. Report on computational assessment of Tumor Infiltrating Lymphocytes from the International Immuno-Oncology Biomarker Working Group. NPJ Breast Cancer 2020, 6:16.
  • Application of a risk-management framework for integration of stromal tumor-infiltrating lymphocytes in clinical trials.Hudeček J, Voorwerk L, van Seijen M, Nederlof I, de Maaker M, van den Berg J, van de Vijver KK, Sikorska K, Adams S, Demaria S, Viale G, Nielsen TO, Badve SS, Michiels S, Symmans WF, Sotiriou C, Rimm DL, Hewitt SM, Denkert C, Loibl S, Loi S, Bartlett JMS, Pruneri G, Dillon DA, Cheang MCU, Tutt A, Hall JA, Kos Z, Salgado R, Kok M, Horlings HM. Application of a risk-management framework for integration of stromal tumor-infiltrating lymphocytes in clinical trials. NPJ Breast Cancer 2020, 6:15.
  • PD-L1 Protein Expression on Both Tumor Cells and Macrophages are Associated with Response to Neoadjuvant Durvalumab with Chemotherapy in Triple-negative Breast Cancer.Ahmed FS, Gaule P, McGuire J, Patel KK, Blenman KR, Pusztai L, Rimm DL. PD-L1 Protein Expression on Both Tumor Cells and Macrophages are Associated with Response to Neoadjuvant Durvalumab with Chemotherapy in Triple-negative Breast Cancer. Clinical Cancer Research : An Official Journal Of The American Association For Cancer Research 2020, 26:5456-5461.
  • Immunological Differences Between Immune-Rich Estrogen Receptor-Positive and Immune-Rich Triple-Negative Breast Cancers.O'Meara T, Marczyk M, Qing T, Yaghoobi V, Blenman K, Cole K, Pelekanou V, Rimm DL, Pusztai L. Immunological Differences Between Immune-Rich Estrogen Receptor-Positive and Immune-Rich Triple-Negative Breast Cancers. JCO Precision Oncology 2020, 4.
  • ISAC Probe Tag Dictionary: Standardized Nomenclature for Detection and Visualization Labels Used in Cytometry and Microscopy Imaging.Blenman KR, Spidlen J, Parks DR, Moore W, Treister A, Leif R, Bray C, Goldberg M, Force IDST, Brinkman R. ISAC Probe Tag Dictionary: Standardized Nomenclature for Detection and Visualization Labels Used in Cytometry and Microscopy Imaging. Cytometry. Part A : The Journal Of The International Society For Analytical Cytology 2021, 99:103-106.
  • Data File Standard for Flow Cytometry, Version FCS 3.2.Spidlen J, Moore W, Parks D, Goldberg M, Blenman K, Cavenaugh JS, Brinkman R. Data File Standard for Flow Cytometry, Version FCS 3.2. Cytometry. Part A : The Journal Of The International Society For Analytical Cytology 2021, 99:100-102.
  • Immune Cell and Cell Cluster Phenotyping, Quantitation, and Visualization Using In Silico Multiplexed Images and Tissue Cytometry.Blenman KRM, Bosenberg MW. Immune Cell and Cell Cluster Phenotyping, Quantitation, and Visualization Using In Silico Multiplexed Images and Tissue Cytometry. Cytometry. Part A : The Journal Of The International Society For Analytical Cytology 2019, 95:399-410.
  • Multiplex Quantitative Analysis of Tumor-Infiltrating Lymphocytes and Immunotherapy Outcome in Metastatic Melanoma.Wong PF, Wei W, Smithy JW, Acs B, Toki MI, Blenman KR, Zelterman D, Kluger HM, Rimm DL. Multiplex Quantitative Analysis of Tumor-Infiltrating Lymphocytes and Immunotherapy Outcome in Metastatic Melanoma. Clinical Cancer Research : An Official Journal Of The American Association For Cancer Research 2019, 25:2442-2449.
  • Pathology of spontaneous and immunotherapy-induced tumor regression in a murine model of melanoma.Blenman KRM, Wang J, Cowper S, Bosenberg M. Pathology of spontaneous and immunotherapy-induced tumor regression in a murine model of melanoma. Pigment Cell & Melanoma Research 2019, 32:448-457.
  • Sentinel lymph node B cells can predict disease-free survival in breast cancer patients.Blenman KRM, He TF, Frankel PH, Ruel NH, Schwartz EJ, Krag DN, Tan LK, Yim JH, Mortimer JE, Yuan Y, Lee PP. Sentinel lymph node B cells can predict disease-free survival in breast cancer patients. NPJ Breast Cancer 2018, 4:28.
  • UV-induced somatic mutations elicit a functional T cell response in the YUMMER1.7 mouse melanoma model.Wang J, Perry CJ, Meeth K, Thakral D, Damsky W, Micevic G, Kaech S, Blenman K, Bosenberg M. UV-induced somatic mutations elicit a functional T cell response in the YUMMER1.7 mouse melanoma model. Pigment Cell & Melanoma Research 2017, 30:428-435.
  • ISAC's classification results file format.Spidlen J, Bray C, ISAC Data Standards Task Force., Brinkman RR. ISAC's classification results file format. Cytometry A 2015, 87:86-8.
  • ISAC's Gating-ML 2.0 data exchange standard for gating description.Spidlen J, Moore W, ISAC Data Standards Task Force., Brinkman RR. ISAC's Gating-ML 2.0 data exchange standard for gating description. Cytometry A 2015, 87:683-7.
  • A two-layer structure prediction framework for microscopy cell detection.Xu Y, Wu W, Chang EI, Chen D, Mu J, Lee PP, Blenman KR, Tu Z. A two-layer structure prediction framework for microscopy cell detection. Computerized Medical Imaging And Graphics : The Official Journal Of The Computerized Medical Imaging Society 2015, 41:29-36.
  • Quantitative and spatial image analysis of tumor and draining lymph nodes using immunohistochemistry and high-resolution multispectral imaging to predict metastasis.Blenman KR, Lee PP. Quantitative and spatial image analysis of tumor and draining lymph nodes using immunohistochemistry and high-resolution multispectral imaging to predict metastasis. Methods In Molecular Biology (Clifton, N.J.) 2014, 1102:601-21.
  • Immune correlates of talactoferrin alfa in biopsied tumor of relapsed/refractory metastatic non-small cell lung cancer patients.Riess JW, Bhattacharya N, Blenman KR, Neal JW, Hwang G, Pultar P, San-Pedro Salcedo M, Engleman E, Lee PP, Malik R, Wakelee HA. Immune correlates of talactoferrin alfa in biopsied tumor of relapsed/refractory metastatic non-small cell lung cancer patients. Immunopharmacology And Immunotoxicology 2014, 36:182-6.
  • IL-10 regulation of lupus in the NZM2410 murine model.Blenman KR, Duan B, Xu Z, Wan S, Atkinson MA, Flotte TR, Croker BP, Morel L. IL-10 regulation of lupus in the NZM2410 murine model. Laboratory Investigation; A Journal Of Technical Methods And Pathology 2006, 86:1136-48.
  • Aberrant signaling in the TNFalpha/TNF receptor 1 pathway of the NZM2410 lupus-prone mouse.Blenman KR, Bahjat FR, Moldawer LL, Morel L. Aberrant signaling in the TNFalpha/TNF receptor 1 pathway of the NZM2410 lupus-prone mouse. Clinical Immunology (Orlando, Fla.) 2004, 110:124-33.
  • The major murine systemic lupus erythematosus susceptibility locus, Sle1, is a cluster of functionally related genes.Morel L, Blenman KR, Croker BP, Wakeland EK. The major murine systemic lupus erythematosus susceptibility locus, Sle1, is a cluster of functionally related genes. Proceedings Of The National Academy Of Sciences Of The United States Of America 2001, 98:1787-92.
  • Genetic reconstitution of systemic lupus erythematosus immunopathology with polycongenic murine strains.Morel L, Croker BP, Blenman KR, Mohan C, Huang G, Gilkeson G, Wakeland EK. Genetic reconstitution of systemic lupus erythematosus immunopathology with polycongenic murine strains. Proceedings Of The National Academy Of Sciences Of The United States Of America 2000, 97:6670-5.
  • Production of congenic mouse strains carrying genomic intervals containing SLE-susceptibility genes derived from the SLE-prone NZM2410 strain.Morel L, Yu Y, Blenman KR, Caldwell RA, Wakeland EK. Production of congenic mouse strains carrying genomic intervals containing SLE-susceptibility genes derived from the SLE-prone NZM2410 strain. Mammalian Genome : Official Journal Of The International Mammalian Genome Society 1996, 7:335-9.
  • Comparison of PD-L1 protein expression between primary tumors and metastatic lesions in triple negative breast cancers.Rozenblit M, Huang R, Danziger N, Hegde P, Alexander B, Ramkissoon S, Blenman K, Ross JS, Rimm DL, Pusztai L. Comparison of PD-L1 protein expression between primary tumors and metastatic lesions in triple negative breast cancers. Journal For Immunotherapy Of Cancer 2020, 8.
  • Checkpoint Inhibitor Colitis Shows Drug-Specific Differences in Immune Cell Reaction That Overlap With Inflammatory Bowel Disease and Predict Response to Colitis Therapy.Lo YC, Price C, Blenman K, Patil P, Zhang X, Robert ME. Checkpoint Inhibitor Colitis Shows Drug-Specific Differences in Immune Cell Reaction That Overlap With Inflammatory Bowel Disease and Predict Response to Colitis Therapy. American Journal Of Clinical Pathology 2021, 156:214-228.
  • Neoadjuvant durvalumab plus weekly nab-paclitaxel and dose-dense doxorubicin/cyclophosphamide in triple-negative breast cancer.Foldi J, Silber A, Reisenbichler E, Singh K, Fischbach N, Persico J, Adelson K, Katoch A, Horowitz N, Lannin D, Chagpar A, Park T, Marczyk M, Frederick C, Burrello T, Ibrahim E, Qing T, Bai Y, Blenman K, Rimm DL, Pusztai L. Neoadjuvant durvalumab plus weekly nab-paclitaxel and dose-dense doxorubicin/cyclophosphamide in triple-negative breast cancer. NPJ Breast Cancer 2021, 7:9.
  • Pitfalls in assessing stromal tumor infiltrating lymphocytes (sTILs) in breast cancer.Kos Z, Roblin E, Kim RS, Michiels S, Gallas BD, Chen W, van de Vijver KK, Goel S, Adams S, Demaria S, Viale G, Nielsen TO, Badve SS, Symmans WF, Sotiriou C, Rimm DL, Hewitt S, Denkert C, Loibl S, Luen SJ, Bartlett JMS, Savas P, Pruneri G, Dillon DA, Cheang MCU, Tutt A, Hall JA, Kok M, Horlings HM, Madabhushi A, van der Laak J, Ciompi F, Laenkholm AV, Bellolio E, Gruosso T, Fox SB, Araya JC, Floris G, Hudeček J, Voorwerk L, Beck AH, Kerner J, Larsimont D, Declercq S, Van den Eynden G, Pusztai L, Ehinger A, Yang W, AbdulJabbar K, Yuan Y, Singh R, Hiley C, Bakir MA, Lazar AJ, Naber S, Wienert S, Castillo M, Curigliano G, Dieci MV, André F, Swanton C, Reis-Filho J, Sparano J, Balslev E, Chen IC, Stovgaard EIS, Pogue-Geile K, Blenman KRM, Penault-Llorca F, Schnitt S, Lakhani SR, Vincent-Salomon A, Rojo F, Braybrooke JP, Hanna MG, Soler-Monsó MT, Bethmann D, Castaneda CA, Willard-Gallo K, Sharma A, Lien HC, Fineberg S, Thagaard J, Comerma L, Gonzalez-Ericsson P, Brogi E, Loi S, Saltz J, Klaushen F, Cooper L, Amgad M, Moore DA, Salgado R. Pitfalls in assessing stromal tumor infiltrating lymphocytes (sTILs) in breast cancer. NPJ Breast Cancer 2020, 6:17.
  • Tumor-specific major histocompatibility-II expression predicts benefit to anti-PD-1/L1 therapy in patients with HER2-negative primary breast cancer.Gonzalez-Ericsson PI, Wulfkhule JD, Gallagher RI, Sun X, Axelrod ML, Sheng Q, Luo N, Gomez H, Sanchez V, Sanders M, Pusztai L, Petricoin EF, Blenman KR, Balko JM, Trial Team IS. Tumor-specific major histocompatibility-II expression predicts benefit to anti-PD-1/L1 therapy in patients with HER2-negative primary breast cancer. Clinical Cancer Research : An Official Journal Of The American Association For Cancer Research 2021.
  • A Novel Immunomodulatory 27-Gene Signature to Predict Response to Neoadjuvant Immunochemotherapy for Primary Triple-Negative Breast Cancer.Iwase T, Blenman KRM, Li X, Reisenbichler E, Seitz R, Hout D, Nielsen TJ, Schweitzer BL, Bailey DB, Shen Y, Zhang X, Pusztai L, Ueno NT. A Novel Immunomodulatory 27-Gene Signature to Predict Response to Neoadjuvant Immunochemotherapy for Primary Triple-Negative Breast Cancer. Cancers 2021, 13.
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