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Cutaneous melanoma is the most common skin cancer, with varying disease and mortality rates across the globe depending on the time of diagnosis and primary care1. Over the last decade, an increased biological understanding of melanoma has helped propel the development of new cancer models to treat solid tumors2. The recent rise of immunotherapy has led to a revolutionary concept of cancer treatment based on activating the endogenous immune system3,4.
The tumor microenvironment (TME) is highly complex, consisting of diverse immune cells, cancer-associated fibroblasts, pericytes, endothelial cells, and various tissue-resident cells5. Several techniques have been applied in the past to study the TME, such as flow cytometry and single-cell sequencing, which compromise spatial context as they are required to destroy the tumor tissue. Traditional microscope imaging, such as immunofluorescence (IF) and immunohistochemistry (IHC), allows the visualization of protein biomarkers without destroying sample tissues. However, these approaches are limited to two or three biomarkers and are unable to provide a full understanding of spatial and structural relationships within the complex TME 6.
To address this problem, several multiplex imaging techniques have been developed to visualize the complex TME spatially7,8,9,10. One of these is CoDetection-by-inDEXing, renamed as the PhenoCycler system, based on DNA oligonucleotide-conjugated antibodies11. The system can provide single-cell imaging and analysis of over 100 biomarkers for human specimens. However, very few inventoried antibodies are available to visualize and analyze murine specimens, particularly Formalin-Fixed Paraffin-Embedded (FFPE) samples12. FFPE offers several advantages over Fresh Frozen (FF) preservation, such as ease of handling and storage, well-preserved morphology over time, and, most importantly, the ability to prepare tissue/tumor microarrays (TMA) that allow for visualization of several specimens on a single slide. We recently designed and developed a murine FFPE CODEX/PhenoCycler antibody panel and successfully applied it to visualize and analyze the spatial proteomics of genetically reprogrammed murine melanoma specimens13.
The overall goal of this protocol is to provide a step-by-step guide for designing a murine FFPE antibody panel and describe the process of antibody-barcode conjugation, tissue staining, and imaging. Additionally, we present a detailed image analysis pipeline utilizing open-source tools such as QuPath and R packages. After following this protocol, researchers will learn how to design a custom-conjugated antibody panel, perform multiplex imaging using a Phenocycler-Fusion device, and gain new insights into the spatial proteomics of the melanoma TME. Furthermore, this protocol can be adapted to study various tumor immune microenvironments and combined with existing spatial transcriptomics techniques.