Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) will become the first treatment center in the United States to routinely test patients’ tumor tissue to determine whether the cancer is likely to respond to immunotherapies.
The testing, expected to begin in early 2018, will initially be offered to select patients in several DF/BWCC treatment centers, and the goal is to offer it to pediatric patients in the future. With both a clinical and laboratory research arm, the initiative will complement Profile, the six-year-old program that scans patients’ tumor tissue for hundreds of cancer-related gene mutations. In the new program, dubbed ImmunoProfile, tumor cells and immune system cells will be screened for protein markers that predict whether a particular type of immunotherapy is effective.
Immunotherapies are treatments that harness the body’s immune system to combat disease. Some have proven exceptionally effective in reining in and even eliminating cancer in certain patients. The main types of immunotherapy for cancer are checkpoint inhibitors, which release the brakes on an immune system attack on cancer; cancer vaccines; and genetically engineered immune cells, which hone the immune system’s ability to identify and destroy tumor cells.
“Cancer immunotherapy is advancing rapidly, with many new drug targets being identified and many new therapies being developed and entering clinical trials,” says Scott Rodig, MD, PhD, director of the Center for Immuno-Oncology (CIO) Tissue Biomarker Laboratory, which will conduct the testing. “Our challenge is to determine which combination of these new therapies work best in which cancer types and for which patients. The goal is to develop tests that will guide oncologists in choosing the best therapy for each patient.”
In its first phase, Immuno-Profile will scan tumor tissue for immune cells responsible for killing tumor cells and for two checkpoint proteins – PD-1 and PD-L1 – that are targeted by immunotherapy drugs. The test will initially be performed for research purposes, with the hope of expanding it for clinical use in the future. As new predictive markers for specific types of immunotherapy are discovered, they’ll be added to the slate of proteins surveyed by Immuno-Profile.
“In the lab, we’re developing completely new types of tissue testing and imaging technology that will capture essentially all immunological information within a tumor biopsy sample,” Rodig remarks. “For the first time, we’ll be able to analyze biopsy samples to obtain a comprehensive picture of the immunological microenvironment,” the mixture of tumor cells and immune system cells found within most tumors.
The information will be vital to understanding the complex interplay between cancer and the immune system – why the immune attack on cancer often stalls, how cancer can evade the immune system’s radar, why the encounter between tumor and immune system cells often results in a stalemate, and, critically, how the situation can be turned in the immune system’s favor.