Pan-cancer molecular tumor board experience with biomarker-driven precision immunotherapy
BH Louie et al, NPJ Precision Oncology, September 22, 2022
Despite remarkable responses to immune checkpoint blockade (ICB) in some advanced cancers, most patients do not benefit, perhaps due to the complexity of tumor/immune/genome interactions. We implemented a multidisciplinary Molecular Tumor Board (MTB) that reviewed multi-omic cancer characteristics to develop N-of-One therapies for patients in the pan-cancer, advanced, refractory setting.
Diet-driven microbial ecology underpins associations between cancer immunotherapy outcomes and the gut microbiome
RC Simpson et al, Nature Medicine, September 22, 2022
The gut microbiota shapes the response to immune checkpoint inhibitors (ICIs) in cancer, however dietary and geographic influences have not been well-studied in prospective trials. To address this, we prospectively profiled baseline gut (fecal) microbiota signatures and dietary patterns of 103 trial patients from Australia and the Netherlands treated with neoadjuvant ICIs for high risk resectable metastatic melanoma and performed an integrated analysis with data from 115 patients with melanoma treated with ICIs in the United States.
Liquid biopsies and tumor mutational burden: the cutoff conundrum
PM Kazi et al, Nature Medicine, September 12, 2022
One of the biggest advances in cancer care has been the advent of immunotherapy, and one of the biggest challenges is predicting which patients are most likely to benefit from it. Several predictive markers have been proposed, with the assessment of the quantity of mutations in a cancer (known as the tumor mutational burden, or TMB) being one of the most promising, particularly as it can be evaluated in the form of a noninvasive, blood-based ‘liquid biopsy’.
Assessment of tumor mutational burden through a simple blood test could help to identify which patients are most likely to benefit from immunotherapy, but optimal cutoffs are not well established.
In CAR T cell-treated lymphomas, the T cell rich get richer
T Anagnostou, Nature Medicine, August 29, 2022
In patients with large B cell lymphomas, immune features of the tumor microenviroment predict clinical outcomes after CAR T cell therapy; as the number of patients treated with CAR T cells is set to increase, refinement of these and other biomarkers will be crucial.