Melanoma breakthrough paves way for personalised treatment for all cancer patients

Melanoma breakthrough paves way for personalised treatment for all cancer patients

14 February 2019

Australian researchers have for the first time identified specific cells and receptors in the immune system which predict how a patient will respond to treatment with immunotherapies, potentially paving the way for the development of personalised therapy for all cancer patients.

The groundbreaking research, published in Cancer Cell by a team of researchers from Melanoma Institute Australia (MIA), identifies markers of response and resistance in metastatic melanoma patients.

Co-Medical Director of Melanoma Institute Australia, Professor Georgina Long, said the findings have the potential to revolutionalise how treatment is delivered for all cancer patients.

‘Immunotherapy is the new frontier of melanoma treatment, and whilst it has had astounding results for patients who respond, there has been a subset of patients who are resistant to the treatment,’ Professor Long said.

‘Being able to identify the immune markers of response takes out the guess work, and allows us to be proactive in providing the right drug treatment for the right patients. This has the potential to revolutionise how all cancers are treated around the world.’

The Melanoma Institute Australia team, led by PhD student Tuba Nur Gide and postdoctoral scientists Camelia Quek and James Wilmott, performed immune profiling on 158 tumour biopsies from melanoma patients treated with anti-PD-1 monotherapy or combined anti-PD-1 and anti-CTLA-4 therapy.

They found that genes involving immune memory and activation were higher in responders to immunotherapy, whereas non-responders showed higher levels of genes related to tumour adaptation and cancer cell survival.

Examining more closely the immune cells in the tumours of responders, a specific sub-type of T-cell was found to be correlated with response and survival. Patients with this immune cell had significant shrinkage of their tumours, and longer progression-free survival .

Non-responding patients were found to lie in two distinct groups – one that can possibly benefit from other available treatment combinations, and another that requires more research into novel treatment strategies. The first group were seen to have several other potential therapeutic targets, possibly leading to the development of individualised immunotherapy for selected patients.

‘In addition to knowing up front which patients are likely to respond to current immunotherapy treatments, these findings will also enable us to focus research efforts on developing new therapies targeting the biological markers identified in current non-responders,’ Professor Long  added.

‘The result will be personalised immunotherapy treatment for all patients, based not on their type of cancer, but based on their tumour’s unique biology.’

The study is the largest dataset of patients treated with anti-PD-1-based therapies to be published to date, and this data is now available for use by researchers and clinicians internationally.

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