Cambridge Healthtech Institute’s Kent Simmons recently spoke with Dr. Sandip Patel, Assistant Professor in the Cancer Immunotherapy Program at the Moores Cancer Center at the University of California, San Diego, about his upcoming presentation “Emerging Predictive Biomarkers for Cancer Immunotherapy”, to be delivered in the Engineering Next-Generation Cancer Immunotherapies meeting at the 2017 Peptalk event.
What is unique about cancer immunotherapy compared to other types of anti-cancer therapy?
Cancer immunotherapy mainly acts on a patient’s own immune cells, where the therapies activate a patient’s immune cells, and those immune cells are actually the main cancer fighting agent. We have traditionally targeted cancer by focusing on the tumor itself, and this is still immensely important in personalized medicine based on targeted therapy, but targeting the disabled immune cells around a tumor so that a patient’s own immune system can fight their cancer and lead to long term remissions in advanced disease is a new way of thinking about cancer.
What are the main challenges with cancer immunotherapy?
Finding the right combination of therapies for any given patient is important, as not all patients will respond to an anti-PD-1 agent alone. Outside of melanoma and Hodgkin lymphoma, the majority of patients with solid tumors will not respond to immune checkpoint blockade, despite the presence of an immune system around the tumor. This is a major area of research interest and where we are focusing drug development on novel agents
What biomarkers best determine whether a patient will respond to immune checkpoint blockade?
To date, PD-L1 immunohistochemistry is the only FDA-approved companion diagnostic for anti-PD-1/PD-L1 agents. However, there are numerous PD-L1 IHC antibodies with varying cutoffs and performance characteristics. Tumor mutational burden and RNA transcriptional signatures are likely to enter the clinical arena soon and can help discern responders from non-responders.
Where is the field of cancer immunotherapy heading?
More sophisticated biomarkers combined with novel therapeutics allows for the development of personalized immunotherapy based on each patient’s unique immunologic deficit. This may require combinations of targeted therapy, cellular therapy, and novel immunologics to maximize anti-tumor responses. The best use of these agents will require novel biomarker methods to best interrogate a patient’s tumor-immune microenvironment
Sandip P. Patel, M.D., Assistant Professor, Cancer Immunotherapy Program, Experimental Therapeutics, Thoracic Oncology, Moores Cancer Center, University of California, San Diego
Dr. Patel is a medical oncologist focusing on phase 1 immunotherapy trials across tumor types and thoracic oncology immunotherapy trials. His clinical research focus is on novel drug development and predictive biomarkers for immunotherapeutic response to generate personalized cancer immunotherapy regimens. Dr. Patel’s translational research focuses on blood-based biomarkers of immunotherapeutic response and discovery of novel immunotherapeutic targets in model systems. The development of novel biomarker methods for cancer immunotherapy is central to the advancement of immunotherapy in rare cancers, an area of research Dr. Patel is involved in. In addition to immune checkpoint blockade, research into cellular therapy combinations will be discussed.