Unleashing the Power of Immunotherapy: A New Age Against Cancer
Immunotherapy Outcomes Prediction: Scientists Discover Methods for Forecasting Response to Treatment
Welcome to the cutting-edge battle against cancer, where the latest weapon in our arsenal is immunotherapy.
But hold your horses! Not every cancer patient or every type of cancer can benefit from this groundbreaking treatment. Researchers at Johns Hopkins University have been hard at work, trying to crack the code on what makes immunotherapy effective.
They've recently stumbled upon a tantalizing clue: a specific set of mutations in cancer tumors that hint at how receptive it will be to immunotherapy. These findings could revolutionize the way doctors select patients for immunotherapy and even predict outcomes.
Here's the lowdown on what they've discovered, according to their publication in the journal Nature Medicine.
What’s the Buzz About Immunotherapy?
Immunotherapy is like a secret superpower that enlists our body's defense system to fight cancer cells. Typically, cancer cells evade our immune system due to mutations that allow them to hide. Immunotherapy gives our immune system a much-needed leg up, making it easier to find and obliterate cancer cells.
Immunotherapy is currently a viable treatment option for breast cancer, melanoma, leukemia, and non-small cell lung cancer. Researchers are assessing its potential as a treatment for other types of cancers, like prostate cancer, brain cancer, and ovarian cancer.
Sifting Through the Genetic Chaos
Currently, doctors base their decisions on the total number of mutations in a tumor—called the tumor mutation burden (TMB)—to guess how well a tumor will respond to immunotherapy. Dr. Valsamo Anagnostou, a senior author of the study and an associate professor of oncology at Johns Hopkins, explains:
"Tumor mutation burden is the number of changes in the genetic material and particularly in the DNA sequence of cancer cells, known as mutations. A large number of mutations in cancer cells clearly distinguishes them from normal cells, in other words, renders them 'foreign' to the immune system and as such gives more opportunities for the immune system to identify and attack the tumor."
In this study, Anagnostou and her team honed in on a specific subset of mutations within the overall TMB—which they dubbed "persistent mutations." These mutations remain even as the cancer evolves, keeping the cancer visible to the immune system and enhancing the immunotherapy response.
"Persistent mutations are always there in cancer cells, and these mutations may render the cancer cells continuously visible to the immune system, eliciting an immune response. This response is augmented in the context of immune checkpoint blockade, and the immune system continues to eliminate cancer cells harboring these persistent mutations over time, resulting in sustained immunologic tumor control and long survival," Anagnostou said.
Foretelling the Future
Dr. Kim Margolin, a medical oncologist, ventured her thoughts on the study's implications for cancer patients and the future of immunotherapy selection:
"It was refreshing to see this incredible article demonstrating that a highly-respective collaborative group has gone way beyond the simple concept of tumor mutation burden, and to define persistent mutations, loss of mutation-containing sequences, and in a new light. These findings, if further validated, would be game-changing in the realm of cancer treatment."
In the not-so-distant future, Margolin foresees high-throughput, next-generation sequencing techniques being utilized to study patients' mutational spectrum and categorize them based on their likelihood of response to immunotherapy. Ultimately, these predictions could guide the integration of immunotherapy with traditional treatments and potentially even pre-empt recurrences.
This is just the beginning—the future of cancer treatment is bright and personalized, one genetic mutation at a time.
[1] https://www.hopkinsmedicine.org/news/media/releases/john-hopkins-researchers-find-higher-tumor-mutation-burden-linked-to-greater-chance-of-success-with-immunotherapy-for-advanced-cancer-patients-051019[2] https://www.hopkinsmedicine.org/press_releases/2020/New_Tumor_Test_Shows_Promisy_Potential_for_Better_Predicting_Responses_to_Immunotherapy_in_Patients_With_Lung_Cancer[5] https://www.cancer.gov/news-events/cancer-currents-blog/2020/tumor-mutation-burden-cancer-immunotherapy
- The groundbreaking treatment, immunotherapy, taps into the immune system's power to combat cancer cells, particularly those with a high tumor mutation burden (TMB), making them easier for the immune system to identify and eliminate.
- The latest research by Johns Hopkins University scientists has led to the discovery of 'persistent mutations', a specific set of mutations that remain in cancer cells throughout their evolution, keeping them visible to the immune system and enhancing immunotherapy response.
- In the near future, high-throughput, next-generation sequencing techniques might be used to analyze patients' mutational spectrum, categorizing them according to their likelihood of responding to immunotherapy, thus guiding the integration of immunotherapy with traditional treatments.
- Understanding and harnessing the role of persistent mutations in cancer cells could revolutionize medical-condition treatments like cancer, opening doors for health-and-wellness therapies and treatments that take an individualized approach, targeting specific mutations in the body's system.
