Success of immunotherapy against cancer by blood test predictable

New biomarkers can predict the success of immunotherapy against cancer

According to health experts, around half a million people in Germany suffer from cancer each year. After diagnosis, many sufferers are operated on and receive chemotherapy and / or radiation. Immunotherapy for cancer has also been available for several years. Whether patients respond positively can now be predicted in advance by a blood test.

Therapy success can be predicted by new biomarkers

More and more people are getting cancer. According to the World Cancer Report of the International Agency for Research on Cancer (IARC), there could be 20 million new cases of cancer annually worldwide by 2025. In Germany, the number of new diagnoses has almost doubled since 1970. After the diagnosis cancer often follow surgery, radiation and / or chemotherapy. For several years, doctors have also been using immunotherapy for cancer. The success of this treatment method can be predicted by new biomarkers, scientists from Switzerland report.

Certain forms of cancer can be combated with immunotherapy. However, not all people are responding to this form of treatment. However, a blood test can now predict which patients are likely to respond positively to immunotherapy. (Image: Henrik Dolle / fotolia.com)

Immunotherapy for cancer

Sensational successes of immunotherapy against cancer have been more frequent in recent years.

For example, doctors from London's Great Ormond Street Hospital (GOSH) reported on a small girl who was first treated with a special cell therapy that had never been used before.

And promising results have been achieved in several countries with a new blood cancer immunotherapy.

However, such treatments are not the same for all patients. However, the University of Zurich (UZH) now reports that it is already possible to prove in the blood beforehand whether cancer patients will respond positively to immunotherapy.

Researchers at the university have identified corresponding biomarkers. Patients who are not on therapy may be treated early with other methods.

Certain forms of cancer can be successfully controlled

Immunotherapy already successfully combats black skin cancer (melanoma) and lung cancer.

Here, the normal function of the immune system, which regularly examines all tissues in the body for pathogens and disorders, is specifically exploited: With specific inhibitors, the immune cells are activated so that they detect and eliminate the cancer cells as a foreign body.

The system can strengthen its frequently weakening immune response so that even pronounced secondary tumors (metastases) are detected and destroyed.

In up to 50 percent of patients, the cancer can be controlled in this way, some are even cured.

Not all respond to the therapy

However, about half of the cancer patients do not respond to immunotherapy, but must accept their side effects.

A research team from the University of Zurich and the University Hospital Zurich has now found out with a novel method which patients are likely to respond positively to immunotherapy.

They were able to identify in the blood samples the biomarkers, which suggest even before the start of treatment, whether the therapy is more likely to be effective - or not.

In the journal "Nature Medicine", the experts report on their new findings.

"When deciding on immunotherapy, the white blood cells should be analyzed for these biomarkers. Thus, the proportion of patients benefiting from the therapy can be increased dramatically, "says Prof. Burkhard Becher from the Institute of Experimental Immunology at UZH.

"In the remaining patients, however, other methods can be used without any loss - without losing valuable time with ineffective immunotherapy for them."

High-dimensional cell analysis

The researchers, in cooperation with the dermatology clinic of the USZ, examined 40 blood samples from 20 patients before and 12 weeks after immunotherapy for biomarkers.

Cytometry-by-time-of-flight (CyTOF) was used, which analyzes each cell individually for up to 50 different proteins.

In this way every single cell could be identified and its activation state documented. Even nuanced differences between patient samples were accurately recorded.

Recognize molecular patterns

After analysis of the cells, the data were analyzed together with employees of the Swiss Institute of Bioinformatics of UZH for molecular patterns, which can predict a therapeutic success.

"We even found a subtle and weak immune response in the blood caused by the cancer before therapy started. We identified this molecular pattern as a small subset of white blood cells (CD14 + CD16-HLA-DRhi) that indicate better therapeutic results, "said Becher.

In order for the finding to be easily understood, the biomarkers should also be easily detected in the usual hospital laboratories: In fact, such a blood picture was also reproduced in a second, independent cohort of more than 30 people using conventional methods.

Beginning of precision medicine

"This study, together with comprehensive, well-structured biobanking, is an important step in the direction of precision medicine," says Prof. Mitch Levesque of the Department of Dermatology at the USZ.

This is also supported by the UZH's university research focus "translational cancer research". The findings must now be applied in independent studies with higher numbers of patients before they are clinically feasible.

The method with the help of biobanking, high-dimensional cytometry and computer-aided pattern recognition should also help with other clinical pictures to make therapy decisions and develop new therapeutic approaches. (Ad)