Treatment Strategies: Scientists Discover Methods for Anticipating Treatment Responses
Embracing the cutting edge of cancer treatment, immunotherapy stands out as a revolutionary approach. But, it's not a silver bullet for everyone or every kind of cancer.
A team of brilliant minds at Johns Hopkins University has made a breakthrough in this arena. Their research focuses on a unique subset of mutations within cancer tumors, dubbed "persistent mutations," that could be the key to determining how receptive a tumor is to immunotherapy.
In simple terms, the presence of these persistent mutations means the cancer cells show up on the radars of the immune system more commonly, increasing the likelihood of immunotherapy success. This could lead to doctors making more accurate selections for immunotherapy and, in turn, better predicting treatment outcomes.
These findings have recently been published in Nature Medicine.
Immunotherapy: A Rambunctious Warrior
Immunotherapy is essentially a battle cry to the body's immune system, coaxing it into aggressively combating cancer cells. Normally, cancer cells hide behind mutations, making them invisible to the body's defenses. But immunotherapy amplifies the immune system's ability to find and eliminate those stealthy invaders.
There are various types of immunotherapy, including checkpoint inhibitors, CAR T-cell therapy, and adoptive cell transfer.
Cancer's Hidden Deceptions
Presently, doctors try to figure out how well a tumor will respond to immunotherapy by considering the total number of mutations in the tumor, known as the Tumor Mutational Burden (TMB).
According to Dr. Valsamo Anagnostou, a senior author of the study and an associate professor at Johns Hopkins, a large number of mutations in a cancer cell makes it more recognizable by the immune system, potentially leading to longer survival with immunotherapy.
A New Angle on the Battle
In this study, Anagnostou and her team identified persistent mutations, less likely to go away as cancer evolves, within the overall TMB. These persistent mutations make the cancer tumor more visible to the immune system, priming it for a better response to immunotherapy.
"Persistent mutations render the cancer cells continuously visible to the immune system, eliciting an effective immune response," Anagnostou explained. "This response is amplified by immune checkpoint blockade, enabling the immune system to eliminate cancer cells with persistent mutations over time."
In essence, the presence of these persistent mutations makes the tumor more likely to respond to immune checkpoint blockade, a type of immunotherapy that blocks mechanisms used by cancer cells to evade the immune system.
"Persistent mutation load may help clinicians more accurately select patients for clinical trials of novel immunotherapies or predict a patient's clinical outcome with standard-of-care immune checkpoint blockade," Anagnostou added.
Hinting at a Brighter Future
Dr. Kim Margolin, a medical oncologist, praised the study for going beyond the simple concept of TMB and focusing on persistent mutations. She believes that this research could lead to a more precise selection of patients for immunotherapy in the future.
"It is likely that in the not-too-distant future, it will be possible to use high-throughput, next-generation sequencing techniques to study patients' mutational spectrum, such as was done in this study," Margolin said. "And thus to categorize patients by their likelihood of response to immunotherapy for advanced cancer or their likelihood of benefit from surveillance for patients who are apparently disease-free after definitive surgery."
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- The research at Johns Hopkins University on persistent mutations within cancer tumors could revolutionize the field of immunotherapy, making it possible for doctors to more accurately select patients and predict treatment outcomes.
- The presence of persistent mutations in a cancer tumor makes the tumor more visible to the immune system, potentially priming it for a successful response to immunotherapy, such as immune checkpoint blockade.
- In the future, high-throughput, next-generation sequencing techniques could be used to study patients' mutational spectrum, allowing for a more precise selection of patients for immunotherapy based on the presence of persistent mutations.
