Researchers at New York University (NYU) have developed a single test they say can help determine which patients are most likely to see their cancer return after treatment with immunotherapies as well as who may be at risk for severe side effects.
The research test focuses on cataloging certain antibodies produced by the body’s immune system. While most bind with invading pathogens such as viruses and bacteria, other antibodies can also react with the body’s own proteins and in some cases lead to autoimmune disease.
By isolating a panel of dozens of autoantibodies and seeing whether they are present in a patient before they receive immunotherapy—treatments that stimulate white blood cells into attacking tumors—the researchers said early findings showed it could accurately predict whether the drugs will have a lasting response against the cancer or if the immune system could be triggered into damaging healthy cells.
Researchers at NYU Grossman School of Medicine and its Perlmutter Cancer Center studied blood samples from more than 950 patients with advanced melanoma. The participants had their tumors surgically removed and were enrolled in one of two phase 3 trials of adjuvant checkpoint inhibitors that aimed to keep their cancer from recurring.
The test itself uses a microchip containing 20,000 attached proteins. When antibodies in a blood sample match up with one of the proteins, those spots glow and intensify as the concentration of antibodies increases.
A certain pattern of autoantibodies, some in amounts too small to contribute to autoimmune disease on their own, was found to interfere with common checkpoint inhibitors such as Opdivo and Yervoy as well as combinations of the two, the researchers said.
“That we identified 283 autoantibody signals shows that the biological phenomena underlying recurrence and toxicity are complex, and cannot be driven by one or two biomarkers,” senior study author Iman Osman, M.D., a professor of dermatology at NYU, said in a release.
The results were published in the journal Clinical Cancer Research. Researchers said further trials are needed to validate the use of the test in the clinic, including how it may offer more precise treatment recommendations.
The researchers said they also plan to put the predictive value of the autoantibody signatures up against other cancer types where checkpoint inhibitors are approved.