Advances in immunotherapy have dramatically changed the landscape for cancer researchers. With significant improvements in overall survival and recurrent free survival in some of the deadliest cancers, lives have been extended by years for some patients while other patients have not experienced benefit from immunotherapy treatment. For some cancer indications, such as non-small cell lung cancer, the FDA approved companion diagnostic test for PD-L1 by immunohistochemistry has predictive value on patient response. However, the test is not a perfect indicator of response as some PD-L1 negative patients will respond to therapy and, conversely, some PD-L1 positive patients will not. At the same time, the number of clinical trials examining immunotherapy and combination therapies with immunotherapy as a backbone has exceeded 1000 in 2017. The possibility of combination therapy brings many questions to light for the researcher and ultimately the physician on which therapy to choose, for how long, in what order and what potential combination. With these questions, comes the increasing need for predictive tests that can lead the physician to the right therapy at the right time.Read More
Path to personalised medicine
Pathology is one of the main driving forces behind personalised or precision medicine. In fact it has always striven towards the accurate diagnosis and prognosis of a patient’s disease through the observation of tissue architecture under the microscope. Through the application of international staging guidelines, such as the Tissue, Node, Metastasis (TNM) system in the majority of cancers, pathologists are very good at predicting prognosis at the population scale but not so good at predicting a prognosis for the individual patient. For example, if a patient presents with stage II colorectal cancer (CRC) they are predicted to have 20-30% chance of succumbing to their disease. However, it is currently difficult to accurately identify if an individual patient will be within that 20-30% group.Read More
One way to develop prognostic and predictive tests in oncology is through the use of genomic biomarkers. And as more diagnostics companies are recognizing the potential benefits of this method, we’re seeing an increase in the number of companion diagnostic tests relying on gene-based biomarkers. Another reason for this continued trend towards personalized medicine is the continually decreasing costs of whole-genome sequencing.Read More
Anitei, M.G. et al. Prognostic and Predictive Values of the Immunoscore in Patients with Rectal Cancer. Clin Cancer Res. 2014 Apr 1;20(7):1891-9. doi: 10.1158/1078-0432.CCR-13-2830.
PURPOSE: To determine whether the tumor immune infiltrate, as recently evaluated with the Immunoscore methodology, could be a useful prognostic marker in patients with rectal cancers. Read more
Ichimura, T. et al. Prognostic Significance of CD204-Positive Macrophages in Upper Urinary Tract Cancer. Ann Surg Oncol. 2014 Feb 4. [Epub ahead of print].
BACKGROUND: Evidence suggests that CD204-positive (CD204(+)) tumor-infiltrating macrophages are associated with aggressive behavior of various cancers; however, the clinical, pathological, and prognostic associations of tumor-infiltrating CD204(+) macrophages in urothelial cancer have not been reported. Read more
Jiao, J. et al. Cell-Type Specific Roles for COX-2 in UVB-induced Skin Cancer. Carcinogenesis. 2014 Feb 17. [Epub ahead of print].
In human tumors, and in mouse models, cyclooxygenase-2 (COX-2) levels are frequently correlated with tumor development/burden. In addition to intrinsic tumor cell expression, COX-2 is often present in fibroblasts, myofibroblasts and endothelial cells of the tumor microenvironment, and in infiltrating immune cells. Intrinsic cancer cell COX-2 expression is postulated as only one of many sources for prostanoids required for tumor promotion/progression. Read more