Doha: Researchers from Human Immunology in collaboration with the Anatomic Pathology and Oncology Divisions at Sidra Medicine have published a ground-breaking study on pediatric cancer tumours.
The study analysed the relationship between tumour cells and immune cells and the impact of anti-tumour immune responses related to the survival of young cancer patients. It was led by Shimaa Sherif (first author) as part of her PhD thesis, who was supervised by Dr. Wouter Hendrickx and Dr. Davide Bedognetti from Sidra Medicine and Dr. Borbala Mifsud from Hamad Bin Khalifa University.
Shimaa Sherif, first author of the study said, "Little is known regarding the importance of immune cells within tumours in children. In fact, despite therapeutic progresses in cancer treatment, it is still the first cause of death by disease in children. Cancer immunotherapy, a therapeutic strategy that unleashes our immune system to fight against cancer cells, has revolutionized the treatment of solid tumours in adults but pediatric tumours are in general resistant to this approach".
"Tumours are classified either as solid tumours, like those that originate in the kidney or in the bone, and liquid tumours, such as leukemia. The study focused on solid tumours in children. For the first time, we were able to demonstrate that solid pediatric cancers can be classified according to their immunologic compositions. We also identified some specific subtypes that might benefit from immunotherapeutic treatment approaches," Sherif continued.
Using the advanced gene expression analysis skills available at Sidra Medicines research branch, the team implemented methods and algorithms to quantify anti-tumour immune responses. Gene expression analysis, is a technique that allows to quantify the expression of approximately 20,000 genes in a single tumour biopsy. These genes are then analysed to quantify the intensity of immune reactions.
The study found that:
1) Pediatric solid tumours can be divided into six different types according to their immunological parameters, called "immune subtypes".
2) Different immune subtypes are associated with distinct risk of death.
3) An immune signature developed at Sidra Medicine, called immunologic constant of rejection (ICR), accurately predicted the risk of death in patients with certain aggressive tumours such as a subtype of neuroblastoma, one of the most aggressive pediatric cancers.
4) Specific immune markers associated with unfavorable prognosis were also identified, which could be explored as targets for novel immunotherapeutic approaches.
5) Knowing the risks associated with the different immune sub-types could be used to decide the intensity and type of systemic treatment for each patient.
Dr. Wouter Hendrix, Principal Investigator from Sidra Medicines Laboratory of Pediatric Cancer Omics who was the leading senior author of the study said, "In solid tumours, the study demonstrated that the presence and function of immune cells (also called the immune contexture) firstly predicts the risk of relapse and death and secondly, it identifies a subgroup of patients that might benefit from immunotherapy. Our study also suggests that the quantification of the immune cells and their function in the tumour could be used as an advanced diagnostics tool to estimate the risk of relapse and death and therefore to guide treatment choice. It is taking a precision medicine approach to pediatric cancer treatment."
Dr. Davide Bedognetti, Executive Director of the Translational Medicine Department, and Director of the Human Immunology Division, who is leading Sidra Medicines cancer immunology research said, "This is a timely research particularly coming out to coincide with Childhood Cancer Awareness Month which falls every year in September and highlights Sidra Medicines continuing commitment to precision medicine and cancer research. Our call to action to the wider pediatric cancer research community is that more larger studies, aimed at increasing sensitivity and specificity of this immune classification, should be performed to bring this approach into clinical practice."
