personalized cancer
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2022 ◽  
Vol 8 ◽  
Author(s):  
Manuela Monti ◽  
Tom Degenhardt ◽  
Etienne Brain ◽  
Rachel Wuerstlein ◽  
Alessandra Argusti ◽  
...  

Background: Academic research is important to face unmet medical needs. The Oncological community encounters many hurdles in setting up multicenter investigator-driven trials mainly due to administrative complexity. The purpose of a network organization at a multinational level is to facilitate clinical trials through standardization, coordination, and education for drug development and regulatory approval.Methods: The application of an European grant foresees the creation of a consortium which aims at facilitating multi-center academic clinical trials.Results: The ERA-NET TRANSCAN Call 2011 on “Validation of biomarkers for personalized cancer medicine” was released on December 2011. This project included Italian, Spanish, French and German centers. The approval process included Consortium constitution, project submission, Clinical Trial Submission, and activation on a national level. The different timescales for submitting study documents in each Country and the misalignment of objections by each Competent Authority CA, generated several requests for changes to the study documents which meant amendments had to be made; as requested by the 2001/20/EC Directive, the alignment of core documents is mandatory. This procedure impacted significantly on study activation timelines. Time to first patient in was 14, 10, 28, and 31 months from the date of submission in Italy, France, Spain, and Germany, respectively. Accrual was stopped on 22nd January 2021 due to an 18F FES shortage as the primary reason but also for having exceeded the project deadlines with consequent exhaustion of the funds allocated for the project.Conclusions: Pharmaceutical companies might be reluctant to fund research projects aimed at treatment individualization if the approval for a wider indication has already been achieved. Academic trials therefore become fundamental for promoting trials which are not attractive to big pharma. It was very difficult and time consuming to activate an academic clinical trial, for this reason, a study may become “old” as new drugs entered into the market. National institutions should promote the development of clinical research infrastructures and network with competence in regulatory, ethical, and legal skills to speed up academic research.


2022 ◽  
Author(s):  
Cody A Ramirez ◽  
Felix Frenkel ◽  
Michelle Becker ◽  
Erica K Barnell ◽  
Ethan D McClain ◽  
...  

Personalized cancer vaccines designed to target neoantigens represent a promising new treatment paradigm in oncology. In contrast to classical idiotype vaccines, we hypothesized that polyvalent vaccines could be engineered for the personalized treatment of follicular lymphoma (FL) using neoantigen discovery by combined whole exome sequencing (WES) and RNA sequencing (RNA-Seq). Fifty-eight tumor samples from 57 patients with FL underwent WES and RNA-Seq. Somatic and B-cell clonotype neoantigens were predicted and filtered to identify high-quality neoantigens. B-cell clonality was determined by alignment of B-cell receptor (BCR) CDR3 regions from RNA-Seq data, grouping at the protein level, and comparison to the BCR repertoire of RNA-Seq data from healthy individuals. An average of 52 somatic mutations per patient (range: 2-172) were identified, and two or more (median: 15) high-quality neoantigens were predicted for 56 of 58 samples. The predicted neoantigen peptides were composed of missense mutations (76%), indels (9%), gene fusions (3%), and BCR sequences (11%). Building off of these preclinical analyses, we initiated a pilot clinical trial using personalized neoantigen vaccination combined with PD-1 blockade in patients with relapsed or refractory FL (#NCT03121677). Synthetic long peptide (SLP) vaccines were successfully synthesized for and administered to all four patients enrolled to date. Initial results demonstrate feasibility, safety, and potential immunologic and clinical responses. Our study suggests that a genomics-driven personalized cancer vaccine strategy is feasible for patients with FL, and this may overcome prior challenges in the field.


2022 ◽  
pp. 399-426
Author(s):  
Amrendra Kumar ◽  
Kevin P. Weller ◽  
Anna E. Vilgelm

2021 ◽  
pp. canres.2200.2021
Author(s):  
Songfa Zhang ◽  
Chuan Yan ◽  
David G. Millar ◽  
Qiqi Yang ◽  
James M. Heather ◽  
...  

2021 ◽  
Vol 23 (1) ◽  
pp. 216
Author(s):  
Hyunho Yoon ◽  
Sanghoon Lee

Precision oncology involves an innovative personalized treatment strategy for each cancer patient that provides strategies and options for cancer treatment. Currently, personalized cancer medicine is primarily based on molecular matching. Next-generation sequencing and related technologies, such as single-cell whole-transcriptome sequencing, enable the accurate elucidation of the genetic landscape in individual cancer patients and consequently provide clinical benefits. Furthermore, advances in cancer organoid models that represent genetic variations and mutations in individual cancer patients have direct and important clinical implications in precision oncology. This review aimed to discuss recent advances, clinical potential, and limitations of genomic profiling and the use of organoids in breast and ovarian cancer. We also discuss the integration of genomic profiling and organoid models for applications in cancer precision medicine.


Pharmaceutics ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 28
Author(s):  
Sarah Shigdar ◽  
Lisa Agnello ◽  
Monica Fedele ◽  
Simona Camorani ◽  
Laura Cerchia

The identification of tumor cell-specific surface markers is a key step towards personalized cancer medicine, allowing early assessment and accurate diagnosis, and development of efficacious targeted therapies. Despite significant efforts, currently the spectrum of cell membrane targets associated with approved treatments is still limited, causing an inability to treat a large number of cancers. What mainly limits the number of ideal clinical biomarkers is the high complexity and heterogeneity of several human cancers and still-limited methods for molecular profiling of specific cancer types. Thanks to the simplicity, versatility and effectiveness of its application, cell-SELEX (Systematic Evolution of Ligands by Exponential Enrichment) technology is a valid complement to the present strategies for biomarkers’ discovery. We and other researchers worldwide are attempting to apply cell-SELEX to the generation of oligonucleotide aptamers as tools for both identifying new cancer biomarkers and targeting them by innovative therapeutic strategies. In this review, we discuss the potential of cell-SELEX for increasing the currently limited repertoire of actionable cancer cell-surface biomarkers and focus on the use of the selected aptamers as components of innovative conjugates and nano-formulations for cancer therapy.


2021 ◽  
Author(s):  
Xian Xian Liu ◽  
Gloria Li ◽  
Wei Lou ◽  
Juntao Gao ◽  
Simon Fong

[Background]: An emerging type of cancer treatment, known as cell immunotherapy, is gaining popularity over chemotherapy or other radia-tion therapy that causes mass destruction to our body. One favourable ap-proach in cell immunotherapy is the use of neoantigens as targets that help our body immune system identify the cancer cells from healthy cells. Neoan-tigens, which are non-autologous proteins with individual specificity, are generated by non-synonymous mutations in the tumor cell genome. Owing to its strong immunogenicity and lack of expression in normal tissues, it is now an important target for tumor immunotherapy. Neoantigens are some form of special protein fragments excreted as a by-product on the surface of cancer cells during the DNA mutation at the tumour. In cancer immunotherapies, certain neoantigens which exist only on cancer cells elicit our white blood cells (body's defender, anti-cancer T-cell) responses that fight the cancer cells while leaving healthy cells alone. Personalized cancer vaccines there-fore can be designed de novo for each individual patient, when the specific neoantigens are found to be relevant to his/her tumour. The vaccine which is usually coded in synthetic long peptides, RNA or DNA representing the neo-antigens trigger an immune response in the body to destroy the cancer cells (tumour). The specific neoantigens can be found by a complex process of biopsy and genome sequencing. Alternatively, modern technologies nowa-days tap on AI to predict the right neoantigen candidates using algorithms. However, determining the binding and non-binding of neoantigens on T-cell receptors (TCR) is a challenging computational task due to its very large search space. [Objective]: To enhance the efficiency and accuracy of traditional deep learning tools, for serving the same purpose of finding potential responsive-ness to immunotherapy through correctly predicted neoantigens. It is known that deep learning is possible to explore which novel neoantigens bind to T-cell receptors and which ones don't. The exploration may be technically ex-pensive and time-consuming since deep learning is an inherently computa-tional method. one can use putative neoantigen peptide sequences to guide personalized cancer vaccines design. [Methods]: These models all proceed through complex feature engineering, including feature extraction, dimension reduction and so on. In this study, we derived 4 features to facilitate prediction and classification of 4 HLA-peptide binding namely AAC and DC from the global sequence, and the LAAC and LDC from the local sequence information. Based on the patterns of sequence formation, a nested structure of bidirectional long-short term memory neural network called local information module is used to extract context-based features around every residue. Another bilstm network layer called global information module is introduced above local information module layer to integrate context-based features of all residues in the same HLA-peptide binding chain, thereby involving inter-residue relationships in the training process. introduced. [Results]: Finally, a more effective model is obtained by fusing the above two modules and 4 features matric, the method performs significantly better than previous prediction schemes, whose overall r-square increased to 0.0125 and 0.1064 on train and increased to 0.0782 and 0.2926 on test da-tasets. The RMSE for our proposed models trained decreased to approxi-mately 0.0745 and 1.1034, respectively, and decreased to 0.6712 and 1.6506 on test dataset. [Conclusion]: Our work has been actively refining a machine-learning model to improve neoantigen identification and predictions with the determinants for Neoantigen identification. The final experimental results show that our method is more effective than existing methods for predicting peptide types, which can help laboratory researchers to identify the type of novel HLA-peptide binding. Keywords: machine learning; Cancer Cell Immunology; HLA-peptide binding Neoantigen Prediction; HLA; Data Visualization; Novel Neoanti-gen and TCR Pairing Discovery; Vector representation


Author(s):  
Guilhem Richard ◽  
Michael F. Princiotta ◽  
Dominique Bridon ◽  
William D. Martin ◽  
Gary D. Steinberg ◽  
...  

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