Imaging Tumor-Infiltrating T-cells in Non-Small Cell Lung Cancer
Imaging Tumor-Infiltrating T-cells in Non-Small Cell Lung Cancer (Donan trial)
In this project the consortium partners introduce advanced imaging technologies to track patients’ own immune cells on their way into a cancer lesion, which is a critical step in immune therapy. In collaboration with AstraZeneca BV, Radboudumc investigates the potential of these imaging technologies in patients with early stage lung cancer.
Following the success of blocking immune checkpoint molecules PD-1/PD-L1, there has been an explosion in immune therapy trials. In 2018, there were 570+ clinical trials open, focusing on PD-1/PD-L1. Without appropriate use of novel imaging techniques, these developments will spin out of control, both in terms of costs and in time to find the most effective combinations.
The consortium partners investigate three novel techniques in patients with early stage lung cancer who will receive a short course of immune therapy prior to their standard treatment, which is surgical removal of the lung cancer. First, the therapeutic antibody targeting PD-L1 will be labeled with a radioactive label, allowing to assess whether it reaches the cancer. Second, a perfusion-CT scan assesses the local blood flow within the cancer, which is critical to efficiently deliver the therapy to the cancer. Last, patients’ own immune cells, which should do the job of attacking cancer cells, are isolated from the blood, labeled with a radioactive label and re-infused to track their ways. The unique setting here is that after surgical removal of the lung cancer, these imaging techniques will be validated on the cancer tissue.
They will deliver a novel imaging toolbox that speeds up the development of effective immune therapy as it allows to assess whether the drugs actually work how they are supposed to work in small pilot studies, before starting large, expensive clinical trials.