Multi-omics biomarker discovery for individualized nivolumab treatment in esophageal cancer
Amsterdam UMC and Auristone aim to identify clinically meaningful biomarkers for improved treatment decision in esophageal cancer. Amsterdam UMC contributes a large well-annotated esophagogastric cancer cohort and expertise in tumor-stroma interactions, alongside an established infrastructure for ethical/regulatory compliance. Auristone provides an advanced multi-omic profiling platform and computational pipelines enabling high-resolution molecular and cellular profiling.
Esophageal cancer affects over 3.000 Dutch patients annually, of whom 600-800 are eligible each year for adjuvant nivolumab, an immunotherapy given after neoadjuvant chemoradiatiotherapy and surgery. However, not all patients respond to this treatment.
Dutch healthcare spending on immune checkpoint inhibitors (ICIs) for solid tumours increased from 63 million (2017) to 429 million (2023), with annual per-patient costs of 70-100k for PD-1 therapy. If biomarkers could prevent ICI use in non-responders, comprising 12-23% of treatments, direct drug-cost savings would be ~50-100 million per year, without counting the burden of unnecessary side effects on patients. Better tools to select patients most likely to benefit from adjuvant nivolumab are therefore urgently needed. Currently, clinically implemented composite biomarkers for guiding individualized treatment are lacking.
The tumour microenvironment, including immune and stromal components, strongly influence immunotherapy responses. Using an innovative approach integrating immune cell profiles, cancer-associated fibroblast subtypes, and transcriptomic/epigenomic features through Auristone’s platform and computational pipelines, patterns predicting treatment response can be identified. This extends beyond current standard diagnostic techniques, enabling robust composite biomarker development for more precise patient selection. Moreover, these biological insights will translate Auristone’s platform into a clinically usable tool for patient selection.
The project will deliver a validated composite biomarker for patient selection, advanced platform that guide treatment decision, and cost-effective insights for Dutch healthcare. Ultimately, this ensures that treatment is directed to those with greatest likelihood of response, improving outcomes while reducing unnecessary toxicity and healthcare costs.
