Clinical trial provides new immunotherapy insights for kidney cancer
Researchers at The Royal Marsden, Francis Crick Institute and University College London (UCL) have found immune cell patterns within tumours that can help predict whether patients with kidney cancer will respond to immunotherapy. Results from the ADAPTeR clinical trial were published in Cancer Cell journal today, 28th October 2021.
Lewis Au, co- lead author and clinical research fellow at The Royal Marsden and the Crick, whose role is supported by funding from The Royal Marsden Cancer Charity said:
“Analysing multiple samples from each patient, both from different parts of the kidney tumour and from tumours that have spread to other organs, is critically important. It’s known that molecular information in kidney cancer is distributed like a mosaic within the tumour – such that taking a single sample may not capture all the information needed for a comprehensive analysis.
“In people who respond to this immunotherapy there is a group of T cells which appear to have already recognised the tumour, through these specific receptors. These cells, with potential tumour killing activity, are sitting on the tumour, but they need the drug to kick them into action. When T cells bearing these receptors are effectively attacking the tumour, we can see them accumulating within the cancer. But in cases where their receptors don’t recognise the tumour, they are replaced by other T cells with different receptors as the immune system tries to find a match that recognises and kills the tumour.
“Our study also shows how in-depth studies of cancer biology within clinical trials can be incredibly powerful.”
Annie Vigneau-Singh, a kidney cancer patient at The Royal Marsden, received treatment through the ADAPTeR trial from May 2017 for four years.
Annie said: “Following my diagnosis in 2015, I’d had surgery to remove my left kidney but six months later, my scans showed that the cancer was spreading to my lungs. I was given the option to be part of a new immunotherapy trial called ADAPTeR and be treated with the drug, Nivolumab, which wouldn’t have been available as a treatment option outside of this clinical trial at the time. Immunotherapy sounded hopeful and I was very keen to try this new treatment. Within eight weeks of starting the trial, scans showed that the growth on the lung had reduced quite a lot. I also had no side effects. Everything had worked so well that it was quite incredible. It was such a positive result and a relief that I burst into tears.
“Sadly, my scans in March 2021 showed small progression in my lungs once again and, whilst I felt well, the drug was no longer working for me. After four years I was taken off the trial and immediately began a new treatment, I hope to be able to join another trial in future. Though the success of clinical research may vary, participation is exactly how advances in cancer care are made. I am so glad to have participated in the ADAPTeR trial and helped The Royal Marsden’s oncologists make new discoveries in the treatment of kidney cancer.”
Samra Turajlic, Consultant Oncologist at The Royal Marsden and group leader of the Crick’s Cancer Dynamics Laboratory said: “Immunotherapy has transformed our ability to treat certain cancers like melanoma skin cancer, kidney cancer, and lung cancers. But there’s still a lot of research to do to help us understand the precise ways it works and why it’s effective in some patients and not others.”
The ADAPTeR trial is sponsored by The Royal Marsden and partly funded by the National Institute for Health Research Biomedical Research Centre (NIHR BRC) at the Royal Marsden Hospital and Institute of Cancer Research, London, and Cancer Research UK.