2020 LCRF Research Grant on Disparities in Lung Cancer
Joshua Campbell, PhD
Boston University
Research Project:
Determining differences in immunotherapy outcomes and immunobiology in African American patients with NSCLC
Summary:
Novel classes of cancer therapeutics work by activating the immune system, which in turn targets and kills cancer cells. These “immunotherapies” have had great success in treating some patients with advanced stage lung cancer. However, we do not fully understand why immunotherapy works for some lung cancer patients yet not for others. There is a major need to more fully characterize the immune system in lung cancer patients and determine the clinical and biological factors that are necessary for an immunotherapy to work effectively. For aim 1 of this study, we will determine if there are significant differences in immunotherapy response and toxicity between African American (AA) patients and other populations. Single-cell RNA sequencing is a new approach that can measure the genes which are turned on or off in individual cells. For the second aim of this study, we will perform single-cell RNA-seq on lung biopsies from AA and non-AA patients to determine if molecular pathways associated with response to immunotherapy are similar or different between populations. Identifying molecular features that are associated with response in AA patients can lead to the development of new diagonostic biomarkers and potentially identify novel avenues of therapeutic development.
Final report:
The goal of the project was to determine whether there were differences in outcomes between African American lung cancer patients and patients from other backgrounds who have been treated with immunotherapy. The researcher hypothesized that there may be differences in response and survival based on underlying molecular differences in immune biology. Patients treated with immunotherapy at the Boston Medical Center were identified and information on race and several other clinical parameters were captured. Unexpectedly the survival of the African American patients was better than other racial groups. The incidence of immune related adverse events was similar. Work for Aim 2 is still ongoing. Patient specimens were collected, and the plan is to analyze them using single cell profiling to look for differences in the patient population that might explain differences in response to treatment.
Impact:
Assessing racial differences in responses and survival from cancer treatment is of great interest. The differences could be related to access to treatment, socioeconomic factors, and development of adverse events making optimal treatment difficult for certain individuals. There is also the possibility that race may be contributing to differences at the very molecular level (pharmacogenomics). All these differences need to be sorted out so that customized treatment can be given to each patient to obtain the best outcomes.