A new collaboration between Roswell Park Comprehensive Cancer Center and University of Rochester’s Wilmot Cancer Institute will help oncologists learn whether black and white cancer patients respond differently to immunotherapy treatment and seeks to improve the safety and effectiveness of these newer drugs in diverse populations.
Funded by a two-year, $2.08 million grant from the National Cancer Institute (NCI), the two Western New York cancer research institutes aim to fill a gap in the science around immune checkpoint inhibitors (ICIs).
ICIs such as nivolumab (Opdivo) and pembrolizumab (Keytruda) have become standard care for 16 different types of cancer, both early and advanced-stage. They work by blocking signals in the immune system, allowing the body’s natural T cells to kill cancer. Since their approval in 2011, the use of these drugs has increased and is believed to be partly responsible for a significant drop in U.S. cancer deaths.
There remain opportunities to improve the care of patients who may benefit from ICIs. For example, few people of African ancestry participated in the original clinical trials to evaluate these treatments. The Roswell Park-Wilmot collaborators plan to collect data that will allow them to investigate side effects, toxicities and outcomes among people of African ancestry who take immune checkpoint inhibitors.
The research builds on discoveries from Roswell Park that helped explain why standard treatments are often less effective in patients of African ancestry.
“Checkpoint inhibitors have largely not been studied in black cancer patients, but our recent findings show that there may be a particular benefit to these immunotherapies for cancer patients of African ancestry — across a variety of cancer types,” said Christine Ambrosone, Chair of Cancer Prevention & Control at Roswell Park and a co-investigator on the study.
“Because Black cancer patients tend to have a prevalence of what we call ‘exhausted,’ non-functional T cells, we realized they may be more likely to do well on immune checkpoint inhibitors, which target the exhausted T cells to revive them and restore their ability to fight cancer cells,” said Song Yao, Professor of Oncology in Roswell Park’s Department of Cancer Prevention and Control, co-principal investigator on the study. “But we can’t know this without further study, and this new project will tackle that knowledge gap in a large and diverse patient population.”
The NCORP network will allow the researchers to carry out the immune checkpoint study at hundreds of community oncology clinics in the NCORP network across the United States. The team also plans to enrol study participants in Western New York.
“Our project is designed to get the full 360 picture of Black patients who receive immunotherapy,” said Dr Charles Kamen, co-principal investigator. “Not only are we measuring their response to treatment, but we’re also looking at factors like discrimination by providers and health care systems and how often treatment is stopped, so that we have a better understand of equity and access to high-quality care.”
The Roswell-Wilmot collaborators have designed a large national study known as the DiRECT Cohort that will seek to enlist 600 black patient volunteers and 1,200 white cancer patients of European ancestry.
The project is reportedly the first large, national study of diverse patients treated with ICIs.
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