Strategic Immuno-Monitoring of Patient Therapy (SIMPATHY) in the context of Basket of Baskets (BoB) trial – Atezolizumab Module

The crucial questions that SIMPATHY will start to address are:

• How to identify tumours that will respond?
• How to identify why some initially responsive tumours become resistant and how to avoid this or render them responsive again?
• How to transform non-responsive tumours into responsive tumours?

In order to do so the SIMPATHY proposal aims to produce a detailed map of the tumour immune microenvironment before, during and after failure of ICI treatment with the anti-PD-L1 monoclonal atezolizumab, contextualized with genomic and systemic immune features. This may allow identification of novel biomarkers across cancers of different cell origin. Recent results have shown that pre-treatment analyses may not be sufficient to predict response but that early biopsies on treatment may provide more useful information.

The context of BoB for SIMPATHY allows:

• Matched trial-grade clinical data.
• Genomic profiling of all baseline tumour samples with the Cancer Core Europe (CCE) gene panel and whole exome sequencing.
• PBMC, cfDNA analyses.
• Simple integration of further translational assays for SIMPATHY within established infrastructure, with required state-of-the-art assays available across the CCE centers.
• Experience of CCE physicians in obtaining high success rates for baseline and repeat biopsies.
• Bioinformatics expertise shared across CCE centres for data analysis.

More information: Gary Doherty, project lead, gd231@cam.ac.uk