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Testing Biomarkers for immunotherapy: Choice or Necessity

posted on 8/2/2018 Facebook Facebook

Immunotherapy has now emerged to be “the drug of choice and desire” among physicians and patients. The treatment however extremely beneficial, is unaffordable by a large cohort of patient population.

Immunotherapy is a type of treatment that assists in stimulating immune cells against the developing disease. In cancer, the tumor mass functions majorly by suppressing the  immune mechanism by displaying surface antigens so as to not be recognized as non-self. This way, the immune cells (T-cells) are secured of cytotoxic action by cancer generated ligands. Immunotherapeutic drugs function to snap the suppressive activities of tumor mass thereby re-activating T-cells towards destruction of non-self cells.

By this approach, foreign cells are destrcuted at the maximum rate with far minimal adverse effects to the normal cells as compared with other approaches. Despite the extreme benefits of immunotherapy in aggressive tumors, failure rates are still high after few cycles due to incompatibility and plasticity of individual genetic make-up. Also, not all types of cancers are targetable by this selected therapy. Cost of immunotherapy is also an alarming factor which demands minimization of unnecessary resource utilization in “trial and error” treatment approach. Thus precision in drug choice is highly challenging among oncologists in this clinical scenario.

Its now the era of genomic biomakers to explore cellular plasticity therbey deliver immunotherapy as utilizable as possible in eligible candidates. Testing biomarkers may also act beneficial in eliminating the unnecessary medical expenditure on trial based treatment. Several national and international guidleines are also in approval of specific biomarkers for immunotherapy.

PDL-1, CTLA4, Microsatellite Instability and Tumor Mutation Burden are some of the major biomarkers employed in determining immunotherapy. Several molecular techniques such as Immunohistochemistry, Real-time PCR, RNA/DNA sequencing are in rise to test these biomarkers rendering response predictive outcomes. Determining the right technique is highly dependent on the treating expert and patient health and economic conditions.However, it is also necessary to apprehend the attributes and limitations of every molecular technique towards accurate prediction of immunotherapy. Different techniques thus assist in predicting different outcomes to be utilized at the right situation for effective decision making. Genomic markers are thus gradually stepping into prediction of therapy shifting the paradigm from choice to necessity.

Let our body best fight its own disease!

By: Aarthi Ramesh, Scientific Officer, Positive Bioscience

Disclaimer:The opinions expressed in this blog are representative of the author and may not express the views of Positive Bioscience. This blog is intended for education and information for the general public. Before making any medical decisions a medical professional must be consulted. All rights reserved.

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