Periodic Reporting for period 1 - FANTOM (Future of ALCL: Novel Therapies, Origins, Bio-Markers and Mechanism of resistance)
Période du rapport: 2023-01-01 au 2024-12-31
Objective 1: Increase our understanding of the biological mechanisms, including the role of the immune system in ALCL, to inform on novel, less toxic therapeutic targets
The pathogenesis of ALCL is for the most part poorly elucidated with the mechanisms giving rise to this malignancy being little understood. However, the cell of origin of ALCL is postulated as an early thymic progenitor in which the driving oncogenic event, expression of the t(2;5) breakpoint product facilitates the acquisition of cancer hallmarks to incipient cancer cells. We are investigating this process further with a specific emphasis on the contributory role of the immune system and inflammatory signalling pathways. Employing a variety of model systems ranging from Genetically Engineered Mouse Models (GEMM) through to Patient Derived Xenografts (PDX), organoids, primary patient tumour material and cell lines, together with multiple omics technologies, we are studying the pathways that drive tumour growth, as well as the role of inflammatory cells with the aim of using these data to inform on novel therapeutic strategies and biomarkers for disease monitoring.
Objective 2: Apply our findings from the biology of ALCL to develop biomarkers for clinical translation
Primary patient tumours are being assessed for the status of their genomes, such as the presence of acquired mutations that may contribute to tumour growth using multiple omics technologies at a single cell level. In particular, single cell (sc) RNAseq, spatial transcriptomics, CyTOF, analysis of the epigenome and sc cDNA genotyping is being applied to develop prognostic algorithms. We are also assessing plasma components including exosomal small RNA (sRNA) species, circulating tumour DNA (ctDNA) and circulating antibodies to ALK. These data will be correlated to clinical data in order to identify at least 2 potential biomarkers for further clinical development, as well as to determine therapeutic targets in a personalised genomics approach.
Objective 3: Uncover mechanisms and origins of resistance of ALCL to therapy with tyrosine kinase inhibitors in order to identify novel therapeutic targets and develop a personalised therapeutic strategy
Relapse/refractory (r/r) disease is one of the major clinical problems and occurs both after chemotherapy, and targeted agents are employed in the clinic. To understand the mechanisms of resistance, we are employing scRNAseq, spatial transcriptomics and CRISPR screens towards the development of rescue therapies and/or therapeutic approaches that prevent r/r disease from occurring. Employing a variety of model systems from cell lines rendered resistant to targeted therapeutics through to PDX models of relapse and primary relapse tumour material, posited resistance mechanisms are being validated and assessed.
Work is ongoing with regards to the scientific aspects of the programme whereby many of the model systems required for the successful implementation of the project have now been developed. These include genetically modified cell lines and mouse models which will enable us to dissect apart the biology of this childhood lymphoma towards improved treatment outcomes. Work will now progress using these models to understand why and how this cancer develops in children. At the same time, a collection of patient samples and specimens has been collected and analysis has commenced to understand the unique genetics of these tumours. We are already developing hypotheses as to why some tumours are resistant to treatment and how this might be overcome in the future. This will be facilitated by the assays that are under development that will allow us to develop better prognostic biomarkers which can also be used to stratify children towards the best treatment approach for them. Ongoing work is now developing and validating these biomarker assays.