The dynamic young founder and director of City of Hope’s Precision Imaging Lab, Ammar Chaudhry, M.D.
, is one of the first recipients of the new ORIEN NOVA
Award. The $1 million grant will fund research for his breakthrough approach to cancer imaging and diagnosis.
The study will focus on a major challenge in this era of targeted cancer therapies — creating advanced diagnostic technologies to help fully realize the potential of these remarkable new treatments.
“The new immunotherapies have been extremely effective for some patients, but the results have been mixed in others,” Chaudhry said. “And the key to better prediction lies in more accurate diagnosis for patient selection.”
He will be working with David Carbone, M.D., of Ohio State University, an internationally renowned lung cancer specialist. This will allow the study to draw subjects from both Southern California and the Midwest, areas with very different demographics, providing to a wider cross-section of age, gender and ethnicities — all factors that can affect the nature of a disease and its treatment outcomes.
BEYOND BIOPSIES — REAL-TIME, WHOLE-BODY DIAGNOSIS
Currently, candidates for targeted immunotherapy are chosen by taking a biopsy to identify the presence of certain tumor markers — but this method has drawbacks.
When there are many tumors, or when the cancer has metastasized, a biopsy of every site might not be possible — yet different sites may have different markers, which is one reason some patients don’t respond to immunotherapy. What’s more, sometimes, in such cases as brain lesions or a tumor next to a blood vessel, a biopsy can have serious consequences, so in many of these instances where a biopsy is not amenable, immunotherapy is excluded as an option.
Chaudhry has developed a noninvasive technology to assess not just a few tumors, but every cancer site throughout the body. The results should be applicable for many different types of treatment, but this study will focus on one medication, pembrolizumab
, an immune checkpoint inhibitor
that has been Food and Drug Administration approved for lung cancer, melanoma and several other types of cancer.
“Basically, we bind the imaging agent copper-64 to pembrolizumab, then we inject it through an IV, which takes about a minute,” Chaudhry explained. “Twenty-four hours later we do a whole-body PET-CT
scan to see where the imaging agent lights up. If it has been taken up at the cancer sites, the patient should respond to immunotherapy treatment.”
Another great advantage of this technology is that it will provide real-time results.
“I don't know if you've had family or friends, God forbid, who have had to deal with these sort of biopsies, but I have,” said Chaudhry, who as a child watched both his parents cope with life-threatening illnesses. “You get a biopsy and may wait six to eight weeks for some sort of result. But with this imaging, you know the result quickly.”
The unusually large grant and the small size of this two-year study — they plan to enroll just 20 patients — will allow greater depth than most pilot projects, and in addition to imaging, they will also do a genomic analysis of the subjects.
Chaudhry decided on this aspect of the study when he noticed that certain mutations increase or decrease the expression of PDL1, a protein marker in tumors that respond to pembrolizumab. Patients with a mutation that suppresses PDL1 aren’t good candidates for this drug — but the genomic information can open the door to alternative treatments.
“I don't just want to tell the patient, ‘Sorry, you're not going to respond to pembrolizumab,’” he said. “With a genomic assessment, I can suggest another therapy they’re more likely to respond to. After all, we're at City of Hope and I want to give them hope.”
OTHER CITY OF HOPE DOCTORS PARTICIPATING IN STUDIES
In addition, two other City of Hope doctors will be participating in ORIEN NOVA research. Alex Herrera
, M.D., an assistant professor in the Department of Hematology and Hematopoietic Cell Transplantation, will be participating in a project led by Christopher Flowers, M.D., at Emory University targeting relapsed non-Hodgkin's lymphoma subtypes. He received a research award of $50,000.
, M.D., assistant clinical professor in the Department of Medical Oncology & Therapeutics Research, will be engaging in a project led by Donghai Dai, M.D., Ph.D., of Holden Cancer Center looking at tumor mutations and how they affect treatment response. There were no research funds attached.
More than 60 proposals were received from ORIEN cancer center faculty across the United States. Three ORIEN (Oncology Research Information Exchange Network) Avatar NOVA (New Oncologic Visionary Awards) grants totaling $2 million and four ORIEN Investigator Initiated Proposal (IIP) NOVA grants totaling $1 million were selected after a scientific peer review of the proposed projects. The ORIEN NOVA program was designed to enhance patient care by encouraging collaborative multidisciplinary team science across the ORIEN members, allowing researchers to share information and expertise, and accelerate cancer research.