Discovery of Tumor and Treatment Response Biomarkers

作为一名执业放射肿瘤学家，寻求将我的实验室和临床工作整合到一个有凝聚力的转化研究计划中，我将我的临床实践集中在转移性癌症患者的护理上，对他们来说，放射可能是有益的。这些放射治疗是在NIH的护理环境中提供的，通常包括某种形式的免疫导向治疗。这一患者群体相当大，这些患者占过去两年在NIH放射肿瘤学分支接受治疗的所有患者的近三分之一。为了能够最好地确定液体活检或生物流体生物标志物与治疗反应相关，该项目的转化研究工作遵循双管齐下的方法：1）与NIH的内科和外科肿瘤学同事合作，研究EV作为肿瘤状态的生物标志物，作为这些合作者现有方案的一部分，以及2）开发新的临床方案，以便以更紧密和信息丰富的方式从该患者群体中捕获信息和样本。这两种方法都得到CCR临床转化使命和转化纳米生物学部分正在进行的EV库研究的基础科学工作的支持，并为CCR的临床转化使命和基础科学工作提供支持。该项目的全部内容都是在为我们的患者提供最佳护理的背景下产生的，无论是标准护理还是临床试验，同时寻求更好的方法来为个体患者提供定制护理。这一努力导致了一些临床试验的发表，一些额外的临床试验的持续进展，以及多个额外的新临床试验的开发，这些临床试验将在未来一年提交CCR审查。

As a practicing radiation oncologist, seeking to integrate my laboratory and clinical efforts into a cohesive translational research program, I have focused my clinical practice on the care of patients with metastatic cancers, for whom radiation may be beneficial. These radiation treatments are provided in the setting of their care at NIH, which often includes treatment with some form of immune-directed therapy. This patient population is size-able, and these patients comprised nearly one third of all of the patients treated in the NIH Radiation Oncology Branch across the past two years. To best be able to determine what liquid biopsy or biofluid biomarkers correlate with responses to treatment, the translational research efforts of this project are following a two-pronged approach: 1) collaborating with medical and surgical oncology colleagues at NIH to investigate EVs as biomarkers for tumor status as part of those collaborators' existing protocols, and 2) developing new clinical protocols to capture information and samples from this patient population in a more cohesive and informative manner. Both of these approaches are supported by and provide support to the CCR's clinical translational mission and the basic scientific work ongoing in the Translational Nanobiology Section for the study of EV repertoires. The entirety of this project arises in the context of providing best available care to our patients, whether standard of care or on clinical trial, while seeking to identify better ways to tailor care for individual patients. This effort has led to publication of a number of clinical trials, ongoing progress of several additional clinical trials, and the development of multiple additional new clinical trials that will be submitted for CCR review in the upcoming year.