Chapter Ten - Nucleic acid biomarker technology for cancer immunotherapy

Abstract

Immunotherapy is an important tool to improve the health outcomes of cancer patients in both the short and long term. It is important to recognize, however, that not every patient will receive the benefits of immunotherapeutic approaches. This leaves many patients with exposure to significant drug toxicities without experiencing the substantial clinical benefits that other patients can experience. Predictive biomarkers can help limit such unnecessary toxic exposure in patients who are not likely to experience clinical benefit from immunotherapy. Moreover, these biomarkers can also help to identify the individuals who will have the best outcome with immunotherapy. The previous chapter topics in the book have focused on cancer immunotherapy, related therapeutic biomarkers, and engineering technology to enhance the efficacy of immunotherapeutic field. The current chapter builds on this by focusing on cancer immunotherapy and use of nucleic acid biomarker. The immune checkpoint inhibitors are investigated much more than other immunotherapy drugs and hence the predictive nucleic acid biomarkers for these drugs are also well studied; however, we will not be focusing only on the immune checkpoint inhibitors. We will also focus on few emerging concepts in the form of epigenomic signatures, single cell genomic approaches and CRISPR-based screening assays for immunotherapy. The circulating tumor DNA, tumor mutational burden, tumor transcriptomic signature, circulating tumor cells as well as host immunological markers, also play a great role in determining the immunotherapy effects and have a potential to impact the translation into the clinical field of nucleic acid biomarker. The integration of genomic and proteomic methods in concert with advancements in artificial intelligence and next-generation sequencing will enable cancer immunotherapy to transition toward personalized medicine