Dr Janice Mehnert on the Importance of Biomarkers, Microbiome in Cancer

Janice Mehnert, MD, Head of the Phase I Developmental Therapeutics Program at Rutgers Cancer Institute of New Jersey, and the Head of the Melanoma Research Team, discusses the role that multiple biomarkers and the microbiome play in treatment decisions in oncology.

Transcript

You’ve written about the importance of biomarkers and about the need for multiple biomarkers. Are you seeing progress in this area?

So, I think we’re seeing a lot of dedicated effort toward the sophisticated quality collection of tissue specimens. I think we are still rather far away from the holy grail of having a test we can run prospectively to tell us when we meet a patient what type of therapy that patient should have. But certainly, the importance of having those assessments is noted by the immunotherapy community.

The problem, as I’ve written, is the immune microenvironment is very dynamic, and having one assessment that captures everything that is relevant is rather challenging—and may be out of reach. But certainly, it’s a topic of hot research, and the value of it is very much recognized. I think that we’re working on it, but I think we are [a way off] from having hard tests we can order in clinical practice.

There have been many studies in the literature recently about the microbiome and the potential here both in diagnostic and therapeutic strategies in immunotherapy. How important is this area, in your opinion?

I think it’s very important—it’s important to understand under the relevance. I just came back from the society of Melanoma Research in Manchester, England, and both Drs Jennifer Wargo and Jennifer McQuade gave excellent talks in this area.

I think of the immune system in three parts. They’re not separate; they’re integrated:

• There’s the tumor and its genomic factors and genomic presence.
• I think of the tumor microenvironment that the tumor sits in and interacts with,
• And there are host-specific factors, and that’s where the microbiome comes into play.

Certainly, understanding the relevance of how an individual microbiome may be applicable to the response to immunotherapy and the development of the cancer is mind-boggling, but it’s a very, very important topic and we’re going to be hearing a lot about it as we move forward.