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An analysis of samples obtained from a uniquely designed window-of-opportunity clinical trial (LUD2015-005) has shown that high tumour monocyte content (TMC) is an unexpected predictor of greater overall survival in inoperable oesophageal adenocarcinoma (OAC) patients.

A sophisticated analysis of samples collecting in the first clinical trial developed by Ludwig Oxford uncovered a link between tumour monocyte content and overall survival in patients with EAC. The study, conducted by Thomas Carroll and colleagues within the Lu research group and the LUD2015-005 project team also found that the association between TMC and improved outcomes could hold for the most common forms of gastric cancer. Tumour mutational burden (TMB) also predicted survival outcomes, and the combination of this measurement with monocyte content was more effective at predicting therapeutic outcomes than either was alone.

The trial, supported by Ludwig Institute for Cancer Research, Cancer Research UK Centres Network Accelerator Award grants, Experimental Cancer Medicine Centre grants, AstraZeneca UK Ltd and National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre grants, gave four weeks of immunotherapy with immune checkpoint inhibitors (ICI) alone prior to the combination immunochemotherapy (ICI+CTX).

In addition, the analysis revealed a novel T cell inflammation signature (INCITE) which is upregulated in tumours from ICI-induced tumour shrinkage during the first few weeks of treatment. With additional clinical assessment, This signature could be used to predict a patient’s likely responsiveness to immunotherapy in a variety of cancers.

More details can be seen in the Press Release by the Ludwig Institute for Cancer Research and the full paper can be found at Cancer Cell.

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DPhil study opportunities are available in the form of Ludwig studentships with Dr Parinaz Mehdipour and Professor Xin Lu/Dr Richard Owen