Researchers with BC Cancer have discovered a way to better predict treatment outcomes in patients with relapsed and refractory, or treatment-resistant, classic Hodgkin lymphoma.

A recent study published in the Journal of Clinical Oncology discovered a new class of biomarker, which is a sign or signal in the body that can provide information about health, disease or the effects of treatment. This new “spatial” biomarker is significant as it sheds light on the unique interactions between cancer cells and the tumour microenvironment, which includes surrounding cells.

“Understanding the exact architecture of a tumour’s environment – the tumour cells, surrounding cells and how they interact – provides a better resolution and more complete data on cancer cells than we have had before,” said Dr. Christian Steidl, senior author of the study, research director of the Centre for Lymphoid Cancer at BC Cancer and professor in the department of pathology and laboratory medicine at the University of British Columbia. “This is an exciting discovery that will allow us to identify biomarkers to not only predict outcomes for patients with relapsed and refractory Hodgkin lymphoma, but hopefully for all people with cancer.”

The research team was led by Dr. Steidl and included collaborating researchers from Cedars-Sinai Medical Center in Los Angeles, California, who performed imaging mass cytometry on primary diagnostic and relapse biopsies to generate detailed analyses of each cell. The researchers then measured the distance of the nearest cells to the cancer cells and used this spatial information in their prognostic models to predict patient outcomes.

This work extends previous studies which have demonstrated the importance of the tumour microenvironment. Specifically, a previous study from BC Cancer researchers has emphasized the importance of the macrophage in classic Hodgkin lymphoma. The macrophage is a type of white blood cell that plays an important role in the human immune system by carrying out functions that include clearing out debris and dead cells, and stimulating other cells involved in immune function.

“With our methodology, we’re improving on the baseline quite significantly,” said Dr. Tomohiro Aoki, postdoctoral fellow at BC Cancer’s Centre for Lymphoid Cancer and lead author of the publication. “This biomarker assay, or comparable techniques to study tumor microenvironment architecture, can now be readily used for clinical trials and can also be tested in a very modern era of immunotherapy in Hodgkin lymphoma.”

Despite recent treatment advances, approximately one-third of patients with relapsed and refractory Hodgkin Lymphoma will not survive the disease, even after being treated with high-dose chemotherapy and receiving an autologous stem-cell transplantation, which involves healthy blood stem cells from their own bodies.

The research team hopes this work will ultimately lead to the ability to profile a patient’s tumour, identifying what type it is and which cells it includes, and recommend a suitable treatment based on this profile. Researchers are currently testing immunotherapy checkpoint inhibitors, which block proteins that stop the immune system from attacking the cancer cells, to guide how to choose the treatment which will result in the best outcomes.

“This discovery could help physicians make better treatment decisions, which could lead to a better chance of a cure for people with cancer,” added Dr. Steidl. “This is the ultimate goal of this work.”

This work was made possible through grant funding from the BC Cancer Foundation, Terry Fox Research Institute, Genome Canada, Genome BC, Canadian Institutes of Health Research, Canadian Cancer Society Research Institute, and the Paul G. Allen Frontiers Group.

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