Biomarker Testing for Anal Cancer

Cathy Eng, MD, FACP, FASCO, a professor of Medicine, co-leader of the VICC Gastrointestinal Cancer Research Program, David H. Johnson chair in Surgical and Medical Oncology, co-director in GI Oncology, and director of the VICC Young Adults Program at Vanderbilt University Medical Center, and a co-chair of the NCI Gastrointestinal Steering Committee, discusses what can be done in order to integrate biomarker testing for anal cancer into clinical practice.

According to Eng, the role of biomarkers is largely exploratory and in the anal cancer space, it is an area of active research, explains Eng. The biomarker one that has been most heavily explored is PD-L1 expression in multiple malignancies where immune checkpoint inhibitors are being considered as it showed promise in other solid tumors as a predictor of response to immune checkpoints inhibitors.

In anal cell carcinoma specifically, more research is needed to be done in order to integrate biomarkers. Moreover, there needs to be an increased consideration of immune checkpoint inhibitors, according to Eng. Because HPV plays such a large role in the development of this rare disease, Eng specifically believes that HPV circulating-tumor DNA should be considered in clinical trials moving forward in order to provide patients with the best treatment.

Transcription:

0:08 | What can be done at this point to integrate biomarkers, I think is increased recognition of immune checkpoint inhibition. I know there's a lot of interest in it currently, obviously in multiple cancers, but we've seen some benefit in this rare cancer as well. We're also looking at it in the adjuvant setting, in EA2165 for high-risk recurrent patients. I think what we can learn from this is that for immune checkpoint inhibitors, we don't have the best answers in regard to biomarkers for our patient populations, we need to think about other aspects. Because HPV has such a large role in the development of anal carcinoma, I think consideration for HPV circulating-tumor DNA really should be considered in all clinical trials moving forward, as well as trying our best to identify other biomarkers as well although.

1:02 | Once again, for all metastatic patients next generation sequencing should be completed when thinking about steps moving forward, should they need alternative treatment options. I always encourage in the metastatic setting, next generation sequencing. In current studies, both early stage and late stage, I'm hoping that they will also incorporate HPV circulating-tumor DNA. I think that's very promising right now.