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8 June, 2020 - 09:01 By Tony Quested

Cambridge spearheads landmark cancer initiative

Sanger Institute spin-out Microbiotica has joined forces with Cancer Research UK and Cambridge University Hospitals NHS Foundation Trust to pilot a major new cancer initiative.

The collaboration is designed to identify and develop microbiome co-therapeutics and biomarkers for cancer patients receiving immune checkpoint inhibitor therapy.

The technology collaboration is based on clinical studies conducted by CUH that evaluate immune checkpoint inhibitor drug response in cancer patients, combined with Microbiotica’s unrivalled microbiome profiling and analysis capability.

The microbiome is the genetic material of all the microbes – bacteria, fungi, protozoa and viruses – that live on and inside the human body.

Two clinical studies are involved: MELRESIST, a completed class-leading melanoma study, and MITRE – a major landmark study in melanoma, lung and renal cancer – involving 1,800 patients and specifically designed for evaluation of microbiome and other biomarker effects.

The MITRE study will be co-led by Dr Trevor Lawley, Microbiotica’s co-founder and CSO, and Dr Pippa Corrie, Consultant in Medical Oncology at CUH, and will involve comprehensive patient sample collection, data collection and biochemical analysis, with medicines provided by the NHS. Microbiotica will undertake mass culturing of patient gut bacteria, microbiome sequencing and machine learning analysis.

Dr Trevor Lawley

Checkpoint inhibitors have transformed the management of cancer due to the range of cancers that can be treated and their high levels of efficacy, including complete remission in some cases. 

However, response rates are low, typically in the range 10-40 per cent of patients. So there is a major unmet need for co-therapies to extend the number of responders and for biomarkers to stratify patients for treatment.

Several studies have shown that the gut microbiome plays a critical and causative role in determining which patients respond to these medicines. But up to now they have failed to identify a consistent gut bacterial signature associated with treatment response or resistance. 

Microbiotica has used its unique microbiome profiling platform with MELRESIST data to identify for the first time a common signature predictive of drug response across multiple melanoma studies, and this is being progressed within the business. 

MITRE will take this further by examining the effects in different cancers, a range of immunotherapy regimens, as well as association with side-effects of immunotherapy.

Microbiotica’s platform comprises the world’s leading Reference Genome Database and Culture Collection of gut bacteria, and an unrivalled capability to culture and characterise all gut bacteria from patients at scale. 

This is complemented by a suite of bioinformatic and machine learning tools that enable the identification of previously undetectable gut bacterial signatures linked to patient phenotype. The company also has capabilities to develop and take such products to the clinic.

The collaboration will identify specific gut bacterial signatures correlated with drug efficacy and side effects in patients under treatment for melanoma, non-small cell lung cancer and renal cancer. 

From these signatures, Microbiotica will progress live bacterial products as co-therapies and microbiome biomarkers predictive of immunotherapy response and toxicity into the clinic.

Mike Romanos

Mike Romanos, co-founder and CEO, Microbiotica, said: “Checkpoint inhibitors have already impacted the lives of many cancer patients for the better but fewer than half of patients respond. 

“There is strong evidence that response rates can be increased through manipulation of the microbiome and Microbiotica’s platform has already been able to identify consistent bacterial signatures predictive of drug response in melanoma for the first time.

“The collaboration enables us to base our therapeutic and biomarker programs on two exceptional studies, MELRESIST and MITRE, bringing together well-powered data in patient efficacy and safety response, immunological and tumour biochemistry, with the most comprehensive microbiome classification and analysis.

“We have been applying our technology in other large-scale clinical studies to identify drug response signatures for biomarker and therapeutic discovery, such as our collaboration with Genentech in IBD, the most precise large-scale microbiome clinical study to date. 

“We are delighted that Cancer Research UK and CUH have also recognized Microbiotica’s leadership in the microbiome and have chosen to partner with us in this landmark cancer microbiome study.”

Tony Hickson, chief business officer at Cancer Research UK, said: “Cancer Research UK is always looking at the most promising new science to advance the treatment of patients and we believe that the microbiome represents a very exciting new area that could play a major role in cancer therapy.

“We believe this partnership is very well placed to do the quality of science required to identify the specific link between the gut microbiome and checkpoint inhibitors in multiple cancers. 

“We look forward to working with the excellent teams in Microbiotica and Cambridge University Hospitals to progress new microbiome medicines and biomarkers toward the clinic.”

Microbiotica is based at the Wellcome Genome Campus in Cambridge with offices in the Biodata Innovation Centre and laboratories in the Sanger Institute. Its investor syndicate includes Cambridge Innovation Capital, IP Group plc and Seventure Partners.

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