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A Breakthrough Test for Lymphoma Patients: Predicting CAR T Cell Therapy Response with Machine Learning

A new article outlines a new tool that measures blood inflammation as a marker for poor CAR T therapy outcomes.

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The article reports on a significant breakthrough in cancer research, as City of Hope and Memorial Sloan Kettering (MSK) researchers have developed a tool using machine learning to predict the response of non-Hodgkin lymphoma patients to chimeric antigen receptor (CAR) T cell therapy. This test, called InflaMix, assesses inflammation in the blood, which is a potential cause of CAR T failure, and can identify patients at high risk for treatment failure.

The study involved 149 patients with NHL, and the machine learning model was able to find an inflammatory biomarker from a series of unique blood tests not usually employed in standard clinical practice. By analyzing this inflammatory signature, researchers found it was associated with a high risk of CAR T treatment failing, including increased risk of death or disease relapse.

The InflaMix model is an unsupervised machine learning approach, meaning it was trained without any knowledge of clinical outcomes. The team’s studies demonstrate that by using machine learning and blood tests, they could develop a highly reliable tool that can help predict who will respond well to CAR T cell therapy.

The researchers used three independent cohorts comprising 688 patients with NHL who had a wide range of clinical characteristics and disease subtypes and used different CAR T products to validate their initial findings. The study’s results were published in Nature Medicine.

City of Hope and MSK plan to investigate whether blood inflammation defined by InflaMix directly influences CAR T cell function and learn more about the source of this inflammation. This research has the potential to improve patient outcomes and inform new clinical trials that can boost the effectiveness of CAR T with additional treatment strategies.

The team’s studies were funded in part by the National Institutes of Health, the National Cancer Institute, and an MSK Support Grant. The work was primarily done at MSK where Dr. Van den Brink worked for more than two decades before coming to City of Hope in 2024.

City of Hope has treated over 1,700 patients since its CAR T program started in the late 1990s and continues to have one of the most comprehensive CAR T cell clinical research programs in the world, with about 70 ongoing clinical trials using immune cell products.

Cancer

Fat-Rich Fluid Identified as Key Player in Immune Failure in Ovarian Cancer

New research has uncovered how lipid-rich fluid in the abdomen, known as ascites, plays a central role in weakening the body’s immune response in advanced ovarian cancer. The findings offer new insights into immune suppression in ovarian cancer and open promising avenues for future immunotherapy approaches. Over 70% of patients with ovarian cancer are diagnosed at an advanced stage, often presenting with large volumes of ascites. This ascites fluid not only supports the spread of cancer throughout the abdominal cavity but also significantly impairs the body’s immune defenses. Understanding how ascites affects the immune system is important for developing better treatments that use the immune system to fight cancer.

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In a groundbreaking study led by Irish researchers, scientists have uncovered how a lipid-rich fluid in the abdomen, known as ascites, contributes to immune failure in advanced ovarian cancer. The findings shed new light on immune suppression in ovarian cancer and pave the way for innovative immunotherapy approaches.

According to the research, more than 70% of patients with ovarian cancer are diagnosed at an advanced stage, often accompanied by significant volumes of ascites fluid. This fluid not only supports the spread of cancer throughout the abdominal cavity but also severely impairs the body’s immune defenses. Understanding how ascites affects the immune system is crucial for developing better treatments that harness the power of the immune system to combat cancer.

Researchers from Trinity College Dublin and University College Dublin explored how ascites disrupts immune cell function, focusing on natural killer (NK) cells and T cells, key players in eliminating tumors. By analyzing the contents of ascites fluid from ovarian cancer patients, the team identified a group of fat molecules called phospholipids as primary drivers of this immune dysfunction.

Dr. Karen Slattery, Research Fellow at the Trinity Translational Medicine Institute, is the first author of the research article published in Science Immunology. She stated: “We discovered that these lipids interfere with NK cell metabolism and suppress their ability to kill cancer cells. Crucially, we found that blocking the uptake of these phospholipids into NK cells using a specific receptor blocker can restore their anti-tumour activity, which offers a compelling new target for therapeutic intervention.”

Prof. Lydia Lynch, formerly based in Trinity and now at Princeton University, is the senior author of the research article. She emphasized: “This study marks a significant advancement in ovarian cancer research, identifying a new mechanism underpinning immune failure and laying the foundation for new therapies that could restore immune function in these patients. By targeting the fat-induced suppression of immune cells, future treatments could empower the body’s own immune defenses to fight back and improve outcomes for ovarian cancer patients.”

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Asthma

Fatty Liver in Pregnancy Increases Risk of Preterm Birth, Study Finds

Pregnant women with metabolic dysfunction-associated steatotic liver disease (MASLD) have an increased risk of giving birth prematurely and the risk increase cannot be explained by obesity, according to a new study.

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Pregnant women who suffer from metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease, are more likely to give birth prematurely. A new study published in the journal eClinicalMedicine has found that these women have a significantly higher risk of preterm birth, and this increased risk cannot be attributed solely to their weight or obesity.

According to the research conducted by Karolinska Institutet, one in five people in Sweden may have MASLD, while globally, it could affect as many as three out of ten individuals. Common risk factors for developing the disease include metabolic disorders like type 2 diabetes and being overweight or obese. The study’s findings are based on Swedish registry data and included a total of 240 births among women with MASLD, along with 1140 matched births from the general population.

Alarmingly, the research revealed that women with MASLD were more than three times as likely to give birth prematurely compared to those without the disease. This increased risk persisted even after adjusting for factors such as weight and metabolic disorders. The study’s lead author suggests that this association may not solely be due to a high BMI, implying that the liver disease itself could have negative effects on pregnancy outcomes.

Moreover, women with MASLD had a 63 percent higher risk of caesarean section compared to the control group. However, this increased risk seemed to be explained by their high BMI, as no significant difference was observed when comparing them to overweight or obese women without fatty liver disease.

While the study’s findings are concerning, it is essential to note that MASLD itself did not increase the risk of congenital malformations in the children born to these women. The authors acknowledge that their research may have been influenced by other factors and emphasize the importance of closely monitoring pregnant women with MASLD to reduce the risk of complications.

The study’s conclusions highlight the need for specific recommendations regarding pregnancy care for women with MASLD, which could potentially be added to clinical guidelines for managing the disease.

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Alzheimer's

The Key to Protein Quality: Unraveling the Role of P97/VCP Enzyme

In neurodegenerative diseases such as Alzheimer’s or Parkinson’s, proteins accumulate in the body’s cells, fold incorrectly and clump together to form larger aggregates. Normally, cells are able to remove these aggregates themselves. However, if a certain enzyme is blocked, this clean-up process no longer works. The new findings provide a better understanding of the molecular basis of these processes.

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The intricate dance of protein quality control within cells has been revealed by researchers led by biochemist Alexander Buchberger at Julius-Maximilians-Universität Würzburg (JMU). A recent study published in Nature Communications sheds light on the crucial role played by the ubiquitin-selective unfoldase p97/VCP enzyme in eliminating malformed proteins and aggresomes.

In cells, proteins are constantly being produced, assembled, transported, and broken down. This delicate balance is vital to prevent serious illnesses, as even small changes can have devastating consequences. To maintain this balance, cells have developed complex systems to control protein quality. One such system involves the formation of aggresomes – a type of cage that collects and isolates proteins prone to clumping.

While the formation of aggresomes has been extensively studied, their protein content and degradation pathways remained poorly characterized. The recent study changes this by revealing that the breakdown of aggresomes requires multiple players, with p97/VCP enzyme emerging as the most critical.

The researchers conducted experiments blocking p97/VCP enzyme and observed that aggresomes no longer disintegrated and were destroyed. This indicates that p97/VCP plays a pivotal role in breaking down aggresomes into smaller components. The findings have significant biomedical implications, particularly for understanding neurodegenerative diseases such as Alzheimer’s, Parkinson’s, and Huntington’s disease.

Mutations in the p97/VCP enzyme cause neuro-muscular degenerative diseases, including certain forms of dementia and ALS – amyotrophic lateral sclerosis. Moreover, disrupted degradation processes within cells could also contribute to Parkinson’s disease, which is characterized by Lewy bodies – roundish inclusions containing harmful protein deposits that disrupt nerve cell metabolism.

The research team concludes that their findings suggest mutations in the p97/VCP enzyme disrupt aggresome degradation, potentially contributing to Lewy body formation and neuro-muscular degenerative diseases. This study highlights the importance of understanding protein quality control mechanisms within cells and how disruptions in these processes can lead to devastating diseases.

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