Maggie Lesch - PhD Candidate, Immunology, Microbiology, and Virology Ph.D. Program
Colorectal cancer (CRC) is a devastating malignancy that ranks as the second leading cause of cancer-related deaths, and fourth in cancer diagnoses annually in the United States. Among CRC cases, rectal cancer (RC) comprises one-third of cases, with over 50,000 people in the US diagnosed each year. Surgical resection is a treatment option for RC, however it can greatly reduce patients’ quality of life and unfortunately, some patients still experience recurrence. Recently, treatment paradigms have shifted towards organ preservation in RC through the adoption of the watch-and-wait approach in which patients undergo total neoadjuvant treatment with active surveillance, often avoiding surgery. While approximately 30% of patients experience a complete clinical response with this approach, most have an incomplete response to neoadjuvant therapy and ultimately require surgery or further therapy. Why this binary divide occurs is poorly understood, and there are no biomarkers for predicting response. To study this question, our lab has developed a clinically relevant orthotopic murine model of RC, in which administration of Short Course Radiation Therapy (SCRT) results in recapitulation of this binary responder/nonresponder phenotype seen in patients. Our model enables the study of both phenotypes during and following treatment. Using this model, we performed a series of experiments to investigate the molecular mechanisms driving this responder/nonresponder dichotomy. Specifically, RNA-sequencing of intratumoral cell populations, following SCRT, revealed an upregulation of the Type I Interferon (IFN) signaling pathway in responder tumors when compared to nonresponders. Type I IFNs have emerged as essential cytokines that mediate the antitumor immune response. Preliminary data has confirmed that responder tumors had higher concentrations of intratumoral Type I IFN protein that were maintained throughout treatment. Blockade of the Type I IFN receptors completely abrogated the responder phenotype further emphasizing the importance of these factors in dictating the responder/nonresponder divide. To explore what may mediate this effect, we investigated the influence of the microbiome, as pathogen associated molecular patterns (PAMPs) from radio-sensitive bacteria are known to contribute to Type I IFN production. To test this, we depleted the microbiota by administering antibiotics throughout SCRT treatment. This resulted in a decrease in responder tumors, indicating that the microbiome plays a significant role in mediating the therapeutic effect. Future experiments using fecal transplants and 16s sequencing will explore whether specific bacteria or subsets of bacteria govern the treatment response. These studies are clinically translatable and may identify noninvasive predictive biomarkers, with the potential to improve the efficacy of SCRT and increase the number of patients who respond to treatment.
Oct 10, 2024 @ 12:00 p.m.
Medical Center | K307 (3-6408)
Host: Advisor: Scott Gerber, PhD