dc.contributor.author | Au, L | |
dc.date.accessioned | 2022-04-26T10:17:19Z | |
dc.date.available | 2025-04-30T00:00:00Z | |
dc.date.issued | 2022-04-30 | |
dc.identifier.citation | 2022 | en |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/5092 | |
dc.description.abstract | The cornerstone of treatment for metastatic clear cell renal cell carcinoma (ccRCC) are anti-VEGF and/or immune checkpoint inhibitors (CPI). However, there are no clinically implemented predictive biomarkers in any therapeutic settings. Intratumour heterogeneity (ITH) is a pervasive phenomenon of ccRCC. Studies to date examining putative biomarkers have used single-region biopsies and therefore not accounted for ITH. Moreover, genomic and tumour immune microenvironment (TME) changes under therapy have not been examined, which could inform potential mechanisms of anti-VEGF/CPI synergy and renal dynamic correlates of therapy response and resistance. I examined the determinants of anti-PD-1 monotherapy response in multiregion tumour samples collected pre- and post-treatment within a prospective phase II clinical trial. I discovered maintenance of previously expanded T cell clones underpin nivolumab response. Within another prospective clinical study which examined effects of axitinib in patients with metastatic ccRCC, I show preliminary data from driver mutation and gene expression profiling of longitudinal, multiregion tumour samples. Separately, using a tumour-informed, phylogenetic approach to profile circulating tumour DNA, I showed clonal phylogeny of ccRCC can be recapitulated by peripheral sampling as a potential means of circumnavigating the shortcomings of tissue-based biopsies. From March 2020, the SARS-CoV-2 pandemic halted routine laboratory operations for 18 months. During this time and as an emergency response, my doctoral studies pivoted towards uncovering the immunological basis of poor outcomes to SARS-CoV-2 infection and functional immunity against SARS-CoV-2 variants of concern (VOC) and following COVID-19 vaccination in cancer patients. I report the rapid establishment of a prospective, pan-cancer study (CAPTURE) for longitudinal immune profiling of cancer patients in the context of SARS-CoV-2 and COVID-19 vaccines. CAPTURE provided a large dataset (n=784 patients enrolled to date), within which I describe a case of cytokine release syndrome following BNT162b2 vaccination in a patient under anti-PD-1 therapy; and show patients with hematological malignancies had impaired neutralising antibody responses against VOC that was disease lineage and anti-CD20 treatment-specific, in the setting of both SARS-CoV-2 infection (n=118) and COVID-19 vaccines (n=585). | en_US |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | Institute of Cancer Research (University Of London) | |
dc.rights.uri | https://www.rioxx.net/licenses/all-rights-reserved | |
dc.subject | Theses, Doctoral | en_US |
dc.subject | Renal Cancer | en_US |
dc.subject | Vaccines | en_US |
dc.subject | Covid | en_US |
dc.title | Biomarkers of therapy response and resistance in clear cell renal cell carcinoma AND Adaptive immune response to SARS-CoV-2 and COVID-19 vaccines in cancer patients | en |
dc.type | Thesis or Dissertation | |
dcterms.accessRights | Public | |
dcterms.license | https://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.version | AO | |
rioxxterms.licenseref.uri | https://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.licenseref.startdate | 2022-04-30 | |
rioxxterms.type | Thesis | |
pubs.notes | 36 months | en_US |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Clinical Studies/Melanoma and Kidney Cancer | |
pubs.organisational-group | /ICR/Students | |
pubs.organisational-group | /ICR/Students/PhD and MPhil | |
pubs.organisational-group | /ICR/Students/PhD and MPhil/17/18 Starting Cohort | |
pubs.embargo.terms | 36 months | en_US |
pubs.embargo.date | 2025-04-30T00:00:00Z | |
icr.researchteam | Melanoma and Kidney Cancer | |
dc.contributor.icrauthor | Au, Lewis | en_US |
uketdterms.institution | Institute of Cancer Research | |
uketdterms.qualificationlevel | Doctoral | |
uketdterms.qualificationname | Ph.D | |
dc.type.qualificationlevel | Doctoral | |
dc.type.qualificationname | Ph.D | |