By Dr. Anagha Jadhav, M.D., Director of Digital Pathology, OptraSCAN


A confluence of immunology and oncology has instigated turbulence in biomarkers new to the cancer community. The tumor microenvironment, comprising of immune cells amidst tumor cells, can be nudged to actively mount a defense against cancer cells. FDA-approved biomarker assays for PD-1 therapeutics will potentially provide a completely new mode of treatment options for a subset of cancers that have begun to unveil the potential of immune-oncology therapies across multiple tumor types. Immune biomarker expression also helps with the selection and monitoring of effectiveness of immune therapies.


Digital Pathology is currently a timely intervention in the field of oncology, and it can act as a checkpoint for immune therapy. Current digitization, archival and image analysis tools, as well as developing computational technologies, support the development of companion diagnostics in immuno-oncology, with an emphasis on tumor microenvironment. These new technologies are enhancing the detection, segmentation, feature extraction, and tissue classification within immune therapy.


The technology does not come without challenges, as the use of multiple assays and staining platforms pose some unique questions with respect to therapeutics and clinical utility. While the above technologies are available on separate platforms, there still lies a challenge in integrating each to a single platform for the registration, segmentation and quantification of cancer cells based on biomarker content, in order to aid immune-oncology development.


How can Digital Pathology systems advance immunotherapy?


A Digital Pathology system, which will integrate morphology-based feature extraction and molecular technology, will serve physicians as they attempt to understand the tumor microenvironment activity in order to allow them to predict response, or resistance to, immune check-point inhibitors. A plethora of unique molecular tests are available today for whole genome and whole transcriptome sequencing of both normal and cancer tissues. The detection and presence of protein biomarkers in patient tumor cells will enable personalized cancer care for patients with actionable insights for potential treatment options. A tumor sample, i.e. a biopsy sample, is required for testing and the accurate identification of cellular alterations, which requires digitization from whole slide scanners to isolate the individual tumor cells from the biopsy specimen.


In conclusion, a systematic application of a methodology to harnesses histopathology data of the tumor, and its corresponding molecular signatures, could be made possible with the use of Digital Pathology to address immunotherapy complexities.


Disclaimer: In seeking to foster discourse on a wide array of ideas, the Digital Pathology Association believes that it is important to share a range of prominent industry viewpoints. This article does not necessarily express the viewpoints of the DPA, however we view this as a valuable point with which to facilitate discussion.