Methods of treating cancer
Multimodal cancer immunotherapy is a combination of cancer immunotherapies used to treat cancer in patients. T cell receptor diversity is used as a component of a method to treat cancer involving cancer therapy, including multimodal cancer immunotherapy.
1 . A method of treating cancer in a patient who has been receiving a multimodal cancer immunotherapy for at least two months, the method comprising:
a. calculating T cell receptor (TCR) diversity in a blood sample from the cancer patient before initiation of the multimodal cancer immunotherapy, or at initiation of the multimodal cancer immunotherapy;
b. calculating the TCR diversity in a blood sample from the cancer patient at least two months after initiation of the multimodal cancer immunotherapy to the patient;
c. comparing the TCR diversity from steps a and b; and
d. continuing administration of the multimodal cancer immunotherapy to the patient, if the T cell receptor (TCR) diversity in the blood sample from the patient increases at least three-fold between steps a and b;
wherein
the multimodal cancer immunotherapy comprises an NK cell selected from the group consisting of aNK, haNK, taNK, and t-haNK; or
the multimodal cancer immunotherapy comprises two or more immunotherapies selected from the group consisting of a viral vector expressing an antigen, a yeast immunotherapy, an immune checkpoint inhibitor, and an IL-15 superagonist.
2 . The method of claim 1 , wherein the multimodal cancer immunotherapy further comprises an immunotherapy selected from the group consisting of aldoxorubicin, N-803, ETBX-011, ETBX-051, ETBX-061, GI-4000, GI-6207, GI-6301, NK cells, avelumab, bevacizumab, capecitabine, cisplatin, cyclophosphamide, 5-fluorouracil, leucovorin, and nab-paclitaxel.
3 . The method of claim 1 , wherein the patient is administered at least one cancer therapy that is not an immunotherapy.
4 . The method of claim 1 , wherein the cancer is selected from the group consisting of lung cancer, skin cancer, brain cancer, spinal cord cancer, breast cancer, colon cancer, rectal cancer, liver cancer, pancreatic cancer, head and neck cancer, gall bladder cancer, ovarian cancer, urothelial cancer, and blood cancer.
5 . The method of claim 1 , wherein the cancer is selected from the group consisting of non-small-cell lung carcinoma (NSCLC), triple negative breast cancer (TNBC), head & neck squamous cell carcinoma (HNSCC), pancreatic adenocarcinoma, chordoma, melanoma, Merkel cell carcinoma, non-Hodgkin lymphoma, acute myelogenous leukemia, myelodysplastic syndrome, neuroblastoma, and glioblastoma.
6 . The method of claim 1 , wherein the TCR diversity is calculated as a Shannon Wiener diversity index.
7 . The method of claim 1 , wherein the TCR diversity is calculated for CDR3 regions from TCR α/β chains.
8 . The method of claim 1 , wherein the TCR diversity is calculated for RNA sequences encoding CDR3 regions from TCR α/β chains.
9 . The method of claim 1 , further comprising administering to the patient a cancer therapy selected from the group consisting of stereotactic body radiation therapy (SBRT), a low dose chemotherapy, and a low dose radiation therapy.