Abstract 993: Comprehensive immunophenotypic strategies to enable equity in remote settings for improved cancer prognosis
Authors: Smith Natalie J. , Cohen Michael , Alipaz Julie , Loh Christina , King David , de St Groth Barbara Fazekas , McGuire Helen M. 
Published: March 2024

Abstract
Improved cancer prognosis begins with insights obtained from high quality data during clinical trials. Execution of longitudinal clinical trials in flow cytometry is complex, primarily due to logistical challenges in high quality sample collection. For instance, highly remote indigenous population centers are both disadvantaged in access to healthcare and often underrepresented in clinical trials. This paradox is highlighted in the case of Australian First Nations communities, for which lung cancer prevalence peaks in males at twice the magnitude of the general population. Our group has developed a novel blood “immune signature” that robustly predicts failure to make a clinical response to checkpoint therapies targeting the PD-1/PD-L1 pathway. Encouraged by these groundbreaking findings, which were achieved through applying a comprehensive 38-plex immunophenotyping CyTOF panel to biobanked cancer samples, recent advances in CyTOF technology now give us the opportunity to expand our clinical implementation to remote settings, with a further expanded panel to 50+ markers. CyTOF is the only technology that allows easily implemented remote asynchronous sample collection and the largest immunophenotyping panel that yields reproducible results. Asynchronous collection is uniquely enabled using a stable lyophilized large-scale staining panel and achieving comprehensive marker coverage in one panel minimizes blood sample required. Furthermore, the new technology enables a highly simplified workflow including blood collection and processing in remote locations to enable the simplest clinical trial infrastructure complexity and cost, easily implemented in current hospital lab environments. As such, this study is designed to ultimately demonstrate both clinical impact of the large panel and utility of CyTOF technology for highly simplified and robust workflow for multi-site clinical trials. This project has 3 phases; i) implementation and evaluation of the collection, analysis technique and data management of this new approach across multiple sites, ii) collection of samples for analysis both pre- and post- initiation of therapy to establish efficacy and optimize as necessary, and iii) blinded clinical trial. We will report on the first phase of this project which is implementing new workflow across clinical collection site, data integration and analysis. This workflow would enable highly simplified collection to access indigenous and under-served populations spread across remote sites in Australia.
Citation Format: Natalie J. Smith, Michael Cohen, Julie Alipaz, Christina Loh, David King, Barbara Fazekas de St Groth, Helen M. McGuire. Comprehensive immunophenotypic strategies to enable equity in remote settings for improved cancer prognosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 993.