Developmental Therapeutics and Cancer Immunotherapy

What we do

The overarching aim of the Developmental Therapeutics Programme (DTP) at Imperial College is to accelerate the development of novel targeted and immunotherapeutic approaches for the treatment of cancer by studying the functional characteristics of the tumour and the associated microenvironment as a method to guide the design of early-phase clinical studies. The DTP programme draws on the strengths of the Liver Cancer research programme, having elected the study of the functional characteristics of the tumour environment in Hepatocellular Carcinoma (HCC), a moderately immune-responsive disease, as a paradigm for the development of combination immunotherapy.

Why it is important

After decades of scepticism, therapeutic reversal of immune-exhaustion with immune checkpoint inhibitors (ICI) have been shown to improve survival outcomes across a widening range of malignancies. However, the clinical development of immune-based therapies has, for most oncological indications, remained poorly guided by clear predictive correlates of response.

How it can benefit patients

Only a fraction of patients respond to immunotherapy and stratifying biomarkers are urgently required to spare patients from potentially life-threatening toxicity (i.e auto-immune hepatitis, pneumonitis) in absence of clinical benefit. A key aim of our research is to improve

Summary of current research

The developmental therapeutics research programme led by Dr David James Pinato has, since its inception, led to the delivery of a portfolio of highly complex, first-in-class multi-centre studies aimed at the qualification of novel anti-cancer therapeutics with a particular emphasis on anti-cancer immunotherapy.

The programme capitalises on the support of the Imperial ECMC, the Imperial CRUK Centre, the ICHT Cancer Theme the NIHR Research Facility and the Imperial College BRC.

Linked to the programme is the Developmental Therapeutics Clinic, a dedicated referral service at the Hammersmith Hospital that has, since 2018 facilitated a streamlined and unified referral process

of patients from Imperial College NHS Trust and other NHS Trusts to aid effective trial allocation across tumour sites, line of therapy and molecularly stratified tumour phenotypes. Within the developmental therapeutics clinic between 5-10 new referrals/week get direct access to a team experienced in targeted and immune-based anti-cancer therapies. With the support of the ECMC, patients undergo prompt clinical sample processing including tumor genomic, circulating biomarker, metabolomic and stool microbiome analysis. Clinical sample analysis feeds into the broader biomarker discovery theme within the Division of Cancer at Imperial College and aids the identification of predictive correlates of response to novel therapies.

Unlike other early-phase programmes, over 50% of the research programme is Imperial College sponsored, putting Imperial College at the forefront of protocol development across a wide range of indications and therapeutic modalities. Key milestones within Imperial College have been the delivery of the first adjuvant dose of immunotherapy in hepatocellular cancer (PETAL Trial, 2016) and the first neoadjuvant dose of immunotherapy in early-stage HCC (PRIME-HCC Trial, 2018).