Pelotonia Institute for Immuno-Oncology (PIIO)
Established in 2019 following a five-year, $102,265,000 pledge from Pelotonia, the PIIO – a bench-to-bedside research initiative focused on harnessing the body’s immune system to fight cancer at all levels – has established a robust foundation on which to pursue its overarching ambition of being a global leader in immuno-oncology (IO) breakthroughs. Through studies utilizing systems IO, PIIO scientists seek a better understanding of cellular systems in order to create more effective immunological tools to fight cancer. This research improves knowledge about the relationship between cancer genomics and immune evasion. Through translational IO research, PIIO scientists turn discoveries into new or improved cancer treatments and broaden patient populations that can be treated with cell therapy.
During the PIIO’s first two full years of operation, it has recruited 18 new faculty who have boosted PIIO membership to over 100 individuals whose annual funding from grants stands at more than $32 million, including $19 million from the National Cancer Institute (NCI). In addition, more than 90 IO clinical trials are under way at Ohio State, the majority of which are experimental early-phase trials. PIIO members have published more than 500 articles in peer-reviewed scientific journals over the past two years and have disclosed over 50 inventions. The PIIO’s Immune Monitoring and Discovery Platform (IMDP), which gives researchers a 360-degree-view of the immune system to see what happens in a patient’s body when treated with cancer immunotherapy, has amassed $3.8 million in resources and technologies in such areas as immunophenotyping, imaging, single-cell genomics, single-cell proteomics, automation and robotics. The IMPD is helping clinicians improve correlative science in the trials they lead by assaying IO clinical trial samples for correlative studies, and by providing expertise from PIIO investigators toward advancing the science of study agents. “We have a strong framework and enhanced research capabilities that position our team to make big strides in the coming years,” says PIIO Founding Director Zihai Li, MD, PhD.
Li says plans call for the opening of many more IO clinical trials in the next few years to facilitate the creation of a pipeline of novel cancer immunotherapeutics that will be tested in the clinic. The PIIO’s IMPD also joined in the global fight against the COVID-19 pandemic in 2021, collaborating with Carlos Malvestutto, MD, MPH, of the Department of Internal Medicine, Division of Infectious Diseases at Ohio State, in an OncoImmune phase III clinical trial of CD24Fc to treat patients hospitalized with COVID-19. CD24Fc is a first-inclass biologic that fortifies an innate immune checkpoint against excessive inflammation. In this study, the researchers assessed safety and efficacy and found that CD24Fc robustly blunts systemic inflammation and is a potential breakthrough for treating patients who are severely and critically ill with COVID-19. Other PIIO-assisted studies relating to COVID-19 can be found elsewhere in this Accomplishments Report. Read more about Li’s lifelong mission to unlock the promise of immunotherapy for cancer patients at health.osu.edu.
Beating Lung Cancer in Ohio (BLC-IO)
Researchers are relying on a network of 50 Ohio community hospitals that was established by the OSUCCC – James for recruiting patients in a statewide clinical research initiative that takes aim at lung cancer, the No. 1 cancer killer among men and women in the United States. Supported by $3 million from Pelotonia, the Beating Lung Cancer – In Ohio (BLC-IO) initiative is led by (above from left) Peter Shields, MD, deputy director of the OSUCCC; David Carbone, MD, PhD, director of the Thoracic Oncology Center at the OSUCCC – James; and Barbara Andersen, PhD, also in the Cancer Control Program.
BLC-IO has two aims. One is to assess the impact of advanced gene testing and to provide expert advice to help each patient’s treating physician determine the best therapy for stage IV lung cancer patients in hopes of prolonging survival. The other is to improve smoking-cessation rates among smokers with lung cancer and their family members (determine the impact of centralized telephone counseling and provider support on cessation). Project leaders anticipate more than 2,000 newly diagnosed patients with stage IV non-small cell lung cancer will enroll in BLC-IO via the community hospital network. Enrollees receive free testing for more than 300 genes in their cancer specimens, and physicians who treat them receive expert support for interpreting test results and determining treatments. BLC-IO also provides smoking-cessation support for up to three years to participants and family members. Papers relating to the BLC-IO that have been published or are awaiting publication in scientific journals cover such topics as: “Cancer Treatment During COVID-19: Resilience of Individuals With Advanced Non-Small Cell Lung Cancer Versus Community Controls”; “Psychological Symptom Trajectories and Non-Small Cell Lung Cancer Survival: A Joint Model Analysis”; “Illness Perceptions and Psychological and Physical Symptoms in Newly Diagnosed Lung Cancer”; and “Newly Diagnosed Patients With Advanced Non-Small Cell Lung Cancer: A Clinical Description of Those With Moderate to Severe Depressive Symptoms.” A significant focus of these studies is on depression and stress.
Ohio Prevention and Treatment of Endometrial Cancer (OPTEC)
Supported by $1.5 million in Pelotonia funds, OPTEC aims to recruit up to 1,000 women with endometrial (uterine) cancer from partner hospitals across the state and screen them for Lynch syndrome (LS) and other inherited genetic conditions linked to greater risk of endometrial, colorectal, stomach and ovarian cancers. Their tumor samples undergo molecular profiling to identify targeted treatments personalized to each patient’s tumor characteristics. Patients with LS and their at-risk family members will be educated about the importance of genetic testing and cancer prevention strategies based on their increased risk for LS-associated cancers. Women whose tumors have defective DNA mismatch repair will be considered for immunotherapy clinical trials for endometrial cancer.
OPTEC is led by David E. Cohn, MD, MBA, FACHE, chief medical officer at the OSUCCC –James, and Paul Goodfellow, PhD, of the Molecular Carcinogenesis and Chemoprevention Program, and is assisted by multiple collaborators from Ohio State (including Casey Cosgrove, MD, lead oncologist and member of the Translational Therapeutics Program) and from Nationwide Children’s Hospital Research Institute. OPTEC will conduct its LS screening with a one-step genetic sequencing technique developed by Elaine Mardis, PhD, a geneticist at Nationwide Children’s Hospital Research Institute and also a member of the Translational Therapeutics Program. Genetic profiling will help identify patients most likely to benefit from new therapies, including immunotherapy drugs that target certain proteins. OPTEC also is supported by a five-year grant awarded by the National Cancer Institute in 2018 to principal investigators Goodfellow, Mardis and Heather Hampel, MS, LGC, to study “Combined NGS TumorBased Detection of Germline Lynch Syndrome Mutations and Prognostic Classification of Endometrial Cancers.” This grant extends research supported by Pelotonia and supports the study of additional tumors from women with endometrial cancer.
Turning the PAGE on Breast Cancer in Ohio
The newest statewide initiative supported by Pelotonia is Turning the PAGE on Breast Cancer in Ohio (Population-Level Precision Prevention Strategies for Preventing Aggressive Breast Cancer), co-led by Electra Paskett, PhD, MSPH, associate director for population sciences and community outreach at the OSUCCC – James, and Heather Hampel, MS, LGC, formerly of the OSUCCC – James. This project uses a multi-level approach in 12 Ohio counties to provide breast cancer education and facilitate access to risk assessment, genetic counseling and testing, appropriate screening/ surveillance, follow-up for abnormal tests, and prompt and proper treatment for African American women who are at greater risk of breast cancer mortality.
Collaborators with the OSUCCC – James include the Ohio Association of Community Health Centers, Susan G. Komen and the North Central Region American Cancer Society. Participating counties include Franklin, Fairfield, Clark, Butler, Hamilton, Lake, Cuyahoga, Lorain, Trumbull, Summit, Stark and Mahoning. Several strategies (e.g., Facebook ads and referrals from providers or community organizations) are being used to direct women to a website that includes educational information about breast cancer screening, prevention and treatment, and a risk-assessment tool that provides a personal prescription for breast health, including whether they need to schedule an appointment with cancer genetics professionals or get a mammogram. Paskett says this study will use geographic predictors (county) of aggressive disease to identify and focus on women who live in high-risk counties, train providers at Federally Qualified Health Centers (FQHCs) to facilitate breast health strategies and deliver personalized breast cancer prevention strategies to women based on their risk stratification, and help women adhere to these strategies via telephone patient navigation. “We will determine whether there were significant increases in the percentage of women who are up-to-date with riskappropriate breast cancer screening in the 12 counties,” she adds. “We also will determine the number of referrals to genetic counseling/genetic testing within the FQHCs, any change in breast-health knowledge among FQHC providers, and the number of community organizations involved in breast health, community events and policy efforts.”