The AUTO-CHECK study

ONCOLOGY: The AUTO-CHECK study: Investigating the molecular determinants of AUTO-immunity and immune-related adverse events in advanced cancer patients treated with immune CHECKpoint inhibitors

Immune checkpoint inhibitors are active in a variety of cancers. The hypothesis of AUTOCHECK is that cancer patients with a genetic susceptibility to autoimmunity are more likely to experience immune-related adverse events (IRAEs) after treatment with immune checkpoint inhibitors. This study aims to determine:

  1. potential molecular 'flags' that can identify who is likely to develop an IRAE
  2. common and rare genetic variants that are linked to IRAEs
  3. changes in different groups of specialised white blood cells in patients with or without IRAE

AUTO-CHECK is a major collaboration between the CTC and four of Australia's leading cancer cooperative trials groups-ALTG, ANZGOG, ANZUP and COGNO-to bring together data and biospecimens from six multi-centre, investigator-initiated trials of immune checkpoint inhibitors in fuve different types of cancer: mesothelioma (DREAM); lung cancer (NIVORAD and ILLUMINATE), endometrial cancer (PHAEDRA), renal cell cancer (KEYPAD) and brain cancer (NUTMEG).

This is our first translational research study spanning multiple cooperative groups and cancer types. Patients provide a few additional blood samples for research when they are having routine blood tests for their treatment. Some of these samples are transported to a central lab at the Australian National University within 24 hours to isolate white blood cells. These samples undergo analysis for changes in subtypes of white blood cells (T cells and B cells). Other components of the blood and tumour tissue from patients will also be studied using research platforms such as genomics (analysing a large number of genes). One aim is to see if those patients who develop IRAEs share any particular gene variants or unusual characteristics in their white blood cells.

AUTO-CHECK was developed as part of the Genomic Cancer Clinical Trials Initiative (GCCTI) funded by Cancer Australia and lead by the CTC in partnership with ZEST Health Strategies. This translational research study brings together clinicians, trialists, and basic researchers from a broad range of disciplines to improve the selection and care of patients best suited to receive immune checkpoint inhibitors for cancer. Over 100 participants have already been recruited.