APOLLO’s high-quality longitudinal samples empower cancer investigators

Cancer’s ability to evolve in response to treatment and develop resistance to available therapies is one of the most significant challenges for clinicians to successfully treat the disease. Combination treatments may be helpful, but it’s also critical for researchers to study how a tumor responds to cancer treatment over time in order to best overcome those resistance mechanisms.

The Adaptive Patient-Oriented Longitudinal Learning and Optimization (APOLLO) platform is working to enable MD Anderson scientists to do just that. By collecting high-quality patient samples over time, the APOLLO team is making it possible to conduct longitudinal analyses of many cancer types.

The platform is one of the research engines powering MD Anderson’s Moon Shots Program®, a collaborative effort to accelerate the development of scientific discoveries into clinical advances that save patients’ lives.

Ignacio Wistuba, M.D., chair of Translational Molecular Pathology and co-leader of the APOLLO platform, spoke with Cancer Frontline about the APOLLO platform and how it’s enabling the Moon Shots Program mission to save lives.

Q: Can you describe the work and focus areas of the APOLLO platform?

A: The APOLLO platform is a program that focuses on assisting clinical and translational investigators at MD Anderson to collect patient specimens, including tissue, blood and other samples, on a longitudinal basis.

The longitudinal component of the collection is the key. Although it is a challenge, we have emphasized the importance of longitudinal tissue collection because it is key to understand the progression of cancer.

Our platform helps investigators in several ways. We have an IRB-approved protocol that allows APOLLO to collect longitudinal samples for research purposes. We have also developed a workflow in collaboration with the Institutional Tissue Bank and different clinical settings to collect high-quality specimens in a timely fashion to be processed for future analysis.

Finally, we have developed a laboratory capable of performing real-time quality control assessment of specimens, directed by Dr. Dipen Maru, professor of Pathology and Translational Molecular Pathology. This tells us what the quality of the material is going in as well as informs the power of the analysis we can run.

Q: How does the APOLLO platform stand apart from others in the field doing similar oncology research?

A: The principal feature that differentiates us from others is that APOLLO is a standardized and centralized sample collection and processing effort. We can offer our collaborating investigators the entire package so they don't have to establish their own sample collection system.

It’s important to note that APOLLO doesn’t analyze any of the samples, but we work to enable high-quality downstream analysis. We collect quality samples, we process and perform quality control, and then we distribute to the different laboratories for analysis. Certain investigators or groups may have done things like this in the past, but this standardized and centralized effort is unique. It’s key to promoting the work of the Moon Shots here at MD Anderson.

Q: How is your work enabled by the Moon Shots Program and integration with the Moon Shots teams?

A: First of all, if we didn’t have a Moon Shots Program, APOLLO wouldn’t exist. The platform was established by the Moon Shots Program, and several of our strategic alliances have also used our resources and supported our efforts.

Secondly, as I mentioned, APOLLO doesn’t do the analysis of these samples. This happens through other groups, such as the Cancer Genomics Laboratory or the Translational Molecular Pathology-Immune Profiling Laboratory. Then, there is integration of the data emerging from the analysis of these specimens in platforms like the Translational Research Accelerator, another Moon Shots platform.

Thus, the Moon Shots Program is key for the development and maintenance of this infrastructure that allows us to collect, process and analyze the data from these samples.

Q: What is some of the most exciting work that APOLLO has been involved with recently?

A: Of course we have a large number of clinical trials on immunotherapy and cell-based therapies – it’s very exciting to collect tissues from patients on those trials in order to understand the potential mechanisms of sensitivity or resistance to these novel therapies. We are learning a lot and that’s very exciting, but I would say our most exciting new project is with MD Anderson’s rare tumor initiative.

This project, which started about six months ago, is a priority area of research for MD Anderson. Andy Futreal, the APOLLO co-leader, and I understood that we can make significant contributions to our patients by focusing on understanding these rare tumors. These cancers don’t receive a lot of attention from biopharma companies or major clinical trials, but we see more than 5,000 cases of what we could consider rare tumors at MD Anderson. Therefore, we have the opportunity to make a real difference for these patients.

We are using the APOLLO platform to collect, process and distribute longitudinal samples from the rare tumor initiative for analysis. That project is going very well – we already have more than 400 specimens in the pipeline for analysis. We’ll be very excited to see where this project takes us.

APOLLO is also assisting with several other new programs at MD Anderson, such as the brain metastasis clinic. We’re going to collect and process samples from that clinic to try and understand how brain metastasis happens, how it progresses and how we can treat these patients better. We’re also involved with the institution’s pre-malignancy effort, helping to understand how pre-neoplastic lesions evolve into invasive cancer.

Q: What do you see as the future of the APOLLO platform?

A: In the future, I see APOLLO as the main mechanism that we use at MD Anderson to collect high-quality samples for research analysis from our patients, from early disease all the way to advanced, metastatic disease. Using this as the primary institutional resource, each investigator can receive help from our group for their work.

By standardizing the collection and processing of these samples and having high-quality material for analysis, we’ll end up with standardized data across multiple diseases, across multiple tumor types, and on multiple forms of therapy. Investigators can then use those data to come up with new hypotheses about the biology of the disease or design new cancer treatment approaches. When we get the critical mass of data out there from the analysis of these samples, our investigators will see the benefit of our approach and more will take advantage of APOLLO.