Infrared multispectral tissue imaging to improve stratification for patients with head and neck cancer – TUMADMIR

Head and neck tumors are clinically and pathologically heterogeneous. While the vast majority of them arise from the malignant transformation of the squamous epithelium covering the upper aerodigestive tract, and are therefore squamous cell carcinomas, several histological subtypes have been described, with various grades of differentiation. Frequently associated with a smoking and/or alcohol history and/or papillomavirus (HPV) infection, 15% of patients have no known risk factor.
Despite the progress made in the clinical management of patients, the risk of locoregional or distant relapse, and the risk of asecond primary cancer, are high. Current management methods only imperfectly anticipate these risks. It is estimated that in 30% of cases, oral squamous cell carcinomas are preceded by an oral potentially malignant disorder (OPMD), which can evolve over long periods of time (10-20 years). It remains very difficult to predict the risk of malignant transformation of an OPMD, due to their clinical heterogeneity, the challenge of clinical and pathological evaluation, and the absence of validated biomarkers. Biologically, the heterogeneity of head and neck squamous cell carcinomas and OPMD cancers has been reported using protein expression levels by immunohistochemistry, at the genetic, epigenetic and transcriptional levels, and more recently at the metabolic and tumor microenvironment levels. Many of these biological characteristics are spatially heterogeneously distributed. Finally, recent studies illustrate the changes over time of various biological parameters, either under the selection pressure of treatments, or 'spontaneously' during the malignant transformation of the squamous mucosa in the early phases of tumorigenesis observable
in OPMD samples. Considering these different levels of biological heterogeneity (proteome, genome, transcriptome, cellular, tissue and cellular, metabolic, spatial & temporal) is essential to improve patient stratification and better personalize treatments.
However, one of the major obstacles to using this biological information is being able to capture it on routinely analyzed tumor tissues (fixed and paraffin embedded), which are available in limited quantities, without having to multiply the number of expensive techniques. To overcome these obstacles, LabCom TUMADMIR proposes to implement the ADMIR infrared multispectral imaging
platform in pathology and cytology labs. This will be made possible by combining the medical, tumor biology and bioinformatics skills of the academic laboratory “Integrated analysis of the dynamics of cancers” (Cancer Research Center of Lyon, Inserm 1052) led by Pr. Pierre Saintigny (principal investigator), and the partner company ADMIR represented by Mr. Laurent Duraffourg (CEO), a CEA-Leti spin-off created in 2022, which is developing an infrared multispectral imaging platform, a disruptive technology that won the i-Lab competition (2022), based on 12 patents and expertise in physics (high-brightness quantum cascade lasers, bolometer arrays and lensless wide-field-of-view architecture) and artificial intelligence (deep learning).
The objectives of LabCom TUMADMIR are specifically to support the development of the ADMIR platform by improving its spatial resolution and developing artificial intelligence for tissue classification; and secondly, to demonstrate the biological relevance of infrared imaging and its clinical utility at diagnostic, prognostic and theranostic levels through the analysis of tissue heterogeneity.