Pancreatic cancer vaccine shows promise, but when will it be ready?

  • Researchers have developed personalized mRNA vaccines for pancreatic cancer patients, which have shown safe and feasible results in a small trial.

  • Personalized vaccines work by instructing certain cells, telling them to produce a protein that triggers an immune response and attacks pancreatic cancer cells.

  • Despite promising early results, experts say it could take many years before vaccines are available to patients.

A new vaccine that uses mRNA technology and can be personalized for patients with pancreatic cancer has shown promising results in a new small study.

Pancreatic cancer is one of the deadliest forms of cancer, killing around 88% of people who get it. Pancreatic cancer is also one of the most difficult types of cancer to treat. even after surgery, about 90% of patients have a relapse within seven to nine months.

However, the future of pancreatic cancer treatment — and even prevention — may be brighter. A group of BioNTech researchers and scientists have demonstrated that tailored mRNA vaccines can offer hope in the fight against this deadly form of cancer.

Read more: What are the symptoms of pancreatic cancer?

According to the small study published in the journal Nature, the vaccines elicited an effective and durable immune response in 8 of 16 participants. The patient’s immune system has learned to recognize and fight cancer cells.

“The main conclusion is that we have evidence that it might be possible to target neoantigens in pancreatic cancer using vaccination,” said Benjamin Greenbaum, PhD, corresponding author of the study and associate in the Department of Computational Oncology at Memorial Sloan Kettering Cancer Center. “Five to 10 years ago it was a disease often considered difficult to target using immune-based therapies, but now it’s not impossible.”

Even though Greenbaum and his colleagues have proven that their mRNA vaccine is safe and feasible to develop and administer to patients with early-stage pancreatic cancer after surgery, experts who were not involved in the study claim that it could be many years before it becomes available. .

“They will need to prove their effectiveness in larger groups of patients, possibly randomizing some patients for treatment and others not to prove that it is the vaccine that contributes to the benefit,” said James Farrell, MD, director of the Yale Center for Pancreatic. Disease and a professor of medicine and surgery at the Yale School of Medicine, Verywell told. “It could take several years to get to an approval stage.”

Read more: Who gets pancreatic cancer?

How the vaccine works

The mRNA vaccines are made by BioNTech, a Germany-based biotechnology company. If the name sounds familiar, it’s the same company that helped make the mRNA vaccines for COVID-19.

Although the technology is similar, Greenbaum said the biggest difference between mRNA vaccines is that the ones his team has developed are custom-made for each patient’s specific tumor.

“It’s a personalized vaccine, which means it’s created from specific mutations in that patient’s tumor that create new proteins in the tumor that the immune system can potentially see,” Greenbaum said. .

To make the vaccines, New York researchers first removed each patient’s tumor and shipped samples to Germany. From there, BioNTech scientists analyzed tumor DNA and RNA to find unique proteins called neoantigens.

“It’s not a one-size-fits-all solution,” Farrell said. “The tumors from these patients were removed and analyzed at the DNA and RNA level. Then the researchers chose DNA and RNA sequences that correspond to what are called neo-antigens .

These exciting results indicate that we may one day be able to use vaccines as a therapy for pancreatic cancer.

Scientists could then create an mRNA vaccine specific to neoantigens, which Farrell says are coated in tiny particles that help protect and transport their genetic material to the patient. In the study, the vaccine was given to patients by IV injection in nine separate doses.

According to Farrell, when the vaccine is given to the patient, it is taken up by special immune system cells called dendritic cells. The cells use the vaccine’s mRNA genetic material to make neo-antigen proteins similar to those seen on a patient’s original tumor.

Once the proteins are released into the bloodstream, Farrell said, they travel through the body and eventually get detected by the immune system. They signal the immune system to “turn it on” and boost its response.

Activated cells of the immune system, called T lymphocytes, recognize these proteins as markers of cancer cells. Then, the T cells multiply and target tumor cells that contain neo-antigens, attacking and potentially destroying them.

Farrell said that when used with an immune checkpoint inhibitor drug to “jumpstart the immune system,” the vaccine “teaches the immune system to recognize and fight tumor cells, which express these types of proteins.”

Read more: How is pancreatic cancer staged?

A small but fascinating study

The researchers included 16 patients in the study, which began in December 2019. All of the patients were white and had early-stage disease that could be surgically removed (resected).

In addition to the vaccine, all patients received chemotherapy and a checkpoint inhibitor drug, which works in conjunction with vaccines to boost immune responses.

Half of the 16 patients analyzed responded to the vaccine. As a result, their immune system learned to recognize and fight cancer cells. The patients also showed no signs of relapse of their pancreatic cancers during the 18 months they were followed.

In a press release for the research, Vinod Balachandran, MD, a pancreatic cancer surgeon who led the first clinical trial, said these “exciting results indicate that we may one day be able to use vaccines as a therapy against pancreatic cancer”.

Read more: Are there vaccines against cancer?

How close are we to cancer vaccines?

Although the trial showed promising results in a small group of patients, other experts who were not involved in the study warn that there could be factors like chemotherapy and other treatments contributing to the good response of some patients to the vaccine.

“You have to be cautiously optimistic, but also take note that patients have received other therapies,” said Anirban Maitra, MBBS, professor of pathology and translational molecular pathology and scientific director of the Sheikh Ahmed Pancreatic Cancer Research Center at UT MD. Anderson Cancer Center, told Verywell. “They received another immunotherapy which was given in conjunction with a vaccine, and they also received chemotherapy, which is usually given as standard of care to all patients after surgery.”

Five to ten years ago, it was a disease often considered difficult to target with immune therapies, but now it’s not impossible.

As there are still many unanswered questions about the effectiveness of the vaccine, such as the magnitude of the effect due to chemotherapy compared to getting the vaccine alone, Maitra said it could take several years before an mRNA vaccine against pancreatic cancer was available.

“We really don’t have full clarity on that,” he said. “But this is a phase one trial, and the two most important questions in a phase one trial are safety and feasibility.”

According to Maitra, future trials (including the second trial) will need to include more patients who will receive multiple therapies and other patients who will receive those therapies plus the vaccine. This will allow researchers to compare the effects of the vaccine to no vaccine.

“It’s going to take a while to do the phase 2 trial and then phase three if that success happens,” he said. effectiveness and it could take between three and five years or more.”

According to the researchers, a larger randomized clinical trial is about to open and will involve patients at multiple sites in various countries. The Memorial Sloan Kettering Cancer Center research team plans to begin recruiting patients for the study this summer.

Learn more: Coping with a diagnosis of pancreatic cancer

What treatments for pancreatic cancer are currently available?

We may not have vaccines for pancreatic cancer yet and it may be years before they are available, but we do have some treatments for pancreatic cancer. If you were recently diagnosed, the right treatment for you will depend on the stage of your cancer, your general health and the recommendations of your healthcare team.

  • Surgery: Depending on the stage of the cancer and the location of your tumour, your provider may recommend surgery. This option aims to remove all cancerous tissue, which may involve removing tumours, parts of the pancreas or other affected organs.

  • Radiotherapy: This treatment uses radiation to target and kill cancer cells. It is also called adjuvant therapy and is usually an option that is given after surgery as a way to prevent the cancer from coming back. It may help some patients live longer. Radiation therapy can also be used before surgery to shrink tumors.

  • Chemotherapy: This treatment option uses drugs that kill cancer cells or slow their growth. It can be given before or after surgery and can be combined with other treatments such as radiation therapy.

  • Immunotherapy: This treatment is also called targeted therapy and uses the body’s immune system to recognize and attack cancer cells. Immunotherapies can be used alone or with other cancer treatments. Recent research has suggested that immunotherapies may be helpful in prolonging survival for people with stage IV pancreatic cancer compared to standard care.

A personalized mRNA vaccine has shown promise in the fight against pancreatic cancer, but experts say it will be many years before this type of vaccine becomes widely available. For now, surgery, radiotherapy, chemotherapy and immunotherapies are among the options available to patients with this often difficult-to-treat cancer.

Next read: What are the treatments for pancreatic cancer?

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