Mna

Personalized mRNA vaccines are promising as pancreatic cancer treatment, a clinical phase -1 study that was published in Nature on Wednesday.

Less than 13% of people in whom pancreatic cancer was diagnosed, live to one of the most fatal types of cancer for more than five years. This is partly because around 90% of cases are diagnosed if the disease is already promoted.

Pancreatic cancer cells also spread much earlier on other parts of the body than in other types of cancer, which typically only spread when the original tumors are large. The disease typically does not cause symptoms until later and there is no routine screening for this cancer, such as: B. a mammography or colonoscopy.

As soon as it has been recognized, there are only a few effective treatments.

“Although we made considerable progress in improving the results in many other types of cancer, they had no major impact on the pancreatic cancer” in the memorial sloan Kettering Cancer Cancer. “Despite our best current treatments, the survival rate has remained about 10%.”

This underlines the desperate need for more options, he said.

Before MRNA vaccines were widespread for covid, the researchers had already developed the technology for cancer treatment. This version of the vaccines teaches a person’s immune system to recognize and attack tumors and transform the immune system into a cancer machine. MRNA technology is currently being examined for melanomas, colon cancer and other solid tumors.

To be effective, MRNA cancer vaccines have to produce many T cells, a kind of immune cell that protects the body from invaders. These T cells must also hold a long time for cancer patients and maintain their ability to demonstrate and combat cancer cells. This is a relatively simple performance when it comes to viruses, it is much more difficult to teach a person’s T cells, not to fight for the body itself that your body has done.

The task is monumental in the case of pancreatic cancer.

In order for a vaccine to teach the body to recognize tumors, goals have to be on the unique tumor cells, which means that they do not appear elsewhere in the body. Since tumors are generated from mutations, these mutations, which are expressed as proteins on the surface of cancer cells, serve as goals. Sure of pancreatic cancer usually does not have many destinations to choose from.

It was a widespread conviction that this lack of mutations that serve as goals for an MRNA cancer vaccine would make pancreatic cancer a bad choice for therapy. However, the new study showed that the assumption may be wrong.

The study was a long track of a first study of 2023, in which the effectiveness of the vaccines in a subgroup of people with pancreatic cancer was first tested. Clinical phase -1 studies are very early stages of research and should determine whether a certain treatment is safe and promises effectiveness.

The new study included 16 patients with surviving pancreatic cancer, which means that surgeon can remove the tumors. This is a relatively rare occurrence of pancreatic cancer – only about 20% of the pancreas cancer are operated, which is the only treatment that can stop this type of cancer. Chemotherapy, radiation and immunotherapies can reduce tumors or reduce them from growth, but are not regarded as a remedy. With an even smaller percentage of people, surgery is possible without first reducing the tumors with chemotherapy, said Wolpin. The cancer returns about half the time.

Balacandran and his team followed the 16 patients in the study for up to four years. The participants first had their tumors remove between 2019 and 2021. Then the team used genetic material of the tumors of every person to design personalized mRNA vaccines from which they hoped that they would teach the patient’s immune system to attack their cancer cells.

In addition to the vaccine, all 16 people were also dealt with with the current supply standard – surgery, chemotherapy and immunotherapy medication, which was referred to as atezolizumab.

Half of the people in the study – eight of the participants – reacted to the vaccine and produced T cells that aimed at their tumors. The other half did not react to the vaccine.

One of the most important aspects when using the immune system of a person to combat their cancer is to ensure their reaction in this case, the cancer-fighting cell-one durability. In this way they stay in the body and fight cancer cells that appear instead of only working for a short time.

In the people in the study that assembled a reaction, the vaccine would give their cancer control cells an average lifespan of almost eight years, the researchers estimated. They believe that about 20% of the T cells could survive and work for decades. The longer the T cells survive, the better it protects against the return of the cancer.

Early studies should test whether treatment is feasible or not -in this case if an MRNA vaccine could produce permanent T cells against pancreatic cancer.

The results indicate that it can. However, it is not yet known whether these T cells extend a person’s life and if so, how much – that is a task for the next phases of experiments. Only two of the patients who reacted to the vaccine returned during the three -year tracking to cancer compared to seven of the eight that did not respond to the vaccine treatments.

“You have to take this with a small perspective. This does not deal with hundreds of thousands of people,” said Dr. Brian Wolpin, director of the gastrointestinal cancer center at the Dana-Farber Cancer Institute. “The fact that they were able to use a vaccine to generate a reaction to new mutations that appear in the tumors and then prove that this can be done is promising.”

Since pancreatic cancer cells can spread at an early stage, some organs cannot accommodate detectable cancer cells that do not appear on scans, which means that these tumors are not treated.

With vaccines, the immune system can possibly kill these cancer cells, and new ones that appear, said Dr. Shubham Pant, professor of gastrointestinal medical oncology at the MD Anderson Cancer Center at the University of Texas.

Very early in the development of pancreatic cancer, “cells in the liver or in the lungs can set up a shop. You can sit quietly in these other organs and then come back, ”he said.

Despite the restriction of a small group of patients and a very early study, Pant said, the results are encouraging.

Other research teams, including MD Anderson scientists, work on mrNA vaccines against pancreatic cancer of mRNA vaccines, which means.

About 90% of the cases of pancreatic cancer include a mutation called Kras, which means that not personalized vaccines could be produced in large quantities and would not generate a piece of the tumor of a person, possibly a further option in the street. (These vaccines are currently also in very early research stadiums).

“This gives us a little more confidence that it is not a shock reaction as soon as you receive a T -Zell reaction that it is durable,” said Pant. “If we can see that this answer was in larger attempts, that’s really important.”