When a routine scan leads to Barbara Brigham Pancreatic cancer The 2020 diagnosis was that all she could think of was that she wanted more time. Her husband had just passed away. She loved working in the local library. Her three children were still raising their own family.
She relied on the care team at Memorial Sloan Kettering Cancer Center to learn about her options. Brigham first came to the cancer centre when he was diagnosed with a small, non-cancerous cyst in the pancreas. Every year she was scanned to make sure she had no new cysts. It was the annual scan that I found the early stages. Pancreatic cancer.
Brigham and her youngest son went to Sloan Kettering the following day to meet Dr. Vinod Balachandran, a surgical oncologist specializing in pancreatic cancer. While laying out her options for fighting cancer, he said he was doing clinical trials that he believed she was the “perfect candidate.”
This trial combines standard surgery with chemotherapy treatments (standard care for pancreatic cancer) with customized ones. mRNA vaccine. Each vaccine is designed based on the individual tumor of the patient. The idea was that vaccines could help the body’s immune system attack cancer, Balachandran told CBS News.
“Looking at my son, he said, ‘Absolutely.’ So we decided to do that,” Brigham said. “The prognosis was not good when I was diagnosed. You know that time is limited. I just wanted to extend that time.”
©Kreg Holt / Memorial Sloan Kettering Cancer Center
Helps the immune system recognize cancer
The inspiration for clinical trials is Long-term pancreatic survivorssaid Balachandran. Only about 10% of people diagnosed with pancreatic cancer have survived for more than five years.
About a decade ago, Balachandran and other researchers turned their attention to these “long-term” survivors. Several studies have found that the immune system of long-term survivors produced a “spontaneous immune response” against cancer. This means that your immune system can recognize that cancer is a threat and respond accordingly. “Teaching the immune system to recognize cancer is usually “challenging,” Balachandran said.
“This led to the question: ‘If this is what’s happening in the best scenario, can we replicate the success of other pancreatic cancer patients?’ “In other words, can you teach other patients to recognize cancer in a very similar way to what happens naturally in long-term survivors? “Balachandran said.
Phase 1 clinical trials examined 16 patients with early stage pancreatic cancer, such as Brigham. To qualify for the exam, the patient’s cancer was only in the pancreas and had to be surgically removable. These conditions occur between 20% and 25% of patients with pancreatic cancer, and reflect the condition of most long-term survivors, Balachandran said. During the surgery, the patient’s tumor was removed and sent to a research partner at Sloan-Kettering, a German biotech company Biontech. From the tumor, BioNTech creates a vaccine, which is administered to the patient along with weeks of immunotherapy and chemotherapy.
The vaccine targeted mutations produced by pancreatic cancer. Genetic errors accumulate when cancer cells divide rapidly in the body, Balachandran said. These errors could function as “the red flag of the immune system,” he says, which became a matter of teaching those cells to warn the immune system and recognize it.
Produces a “strong immune response”
Of the 16 patients included in the trial, eight had a “strong immune response,” Balachandran said. The difference seemed to depend on the type of surgery that had to be removed for pancreatic cancer. Those who removed the spleen as part of their treatment did not generate a strong immune response due to the important role the organs play. Immune function.
Previous data published by Balachandran showed that of eight out of eight who had a strong immune response, the cancer was free from cancer 18 months after treatment. On average, we see early stage pancreatic cancer being treated with chemotherapy and the cancer is repeated within a year of surgery.
Now, a new study published in Nature examined the same patients three years after treatment. Follow-up found that only two of the eight patients with a strong immune response had seen cancer return.
Meanwhile, seven of the eight non-responder patients had returned cancer within the window of that 3.2 years, Balachandran said.
Although the data appears promising, Balachandran warned that “it is still difficult to attribute causality to causality” especially due to the small size of the trial.
Dr. Suneel Kamath, a gastrointestinal oncologist at Cleveland Clinic, noted that the survival rate of patients during the trial was similar to that of early pancreatic cancer treated with surgery, as he was not involved in the trial. . and chemotherapy.
“This is a great proof-of-concept study showing that we can create a vaccine for this disease, and it actually produces an immune response and an immune response,” Kamas said. “It’s a really great backbone to build.”
Another larger clinical trial is ongoing, Balachandran said. The randomized trial will focus only on patients with early pancreatic cancer in the intact spleen, confirming the role that organs play in the process, he said. It also helps to see if there is a link between the vaccine and better outcomes for patients with pancreatic cancer.
mRNA vaccines for cancer treatment
Many other researchers have focused on how to do this mRNA Vaccines can be used to treat cancer. Such a study is currently underway long before coronavirus pandemic last mRNA vaccination progresses to the spotlight, and Camas, which is working with Modernida in another mRNA vaccine trial, examining pandemic and stomach cancer. I stated.
What makes mRNA vaccines suitable for cancer treatments is how easy they can be customized, Kamas said. Balachandran said it took about nine weeks for the vaccine to be made for each patient in clinical trials. That included international delivery on both sides, he said.
“The beauty of mRNA vaccines is very fast to make them, as we saw in COVID development. It’s easy to generate. Once you find a new target, you’ll find a vaccine for that particular target. is very quick,” Kamath explained. . “When talking about cancer treatments, it’s really not a single monolithic disease, so it’s really exciting. Perhaps there are hundreds of different targets for all cancer types, so it’s very exciting for many different targets of those. The ability to quickly make vaccines is really strong.”
Part of that research is learning which cancers are better candidates for mRNA vaccines to be used as part of the treatment, Kamas said. Something like melanomait is easier to induce the immune system as it causes many mutations in the body. Kidney and lung cancer are other promising options, he said.
Something like pancreatic cancer with fewer mutations is more difficult, Subjects of previous research. Balachandran said that part of his goal when looking at pancreatic cancer is to see if mRNA vaccines can make a difference “between the most challenging cancers in oncology.”
“Hopefully this can provide some important lessons and clues, and how this can be done with other types of cancer,” Balachandran said.
“That kind of strange thing”
In Brigham’s case, taking part in a clinical trial gave her what she wanted: over four years since she was diagnosed with pancreatic cancer. Johns Hopkins said that people who, on average, are captured by pancreatic cancer “before the tumor grows or spreads” survive about three to three and a half years.
Over the past few months, Brigham has celebrated several milestones. Her youngest son welcomed his first child, the eighth grandson, in late 2024, and recently joined the extended family for his brother’s 60th anniversary.
Brigham has not had a recurrence since he joined the trial. Removed part of her pancreas and the organs produce insulin, leaving out diabetes, but she says it’s easier to manage.
“The trial was very strange,” Brigham said. “It’s given me this update in my life. Sometimes it’s a little difficult, but it’s worth it, it’s worth it.”
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