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Ivan Pourmir (medical oncologist)
A personalized treatment trial based on messenger RNA and published in the journal Nature has revealed promising initial results against pancreatic cancer. Hope in this cancer with a rather gloomy diagnosis? The opinion of Dr Ivan Pourmir, oncologist.
This is an important scientific announcement that was published on Wednesday in the scientific journal Nature. A personalized treatment based on messenger RNA developed by BioNTech and Roche on aggressive forms of pancreatic cancer would have given good results. A real glimmer of hope when we know that pancreatic cancer, precisely the pancreatic ductal adenocarcinoma (PDAC) studied here, very often develops without symptoms without being detected, until an advanced stage against which treatments are not very effective. , whether chemotherapy, radiotherapy, immunotherapy or targeted therapies.
Half of the participants developed an immune response
In its press release, the Memorial Sloan Kettering cancer center explains the approach involved: vaccines are tailor-made for each person, designed with proteins from pancreatic tumors, called neoantigens. The aim is to train the immune system to identify cancer cells as foreign and thus reduce the risk of recurrence after surgical removal of the main tumour.
During this first phase of testing, half of the 16 participants receiving this personalized vaccine developed cells capable of spotting cancerous cells and preventing them from reappearing. Among the eight trial participants whose immune response was detectable, there was no evidence of cancer recurrence 18 months after the operation when recurrence is common in this type of cancer. “These data are extremely promising and will provide the framework for a planned new clinical trial”explains the scientific journal.
Results which also reinforce the idea that the messenger RNA used and sometimes criticized in the context of anti-Covid vaccines has real potential against cancer.
“These results provide a better understanding of the role of tumor vaccination”
For Dr. Ivan Pourmir, medical oncologist at the George-Pompidou European Hospital in Paris, the announcement is important, and comes as the logical continuation of other research in this field.
“This is an interesting cancer immunotherapy approach that has recently been successfully employed in the case of melanoma by Moderna and Merck. The added value of vaccination is particularly interesting in the case of the pancreas, because it is a cancer which has a very strong tendency to recur in the form of metastases despite treatments complementary to surgery, and unlike melanoma, patients rarely initiate a anti-cancer immune response. What’s also interesting is that chemotherapy, which is toxic to immune cells, is not given at the same time as immunotherapy.” he details.
However, the researcher mentions a path still to be traveled to reach a real cure:
“Despite these theoretical advantages, I am reserved on the practical application. Among 32 patients initially included in the trial, only 16 received the experimental treatment. In addition, this protocol required delaying the administration of chemotherapy after the operation, while the personalized vaccine was designed and administered. Thus, it took 5 months for the usual chemotherapy to be administered. It is to be feared that such a delay leaves time for metastases to settle. The authors hope that it will be reduced in future trials, but this seems unrealistic in current practice because all procedure times were already reduced to the maximum.
In conclusion, these results are promising and provide a better understanding of the role of tumor vaccination. But they remain to be confirmed or invalidated on large cohorts, with a control group to verify that this treatment is feasible and superior to the current standard chemotherapy treatment.