May is National Cancer Research Month. While the cure for many types of cancer still remains to be discovered, recent advancements and trials are getting researchers closer. Here we highlight some of the top trends and developments in cancer research.
Personalized Cancer Vaccines
When we think of vaccines, we typically think of disease prevention. While there are vaccines that prevent cancer, researchers are developing therapeutic vaccines to treat cancer. These vaccines use immunotherapy to boost the body’s immune system to keep the cancer from coming back, destroy any cancer cells left after treatments end, and/or stop a tumor from growing or spreading.1 Though cancer vaccines have been around for awhile, researches are now getting more robust and consistent results with personalized cancer vaccines and are learning more about vaccine-induced immune response.2
A personalized cancer vaccine, known as PGV-001, showed promising results in its phase I clinical trial in 13 patients with either multiple myeloma, head and neck cancer, lung cancer, breast cancer, or bladder cancer—all with a high risk of recurrence. After an average of 880 days, four patients who had not received additional therapy had no evidence of cancer.3
Researchers also recently reported success for a personalized cancer vaccine designed to prevent melanoma recurrence. Eight high-risk melanoma patients who had their melanoma surgically removed were given these vaccines, targeted individually to their cancer. Four years later, the researchers found that the initial immune response to the vaccine was still present.2
Personalized Cancer Therapy
While cancer vaccines are one example of personalized cancer therapy, recent discoveries are paving the way for other personalized forms of cancer therapy. Using a new algorithm via machine learning technology, researchers discovered 165 new, unaltered genes that cause cancer. Shown to be essential for the survival of tumor cells, these genes interact closely with cancer genes.
"Ideally, we obtain a complete picture of all cancer genes at some point, which can have a different impact on cancer progression for different patients," says Marsico, head of a research group at Helmholtz Zentrum München. "This is the foundation for personalized cancer therapy."4
Personalized medicine for breast cancer patients has been here for awhile. Decades of breast cancer research has led to genomic testing which helps identify risk for recurring cancer for breast cancer patients. This helps inform treatment plans—i.e. whether or not chemotherapy is needed. Until recently, however, there was still uncertainty of how much those with intermediate risk for breast cancer recurrence would benefit from chemotherapy. New research has helped answer this question. Results from a recent trial demonstrated that most women over the age of 50 with intermediate risk did not benefit from chemotherapy. Women under the age of 50 responded better to a combination of chemotherapy and hormone therapy. Trials like this one have moved the needle for more personalized treatment decisions based not only on the stage and type of cancer, but additional factors like the age of the patient.5
Immunotherapy-Based Combination Therapy
First used to treat bone cancer in 1891, immunotherapy has existed for a long time. The discovery of T-cells and their role in immunity was discovered in 1967, guiding researchers towards cancer immunotherapy as we know today.6 While immunotherapy treatments continue to show promise, challenges remain both in patient response and dose-limiting toxicities.7
Many researchers are studying promising effects of immunotherapy in combination with other therapies. Tian Zhang, MD, a medical oncologist and assistant professor of medicine at Duke Cancer Institute discusses ‘first-line’ renal cell carcinoma (RCC) trials for patients receiving an immunotherapy-based therapy combination. She quotes, "We are really coming into a different era of immunotherapy-based treatments for patients with metastatic kidney cancer.” She goes on to conclude that through these studies, a lot more is now known about when to stop treatment and what to look out for during the course of treatment.8
CAR T-cell therapy is a type of immunotherapy in which a person’s T-cells are removed from their body and ‘reprogrammed’ in a lab to fight and attack cancer cells. Once these genetically altered T-cells are injected back into the cancer patient's own body, they go on to multiply and continue to fight cancer over time.9
In a recent phase 2 trial with multiple myeloma (MM) patients who had previously relapsed multiple times, the expected length of remission almost tripled for some through a new chimeric antigen receptor CAR T-cell therapy.10 Though the question still remains similar to other immunotherapies—why is there success for some and not others?
To help address this question, CAR T-cell therapy is being studied in combination with immune checkpoint inhibitors and bispecific antibodies.
Stephen J. Schuster, MD, Director of the Lymphoma Program at the Abramson Cancer Center, University of Pennsylvania quotes, “We’re going to be combining CAR T-cells with other therapies, and moving it up earlier in therapy for patients… I think it's going to change the landscape.” The order and role of immune checkpoint inhibitors and bispecific antibodies in combination with CAR T-cell administration ‘will open new possibilities’.11
Repurposing Drugs
In 1995, the FDA approved a drug called metformin which has become the most prescribed drug for diabetes in the United States. Prior to the development of metformin, a drug called phenformin was used, but was pulled from the market due to a potentially fatal buildup of lactic acid in the blood in some instances. In 2005, scientists discovered that people who had been taking metformin were less likely to develop cancer. While subsequent studies failed to support positive outcomes for using metformin to treat cancer, lab research showed that phenformin had greater potential for treating skin cancer—especially when used in combination with immunotherapies. And while phenformin is more toxic than metformin, it’s less toxic than other current chemotherapies.12
BioMatrix provides access to specialty and limited distribution oncology drugs with individualized patient support removing barriers to care, reducing adverse events, increasing adherence, and improving quality of life.
We help our patients better understand the details of their cancer treatment and, partnering with the patient and their physician, we provide compassionate support, education, and expert pharmaceutical services.
References
ASCO. What are Cancer Vaccines? https://www.cancer.net/navigating-cancer-care/how-cancer-treated/immunotherapy-and-vaccines/what-are-cancer-vaccines
The Harvard Gazette. Cancer Vaccine Shows Durable Immune Effects. https://news.harvard.edu/gazette/story/2021/04/personalized-melanoma-vaccines-show-lasting-effects/
WebMD. Cancer Vaccine Shows Early Promise Across Tumor Types. https://www.webmd.com/cancer/news/20210416/cancer-vaccine-shows-early-promise-across-tumor-types
Science Daily. 165 New Cancer Genes Identified with the Help of Machine Learning. https://www.sciencedaily.com/releases/2021/04/210412142730.htm
Harvard Health Publishing. Can Some Postmenopausal Women with Breast Cancer Skip Chemotherapy? https://www.health.harvard.edu/blog/can-some-postmenopausal-women-with-breast-cancer-skip-chemotherapy-2021041522344
US National Library of Medicine National Institutes of Health. The Intriguing History of Cancer Immunotherapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928196/#:~:text=The%20next%20significant%20advances%20came,treating%20bone%20cancer%20in%201891.
Nature Reviews. Cancer Nanomedicine for Combination Cancer Immunotherapy. http://umich.edu/~moonlab/ewExternalFiles/66-Nam-NatRevMat-2019.pdf
OncLive. Entering an Era of Immunotherapy-Based Combinations for Metastatic RCC. https://www.onclive.com/view/entering-an-era-of-immunotherapy-based-combinations-for-metastatic-rcc
ASCO. CAR T-Cell Immunotherapy: The 2018 Advance of the Year. https://www.cancer.net/blog/2018-01/car-t-cell-immunotherapy-2018-advance-year
AJMC. CAR T Therapy Induces Response in Majority of Patients With Relapsed Multiple Myeloma. https://www.ajmc.com/view/car-t-therapy-induces-response-in-majority-of-patients-with-relapsed-multiple-myeloma
AJMC. Looking at Long-term Results, New Opportunities With CAR T-Cell Therapies. https://www.ajmc.com/view/looking-at-long-term-results-new-opportunities-with-car-t-cell-therapies
Medical News Today. Diabetes Drug May Be A Valuable Ally Against Cancer. https://www.medicalnewstoday.com/articles/diabetes-drug-may-be-a-valuable-ally-against-cancer
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