In a recently conducted pilot research, a novel vaccination against pancreatic cancer that is based on mRNA technology and can be tailored to the specific needs of individual patients showed promise.
About 88 percent of persons who are diagnosed with pancreatic cancer will pass away as a direct result of the disease, making it one of the deadliest types of cancer.1 Even after surgery, around ninety percent of pancreatic cancer patients will experience a recurrence of their disease within seven to nine months. Pancreatic cancer is also one of the most difficult types of cancer to cure.2
On the other hand, there is hope for a better future in terms of therapy for pancreatic cancer, and even prevention. It has been proved by a team of academics and scientists working for BioNTech that tailor-made mRNA vaccines may give some glimmer of hope in the battle against this particularly lethal kind of cancer.
Eight of the sixteen participants in the trial had an immune response that was both efficient and long-lasting as a result of the vaccines, as was revealed in the research that was published in the journal Nature. The patients' immune systems were taught to recognize cancer cells and eliminate them from their bodies.2
"The key finding is that we have evidence that there might be the ability to target neoantigens in pancreatic cancer using vaccination," Benjamin Greenbaum, Ph.D., corresponding author of the study and Associate Attending the Computational Oncology Service at Memorial Sloan Kettering Cancer Center, said in an interview with Verywell. Greenbaum is also the Associate Attending the Computational Oncology Service at Memorial Sloan Kettering Cancer Center. "It was a disease that was often thought to be difficult to target using immune-based therapies five to ten years ago, but now it's not impossible," said the researcher.
Even though Greenbaum and his colleagues have demonstrated that their mRNA vaccine is risk-free and doable to manufacture and deliver to patients with early-stage pancreatic cancer following surgery, experts who were not part of the study state that it may take a significant amount of time before the vaccine is made available to the public.
"They will need to prove efficacy in larger groups of patients, possibly randomizing some patients to the treatment and others not to prove that it is the vaccine which is contributing to the benefit," James Farrell, MD, director of the Yale Center for Pancreatic Disease and a professor of medicine and surgery at the Yale School of Medicine, said in an interview with Verywell. Farrell is also a professor of medicine and surgery at the Yale School of Medicine. It may take several years before this is ready for approval.
The Mechanism Behind the Vaccine
BioNTech, a biotechnology business with headquarters in Germany, is the manufacturer of mRNA vaccines. If the name rings a bell, it's because it belongs to the same business that contributed to the development of the mRNA vaccines for COVID-19.3.
Greenbaum stated that the most significant distinction between the mRNA vaccines is that the ones his team developed are tailor-made for each patient based on the type of tumor that they have. Even though the technology is comparable.
According to Greenbaum, "This is a personalized vaccine, which means that it is created from the specific mutations in that patient's tumor." These mutations are responsible for the production of novel proteins within the tumor, which the immune system may be able to recognize.
Before beginning work on the vaccines, the scientists working in New York removed a portion of the tumor from each patient and sent a sample of it to researchers in Germany. Following this, the researchers at BioNTech examined the DNA and RNA found in the tumors to identify specific proteins known as neoantigens.
"This is not a one size fits all," said Farrell. "This is not a universal solution." "The malignancies of these patients have been removed, and the DNA and RNA contained within them have been examined. The researchers have then selected sequences of DNA and RNA that are a match for what is known as neoantigens.
The encouraging findings suggest that vaccination could one day serve as a treatment option for pancreatic cancer.
— VINOD BALACHANDRAN, MD
The researchers would then be able to develop an mRNA vaccine that is particular to the neoantigens, which, according to Farrell, are encased in very small particles that help protect their genetic material while it is being transported to the patient. During the research project, the patients received the vaccination via intravenous (IV) injection, and it was administered in a total of nine distinct doses.
Dendritic cells, which are specialized white blood cells that are part of the immune system, are responsible for absorbing the vaccine once it has been given to the patient, as stated by Farrell. The genetic material found in the mRNA vaccination is used by the cells to produce neoantigen proteins, which are proteins that are analogous to those found on a patient's primary tumor.
According to Farrell, once the proteins are released into the bloodstream, they move throughout the body and are finally recognized by the immune system as foreign invaders. They send a message to the immune system that tells it to "activate" and ramp up its reaction.
These proteins are recognized as markers of cancer cells by the activated cells of the immune system, which are referred to as T cells. Next, the T cells multiply and begin to zero in on the tumor cells that are displaying neoantigens, which they then proceed to assault and, in some cases, eliminate.
According to Farrell, when the vaccination is administered in conjunction with a medicine that blocks an immunological checkpoint to "rev up the immune system," it "teaches the immune system to recognize and fight tumor cells, which express these types of proteins."
A Limited But Fascinating Research Project
The researchers recruited a total of 16 participants for the study, which got underway in December 2019. All of the patients were white, and they were in the early stages of the disease when it was still possible to remove it surgically (resect).
In addition to receiving the vaccination, each patient also received chemotherapy and a checkpoint inhibitor medicine. These treatments, which work together to enhance immune responses, were given to all of the patients.3
The vaccination was effective for eight of the sixteen patients who were tested. Because of this, their immune systems were able to learn how to identify cancer cells and eliminate them from the body. During the 18 months during which the patients were monitored, there were no indications that the patients' pancreatic malignancies had returned.
Vinod Balachandran, MD, a pancreatic cancer surgeon who conducted the initial clinical trial, stated that these "exciting results indicate that we may someday be able to use vaccines as a therapy against pancreatic cancer." This quote was included in a news release that was issued in conjunction with the research.
How Close Are We to Developing Vaccines Against Cancer?
Although the clinical trial revealed encouraging results in a limited sample of patients, other experts who were not involved in the study have cautioned that it is possible that factors such as chemotherapy and other treatments contributed to the reason why some individuals responded well to the vaccination.
"One has to be cautiously optimistic, but also take note of the fact that the patients did get other therapies," 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, said in an interview with Verywell. Maitra is also the scientific director of the Sheikh Ahmed Pancreatic Cancer Research Center. "They received chemotherapy in addition to another immunotherapy that was administered in conjunction with a vaccine." "Chemotherapy is typically administered to all patients as a standard of care following surgical procedures."
It was a disease that was commonly regarded to be difficult to target with immune-based therapies anywhere from five to 10 years ago, but now it is not impossible to do so.
— BENJAMIN GREENBAUM, PHD
According to Maitra, it may be a few years before an mRNA vaccine for pancreatic cancer is accessible. This is because there are still a lot of concerns that need to be solved about the efficiency of the vaccine, such as how much of the effect is because of chemotherapy compared to obtaining the vaccine by itself.
"We don't have full clarity on that," he added. "I'm sorry." However, this is only the first step of the study, and the two most crucial concerns to ask at this stage are if the procedure is safe and whether it can even be done.
According to Maitra, further clinical tests, including the second study, will need to involve a greater number of patients who will be receiving numerous treatments, as well as patients who will be receiving those treatments in addition to the vaccination. The researchers will be able to evaluate the effects of the vaccine alongside the impacts of not receiving the vaccine as a result of this.
"It's going to take some time to do the phase 2 trial and then to move on to phase three if that success happens," he said. "At this point, we have to see what the larger trials show in terms of efficacy, and that could take anywhere from three to five years or more." "We are some ways from that because, at this point, we have to see what the larger trials show."
According to the findings of the researchers, an expanded randomized clinical trial that will involve patients at different locations across several nations is about to get underway. This summer, the research team at Memorial Sloan Kettering Cancer Center anticipates getting the ball rolling on recruiting patients for the study.
What Types of Treatments Are Currently Available for Patients with Pancreatic Cancer?
However, there are some treatments available for pancreatic cancer, even though pancreatic cancer vaccines do not yet exist and it may be many years before they become accessible. If you have just received a diagnosis, you should be aware that the therapy that is appropriate for you will be determined by the stage of your cancer, your overall health, and the recommendations of your healthcare team. If you have just received a diagnosis, you should know this.4
- Surgery: Your healthcare practitioner may propose surgery to remove the tumor depending on the stage of the cancer and the location of the tumor. This course of action seeks to eliminate all malignant tissue, which may involve the removal of tumors, sections of the pancreas, or any other organs that are impacted by the disease.5
- Radiation therapy refers to a type of treatment in which radiation is focused on and used to kill cancer cells. It is also known as adjuvant therapy, and it is an option that is often provided after surgery as a method to prevent cancer from returning. Adjuvant therapy is typically given as a way to prevent cancer from returning. It may make some patients live longer. To reduce tumors before surgery, radiation therapy may also be employed.4
- Chemotherapy is a therapeutic approach that involves the use of medications that kill cancer cells or reduce the growth of cancer cells. It is also possible to combine it with other therapies such as radiation therapy. This allows it to be administered either before or after surgical procedures.4
- Immunotherapy is a form of treatment that is also known as targeted therapy. In this treatment, the immune system of the patient is used to identify and destroy cancer cells. Immunotherapies may be administered on their own or in combination with other types of cancer treatment. Immunotherapies, according to certain findings from recent studies, may be superior to standard care in terms of their ability to increase the length of life for patients diagnosed with stage IV pancreatic cancer.