Breast cancer patients have found new hope after a new vaccine showed “promise” in treating an aggressive form of the disease.
The findings come from a clinical trial involving U.S. patients with triple-negative breast cancer who received an experimental drug designed to prevent tumors from recurring.
The trial, using a therapy designed by researchers at Washington University School of Medicine in St. Louis, is the first to report results from a “neoantigen DNA vaccine” for patients with breast cancer.
The results, published in the journal Genome Medicine, showed that the vaccine was “well tolerated” and properly stimulated the immune system.
The trial included 18 patients diagnosed with triple-negative breast cancer that had not yet metastasized. Each patient received standard care and three doses of a personalized vaccine tailored to target key mutations in their specific tumor and train immune cells to recognize and attack any cells carrying the mutations.
After treatment, 14 of the 18 patients showed an immune response to the vaccine, and after three years, 16 patients were cancer-free.
Although the early-stage trial was designed to evaluate the safety of the vaccine and did not include a control group to determine effectiveness, the research team analyzed historical data from patients with breast cancer. triple negative breast treated only with standard care.
In this group, on average, only about half of the patients remained cancer-free three years after treatment.
The study’s lead author, Professor William Gillanders, of the University of Washington School of Medicine, admits it is not a perfect comparison and says there are key limitations to this type of analysis.
“But we continue to pursue this vaccine strategy and are currently conducting randomized controlled trials that do a head-to-head comparison between standard of care plus a vaccine and standard of care alone,” he said.
“We are encouraged by what we are seeing so far with these patients. »
Triple negative breast cancer is an aggressive type of tumor that grows even in the absence of the hormonal fuel that causes other types of breast cancer to grow. There is currently no targeted treatment and is usually treated with traditional approaches including surgery, chemotherapy and radiotherapy.
For the trial, patients with triple negative breast cancer who still had evidence of a tumor after a first cycle of chemotherapy were eligible to participate.
Researchers say these patients are at “high risk” of cancer recurrence, even after the remaining tumor is surgically removed.
After surgery, the team analyzed and compared the tumor tissue with healthy tissue from the same patient to find unique genetic mutations in the cancer cells.
These can modify proteins only in the tumor, thereby training the immune system to attack the altered proteins and leave healthy tissue alone.
Using the software they designed, the researchers selected modified proteins called neoantigens, made by the patient’s tumors and identified as most likely to trigger a strong immune response.
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On average, each patient’s vaccine contained 11 neoantigens, ranging from a minimum of 4 to a maximum of 20, all specific to their tumor.
“These are complex algorithms, but in general the software takes a list of mutations and interprets them in the context of their potential to become good candidates for neoantigens,” said Professor Malachi Griffith, who co-led the development of the software.
“The tools classify possible neoantigens based on our current knowledge of what matters in stimulating the immune system to attack cancer cells.”
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Several studies of cancer vaccines developed at the University of Washington School of Medicine are currently underway.
In some trials in breast cancer patients, personalized vaccines are being studied in combination with immunotherapies called checkpoint inhibitors that stimulate the action of T cells.
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