Breakthrough mRNA vaccine promises cure for deadly pancreatic cancer

Positive results from a new vaccine have raised hopes for a cure for pancreatic cancer. One of the deadliest cancers with limited treatment options, the survival rate for patients with pancreatic cancer is extremely low despite medical advances over the past two decades. This makes the messenger RNA vaccine [the same technology used to make the COVID-19 vaccines of US firms Pfizer and Moderna] a major medical breakthrough in the treatment of pancreatic cancer.

The autogenous cevumeran vaccine produced promising results in a small trial involving people whose cancers were detected early. Half of the 16 patients remained cancer-free 18 months after their tumors were removed and the mRNA vaccine was administered.

About 460,000 people worldwide are diagnosed with pancreatic cancer each year, resulting in nearly 430,000 deaths per year, according to the Cancer Research Institute in New York.

Healthcare professionals are thrilled as the results showed the tailored vaccine could train the human immune system to kill pancreatic cancer cells by stimulating immune cells that target tumours.

This is only the phase I trial; further trials are needed to confirm its effectiveness. Yet, given the high mortality, the vaccine offers real hope.

Here is an overview of the pancreas, its functions and how the vaccine fights pancreatic cancer.

What is the pancreas?

The pancreas is a vital organ located behind the stomach at the back of the abdomen, near the gallbladder. About 15cm long, it plays a crucial role in digestion by producing hormones, including insulin, and enzymes to digest fats, carbohydrates and proteins.

What is pancreatic cancer?

Pancreatic cancer results from uncontrolled cell growth in part of the pancreas. There are no warning signs until the cancer has reached an advanced stage. Even in advanced stages, some symptoms of pancreatic cancer can be subtle, according to Healthline.

Pancreatic cancer affects more men than women. Although it can occur at any age, pancreatic cancer is more likely to appear after the age of 55.

What are the types of cancer?

There are two main types of pancreatic cancer: pancreatic adenocarcinoma and pancreatic neuroendocrine tumors.

Cancer that begins in the ducts of the pancreas is called pancreatic adenocarcinoma or exocrine cancer of the pancreas. This is the most common type.

When cancer forms in the hormone-producing cells (neuroendocrine cells) of the pancreas, it is called pancreatic neuroendocrine tumors or pancreatic endocrine cancer. It’s quite rare.

What is the extent of this cancer?

About 460,000 people worldwide are diagnosed with pancreatic cancer each year, resulting in nearly 430,000 deaths per year, according to the Cancer Research Institute in New York.

Some reports indicate that the number of new pancreatic cancer cases and deaths will double by 2030.

Pancreatic cancer is the deadliest common cancer, with 90% of patients dying within two years of diagnosis. It is the only cancer with a 5-year survival rate of less than 10%.

What are the possible symptoms?

Some symptoms that appear in advanced stages include jaundice and abdominal pain. Pancreatic cancer can also affect your blood sugar levels and lead to diabetes or the worsening of pre-existing diabetes.

There are no specific symptoms of pancreatic cancer. The disease can cause some of the following symptoms, depending on the Health Line and Medical News Today:

  1. Loss of appetite
  2. Unintentional weight loss
  3. Abdominal pain, which may radiate to your back
  4. Lower back pain
  5. Blood clots (often in the leg, causing redness, pain and swelling)
  6. Jaundice
  7. Swelling of the gallbladder or liver
  8. Diabetes
  9. The Depression
  10. Light or oily stools
  11. Diarrhea or constipation
  12. Indigestion
  13. Dark or brown urine
  14. Itchy skin
  15. Nausea and vomiting
  16. Fever and chills
  17. Fatigue

Image credit: Seyyed dela Llata/Gulf News

What are the causes and risk factors?

The US-based Mayo Clinic, citing a large study, said the combination of smoking, diabetes and poor diet significantly increases the risk of pancreatic cancer.

Other risk factors include:

  • Smoking
  • Diabetes
  • Pancreatitis (chronic inflammation of the pancreas)
  • Family history of genetic syndromes
  • Family history of pancreatic cancer
  • Obesity
  • Old age (most people are diagnosed after age 65)
  • Heavy alcohol consumption
  • Diet (A diet high in red and processed meats, fried foods, or sugar may increase the risk)
  • Occupational exposure to certain chemicals
  • H. pylori infection or hepatitis B

Why is pancreatic cancer so deadly?

Pancreatic cancer is the deadliest common cancer, with 90% of patients dying within two years of diagnosis. It is the only cancer with a 5-year survival rate of less than 10%. Part of the reason is late diagnosis. And this results from the absence of symptoms in the early stages. By the time pancreatic cancer is detected, 70% of people are so sick that it’s too late for any treatment, says Chris Macdonald, head of research at Pancreatic Cancer UK.

Currently, only limited effective treatments are available for patients with advanced disease, especially those who are not eligible for surgery. “Pancreatic cancer is much more resistant to chemotherapy than other types of cancer, leaving patients with fewer options when it comes to treating the disease in its early stages,” says a report from the Institute. cancer research.

Is pancreatic cancer curable?

No, the disease is mostly incurable. But it has the potential to be curable if caught early. According to Johns Hopkins Medicine, up to 10% of patients who are diagnosed early are disease free after treatment.

“Pancreatic cancer is not a death sentence,” says Horacio Asbun, chief of hepatobiliary and pancreatic surgery at the Miami Cancer Institute, Baptist Health South Florida. “Although the prognosis is not good, new treatments and approaches are being developed all over the world…For the first time in a decade, we are making a significant improvement in the overall longevity of patients with breast cancer pancreas,” the US government said. -based doctor said Eat this, not that! Health.

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Image credit: Seyyed dela Llata/Gulf News

What is the new pancreatic cancer vaccine?

The new vaccine is called autogene cevumeran, an individualized neo-specific mRNA-based immunotherapy (iNeST), jointly developed by BioNTech with Genentech, a member of the Roche group. Each vaccine, given by intravenous infusion, is made with mRNA specific for these proteins in that individual’s tumor.

The vaccine will stimulate the production of immune cells (T cells) that recognize pancreatic cancer cells and attack them. Since T cells are on high alert to destroy cells containing these proteins, the risk of cancer recurrence is reduced after surgical removal of the primary tumour.

How is the vaccine personalized for each patient?

After a patient’s pancreatic tumor is removed, it is genetically sequenced to find mutations that produce neo-antigen proteins foreign to the body’s immune system. The vaccine is made with mRNA specific to these proteins in the patient’s tumor, according to a report from Memorial Sloan Kettering Cancer Center.

Once the vaccine is given to a patient, it stimulates the immune cells to make the neo-antigen proteins. Immune cells train the rest of the immune system (including T cells) to recognize and attack tumor cells that have the same proteins.

With T cells seeking to destroy cells containing these proteins, cancer may be less likely to come back, the report adds.

Is it a vaccine or a cure?

The job of a vaccine is to get the body’s immune system to fight a particular disease. Autogene cevumeran is a vaccine because it aims to prevent pancreatic cancer from coming back. The vaccine is given after the cancerous part of the pancreas or tumor has been surgically removed. It’s to keep the cancer from coming back, that’s why it’s called a vaccine.

What are the results of the phase 1 trial?

Memorial Sloan Kettering Cancer Center researchers, led by surgeon scientist Vinod Balachandran, worked with BioNTech to develop the vaccine.

In the phase 1 trial, 16 people received the vaccine nine weeks after surgery to remove their tumors. There was no effective immune response in eight cases when the cancer returned. But the vaccine elicited a good response in the other eight, and they remained cancer-free 18 months later.

The results of the groundbreaking trial were presented at the American Society of Clinical Oncology conference in Chicago in early June.

What do the vaccine results mean?

The phase 1 trial is very small. More extensive trials with more people and of longer duration will be needed to confirm the effectiveness of the vaccine. More importantly, the phase 1 trial only included people whose cancers were diagnosed and detected early enough to remove the tumors. Only 10% of people are diagnosed with the disease at this stage, said Chris Macdonald, head of research at the charity Pancreatic Cancer UK. new scientist. It is therefore far too early to say whether the vaccine will be able to help people with more advanced pancreatic cancer.

The trial participants also received chemotherapy and were given a drug called atezolizumab (a checkpoint inhibitor), the new scientist quoted Macdonald as saying. Some cancers prevent the immune system from attacking them, and checkpoint inhibitors block this signal, releasing a natural brake on the immune system.

Will the vaccine ward off cancer?

It is too early to tell as further testing is needed to find out. The new scientist The report states: “If some cancer cells survived the combination treatment, they could evolve to resist the immune attack triggered by the vaccine. This is why many tumors initially respond to treatment, but then develop resistance. That’s the risk with every type of cancer, according to Macdonald.

When will the vaccine be available?

A vaccine will need to go through several trials before being approved by regulatory agencies. The pancreatic cancer vaccine has only done phase 1 trials. More trials are needed to confirm its effectiveness.

Since survival rates for pancreatic cancer are so low, regulators are likely to speed up the approval process if larger trials are successful, the new scientist says the report.

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