Remember how sun rays wake up En Sabah Nur after millennia of deep slumber in X: Men Apocalypse? Well, a new immunotherapeutic drug has been discovered that ‘wakes up’ the immune system of metastatic pancreatic cancer patients, after it has effectively gone into hibernation as a result of the tumor.
Cancer of the pancreas is one of the most aggressive types of cancer and about 80% of patients have locally advanced or metastatic disease at the time of diagnosis*. 18% of patients with advanced pancreatic cancer survive a year and only about 4 percent survive about five years. It ranks among those cancers with one of the worst survival rates**. Statistical evidence shows the dire need for novel therapeutic options.
The immunotherapy drug discovered, IMM-101, is an immune modulator and was originally developed as a cancer vaccine, containing an inactivated bacterium. It then got realized as an immunotherapy drug for cancer. The uniqueness of the drug? It has no side effects. This is unlike any other immunotherapy drug studied or used to date. The mechanism of action of IMM-101 is summarized in the following figure.
A team of researchers led by Angus Dalgleish, professor of Oncology at St.George’s, University of London, found that patients who received this novel immunotherapy drug showed a better response than those on conventional chemotherapy.
Dalgleish is thrilled about IMM-101, “This is the first time we have got an immunotherapy that is a really good candidate to help control pancreatic cancer, which is one of the biggest killing diseases. Its incidence nearly matches its mortality. It is absolutely staggering.” The fact that the drug has no side effects, elevates its importance. Therapeutic drugs with no side effects is not common. “That’s never been seen before,” he said. “You always add toxicity and misery in my experience with each additional thing you put in.”
Most of the patients taking part in the trial, 85%, had metastatic cancer. Those solely on the standard chemo drug lived for a median of 4.4 months, but those with the standard drug as well as IMM-101 survived about seven months. And a few more survived for more than twelve months, with one even living on for three years. The results of the study are published in the British Journal of Cancer.
Immunotherapy drugs have previously been tested, with positive and astonishing results, on lung cancer and skin cancer. Dalgleish had previously carried out studies of IMM-101 in skin cancer patients- with positive results. “In my melanoma patients in particular, patients have shown greatly increased survival rates and enjoy a much better quality of life. In some patients I’ve actually seen the cancer disappearing altogether,” he said.
The current study was a first test on pancreatic cancer, a daunting type of tumor that is generally very protected from immunotherapy drugs. The overall survival (OS) between patients – taking part in the study- on IMM-101 immunotherapy with those on chemotherapy, was not significant, however. The former survived a median of 6.7 months, a month over the latter, who survived a median of 5.6 months.
That may not sound huge in itself. But living without experiencing any treatment-induced side-effects, especially the highly unpleasant ones accompanying chemotherapy, and surviving for a month more, is in itself an achievement: it’s better quality of life.
The reason for this slight difference is that 18 of the 110 patients in the trial, had locally advanced disease and they seemed to be better off without the immunotherapy drug. Their overall survival was a median of 6.7 months with IMM-101 and 9.2 months without it. A combination treatment of IMM-101 and the chemo drug gemcitabine, did not benefit patients whose cancer was local -that is, restricted to the pancreas. However, it did benefit patients whose cancer had metastasized – that is, cancer that has spread from the primary site of the pancreas to secondary sites in the body. But results from 18 patients is not generalizable to the entire population of metastatic pancreatic cancer patients. Since metastatic cancer is in effect a different disease, a bigger study is being planned that will include patients only with metastatic pancreatic cancer.
This study has made the scientific community excited about a cancer treatment that has no side-effects, and they are optimistic about future cancer therapies. Kevin Harrington, consultant at the Royal Marsden and professor of biological cancer therapies at the Institute of Cancer Research in London, said, “This looks like a very interesting approach. It is different. It appears to be extremely well-tolerated and it has led to something that looks interesting in terms of survival but it hasn’t quite got there.”
Dr.Justine Alford, senior science information officer at Cancer Research UK, said, “While the results of this early trial didn’t show whether combining the immunotherapy drug with standard chemotherapy actually improved survival, they showed the combination treatment was safe and might help some patients. Further research with more patients is needed to develop therapies that can improve survival. Pancreatic cancer is difficult to treat and survival still remains low, which is why new treatments are urgently needed.”
The Institute for Cancer Vaccines and Immunotherapy supported the study, with its chair of trustees Harry Cotterell saying, “These are exciting results and support our hope that immunotherapy will in future become a generally accepted treatment for a wide range of cancers, improving both survival rates and quality of life.”
This is so nerdy and I can’t believe I’m saying this, but yeah: Remember how En Sabah Nur (when ‘recruiting’ Eric) says, ”Everything they’ve built will fall! And from the ashes of their world, we’ll build a better one!” Well, that’s our message to cancer cells. Everything they’ve built within the human body, will fall and be destroyed by ever-evolving novel cancer drugs. And we’ll try curing the body and building it back as best possible.