An anti-cancer vaccine to be used alongside chemotherapy or immunotherapy in patients with advanced lung cancer who no longer respond to first-line therapies. An important challenge given that for some patients at some point the charm of immunotherapy breaks down and resistance develops. Many patients, in fact, after an initial period of benefit, tend to have a progression and evolution of the disease again. But from the annual congress of the American Society of Clinical Oncology (Asco) new possible perspectives come thanks to the presentation of a phase 2 study conducted by the IRCCS Istituto Regina Elena in Rome which involves 20 Italian centers and 10 French and Spanish centers.
Research
The trial kicked off a year ago and is enrolling over 100 patients with metastatic non-small cell lung cancer (NSCLC) who are no longer responding to first-line chemo and immunotherapy. The aim is to evaluate the efficacy of an innovative experimental anti-cancer vaccine, based on neo-epitopes, combined with chemotherapy or immunotherapy. “On patients resistant to immunotherapy – he declares Federico Cappuzzo, director of Medical Oncology 2 of the Irccs Regina Elena Institute in Rome, creator and promoter of the study – the efforts of clinicians and researchers are focusing more on identifying new drugs or new therapeutic combinations. We hope that our international multi-center study will advance and achieve these goals ”.
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Resistance to treatment
Immunotherapy has revolutionized the prospects for treatment. Until 10 years ago, a diagnosis of invasive, advanced or metastatic lung cancer almost always corresponded to a poor prognosis. Today, thanks to immunotherapy, the prognosis and quality of life of many patients has improved. What we are trying to understand now is why at some point we no longer respond to treatment. “After an initial period of benefit – explains Cappuzzo – some patients unfortunately tend to have a progression of their disease. For these patients we have experimental programs including a program with an innovative vaccine that we are using in association with chemotherapy or in association with immunotherapy itself and we obviously hope that the results of this study can help improve the performance of patients with this type of pathology “. The study is aimed at selected people with very specific characteristics and requirements that doctors evaluate from time to time when the patient comes for their observation.
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How the cancer vaccine works
The new anti-cancer vaccine acts on 5 tumor antigens that are very common in lung cancer. Its use in previous studies has shown a positive risk-benefit ratio, compared to standard of care, in patients with advanced NSCLC, resistance to chemotherapy followed by immunotherapy and no therapeutic alternatives. Now an extra piece is added, thanks to the experiment in which the vaccine is combined with chemo or immunotherapy itself.