In a 61-year-old patient with a metastatic tumor, a spontaneous regression of the tumor mass occurred after vaccination against Covid19. Let’s try to understand how the vaccine may have contributed and how this phenomenon can be exploited in the future.
Immune system and tumors
The immune system plays a fundamental role in the prevention and fight against cancer, it acts silently and for years and for this reason its role is not always recognized.
Dangerous DNA mutations accumulate inside our bodies every day due to various factors: aging, UV rays, chemicals, smoking, etc. Our immune system is very efficient at detecting cells in which dangerous mutations are accumulating that could lead to the development of a tumor.
The ‘Natural Killer’ cells are a particular type of white blood cells responsible for the recognition and destruction of aberrant or tumor cells. With the passage of time and the accumulation of mutations, Natural Killer cells lose their effectiveness and tumors develop out of control.
When the tumor mass begins to grow, other immune mechanisms such as cytotoxic T lymphocytes come into play. As with viral infections, these T lymphocytes detect cancer cells and kill them.
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Cancers often accumulate so many mutations that they turn into ‘foreign elements’ for the immune system, which attacks and destroys them.
Why doesn’t the immune system eliminate all cancers?
Because tumors develop a series of defense mechanisms with respect to the immune system, they ‘hide’ or remain silent so that they are not ‘seen’.
Vaccine anticovid19 and cancer patients
Cancer patients are considered fragile and particularly susceptible to Covid19, the anti Covid19 vaccines have proven to be safe and effective in this type of patient. The patient we are talking about is 61 years old and was suffering from a myoepithelial carcinoma of the salivary gland with lung metastases.
This patient developed lung metastases after being operated on at the primary site of the tumor (salivary gland) and receiving radiotherapy in situ.
The doctors in charge of the patient decided not to proceed with the treatment of lung metastases because: the symptoms were mild, the disease was relatively silent and there were no clear guidelines on what to do. The patient received two doses of the Covid19 vaccine and after both injections she had very strong immune reactions: pain, fever, fatigue and headache.
After the double inoculation, the doctors proceeded with the staging (control of size and position of the tumor) of the metastases, finding a shrinkage from before 13% up to 70% compared to the pre-vaccine size.
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What may be the reason for the observed shrinkage?
As explained above, tumors often acquire a certain ability to hide from the immune system: the mRNA vaccine may have awakened the immune system which has become aware of the presence of metastases in the lungs. This hypothesis is supported by the fact that the researchers analyzed the tumor mass in the lungs before and after the vaccine and in the post-vaccine tumor mass, ‘immune infiltrates’ were identified, i.e. immune cells within the tumor mass (which were not previously present). This means that the vaccine not only activated the immune system but also directed it against the cancer.
After the two vaccine injections the patient had very violent immune reactions which probably indicated an activation of the immune system, first innate and then adaptive.
Why is this story important?
Although this case is isolated and probably fortuitous, it underlines the importance of the immune system in the fight against cancer. In recent decades, many therapies called immunotherapies have developed, ie therapies that involve the use or activation of the immune system or its elements. Currently, many laboratories and pharmaceutical companies are working on a cancer vaccine, which should activate and direct the immune system to fight the tumor just as happened to the patient in the clinical case.
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TAKE HOME MESSAGES:
- Reported a case of tumor shrinkage after vaccination against Covid19
- The vaccine triggered a strong immune response in the patient
- The vaccine by ‘waking up’ the immune system targeted it against the tumor, shrinking it
REF:
https://jitc.bmj.com/content/10/3/e004371
https://www.nature.com/articles/s41573-019-0052-1
https://www.nature.com/articles/s41577-020-0306-5
Aureliano Stingi, doctor in molecular biology works in the field of precision oncology. He collaborates with the World Health Organization in the battle against Covid19-themed fake news
Twitter: @AurelianoStingi Instagram: Aureliano _Stingi