There could be new hope on the horizon for kidney cancer patients in the form of an experimental vaccine.
Researchers at Dana-Farber Cancer Institute, Harvard Medical School, Yale Cancer Center and other universities have announced early findings from a study of an anti-tumor vaccine for patients with advanced kidney cancer.
“Patients with stage 3 or 4 kidney cancer are at high risk of recurrence,” said co-senior author and co-principal investigator Toni Choueiri, MD, director of the Lank Center for Genitourinary Cancer at Dana-Farber, in a press release.
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“The tools we have to lower that risk are not perfect, and we are relentlessly looking for more.”
After undergoing surgery to remove a malignant tumor, the study’s nine participants received a cancer vaccine that was intended to “train” their immune systems to identify and attack any lingering cancer cells, according to the press release.
Each vaccine was personalized to match the individual patient’s tumor type based on cancer cells that were removed during surgery. These cells contain “neoantigens,” which are “tiny fragments of mutant proteins,” the release stated. The researchers used “predictive algorithms” to determine which neoantigens should be included in the vaccine to provide the highest level of immunity.
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Five of the patients also received ipilimumab, a type of immunotherapy drug.
All nine patients showed a “successful anti-cancer immune response” after getting the vaccine. After an average of 34.7 months, they all remained cancer-free.
Within three weeks of receiving the vaccine, patients showed an “immune response,” with T-cells spiking by more than 166 times, the release said. (T-cells, also known as T lymphocytes, are immune cells that help to fight cancer and prevent infection.)
“The tools we have to lower that risk are not perfect and we are relentlessly looking for more.”
In the study, the T cells were found to remain in the patient’s body for up to three years and attacked the existing tumor cells.
“We observed a rapid, substantial, and durable expansion of new T cell clones related to the vaccine,” said Patrick Ott, MD, PhD, director of the Center for Cancer Vaccines at Dana-Farber.
“These results support the feasibility of creating a highly immunogenic personalized neoantigen vaccine in a lower mutation burden tumor and are encouraging, though larger-scale studies will be required to fully understand the clinical efficacy of this approach.”
The results of the clinical trial were reported in the journal Nature on Feb. 5.
“We’re very excited about these results, which show such a positive response in all nine patients with kidney cancer,” Choueiri noted.
For most stage 3 or 4 kidney cancer patients, the standard treatment is surgical removal of the tumor, which is often followed by an immunotherapy drug called Pembrolizumab (Keytruda).
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“Pembrolizumab induces an immune response that reduces the risk of the cancer coming back,” according to Dana-Farber. “However, about two-thirds of patients can still recur and have limited treatment options.”
First author David A. Braun, MD, PhD, a medical oncologist and physician-scientist at Yale Cancer Center and Yale School of Medicine, noted that the approach used in this study was “truly distinct from vaccine attempts in kidney cancer.”
“We pick targets that are unique to the cancer and different from any normal part of the body, so the immune system can be effectively ‘steered’ toward the cancer in a very specific way,” Braun said in the release.
“We learned which specific targets in the cancer are most susceptible to immune attack and demonstrated that this approach can generate long-lasting immune responses, directing the immune system to recognize cancer. We believe this work can form a foundation for the development of neoantigen vaccines in kidney cancer.”
‘Exciting and promising’
Charles Nguyen, MD, a medical oncologist who specializes in kidney cancer at City of Hope in Orange County, California, noted that kidney cancer is among the 10 most common cancers among men and women in the U.S.
“This is a very exciting and promising tool for many of our patients with kidney cancer, where we can one day make a cure possible for all.”
“Patients with early stage (localized) kidney cancer are often first treated with surgery to remove the tumor — however, many patients have a risk of the cancer coming back years after surgery, and there is a great interest in finding ways to lower the risk of cancer recurrence,” Nguyen, who was not involved in the study, told Fox News Digital.
“This exciting clinical trial evaluated a personalized cancer vaccine that uses genetic information from each patient’s cancer to train and enhance the patient’s immune system to recognize the cancer and prevent it from recurring.”
While Nguyen acknowledged that this was a small study, all nine patients who received the vaccine were cancer-free even three years later.
“This is a very exciting and promising tool for many of our patients with kidney cancer, where we can one day make a cure possible for all.”
Side effects and limitations
Some patients did experience side effects from the vaccine, including local reactions at the vaccine injection site and flu-like symptoms, although “no higher-grade side effects were reported.”
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The researchers also acknowledged that there were some limitations associated with the study.
“There were limitations in the antigen-prediction tools available at the time and in the ability to target only a single antigen,” they wrote.
“Moreover, it was conducted in the setting of active metastatic disease in a number of study participants.”
Future research with larger clinical trials are planned to confirm the vaccine’s effectiveness and full potential, the release stated.
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Funding for this study was provided by the Gateway for Cancer Research, the U.S. Department of Defense, Yale Cancer Center, Dana-Farber/Harvard Cancer Center, Harvard Medical School, Trust Family Foundation, Michael Brigham, Pan-Mass Challenge, Hinda L. and Arthur Marcus Foundation, The Loker Pinard Fund for Kidney Cancer Research at Dana-Farber Cancer Institute, National Institutes of Health, Conquer Cancer Foundation/Sontag Foundation, the release stated.
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