Vaccine injects fresh hope into pancreatic cancer care
Pancreatic cancer is the fourth-leading cause of cancer deaths in the United States and has the lowest survival rate.
The Record (Hackensack N.J
A vaccine injected directly into a pancreatic tumor has shown promise as a way to keep the cancer from spreading in patients whose cancer can't be treated surgically, early results from a clinical trial in New Jersey show.
The Phase 1 clinical trial — designed to determine if the treatment is safe and how best to administer it — involved six patients with inoperable pancreatic cancer at the Cancer Institute of New Jersey in New Brunswick. Two of them were removed from the study when their cancer quickly worsened.
All four remaining patients had "clinically stable" disease after 15 months, 13 months, 12 months and nine months, according to the study.
"For these four patients ... the cancer doesn't seem to have gone anywhere," said Dr. Elizabeth Poplin, an oncologist and lead researcher for the study, sponsored by the National Cancer Institute. "It's not spreading like we would have expected it to have done. It's different than what we're used to seeing."
The cancer in the pancreas is still active and can be seen on X-rays, she said, and the patients are still receiving conventional chemotherapy treatment for it.
"It's still a small number of patients, so we can't generalize," she cautioned. The treatment is not intended for patients whose cancer has already spread.
Pancreatic cancer is the fourth-leading cause of cancer deaths in the United States and has the lowest survival rate. More than 44,000 people are diagnosed each year. Nearly three-quarters die within a year of diagnosis and 94 percent die within five years.
Typically, pancreatic cancer spreads to the liver, lungs and body cavity.
"We're intrigued that some of our patients have done so nicely," said Poplin. "I'm kind of tickled the first patient is doing so well." She spoke to him on a recent birthday, she said, and "he and his wife are happy to have more time than they thought they otherwise would."
Injecting the vaccine directly into the pancreatic tumor appears to work by reawakening or stimulating the body's immune system to fight the cancer, she said.
The next step for the research is to increase the dose of the vaccine to the pancreas to see if it can be tolerated, and to use the treatment on patients who are also eligible for surgery to see if it improves their survival rates.
To be eligible for the current clinical trial, patients must have been diagnosed with an inoperable pancreatic cancer that has not metastasized. They should be otherwise healthy. They cannot have undergone chemotherapy treatment yet, although they may proceed with normal oncology treatment about a month after they begin the study.
After a patient is found to be eligible, he or she undergoes an endoscopy, in which a lighted tube is threaded into their stomach. Using sonar technology, a gastroenterologist visualizes the pancreas through the stomach wall and injects the vaccine directly into the pancreatic tumor. The next day, the patient is given a similar vaccine in the arm. That is followed by four days of treatment with a drug to stimulate the immune system.
Two weeks later, the process is repeated. The patients then receive three more injections in the arm over a two-month period.
"By utilizing the body's own defenses in this way, in combination with traditional therapies, we have an opportunity to better identify more effective treatment," Poplin said.
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