A vaccine to prevent pancreatic cancer in high-risk individuals is safe and induces long-lasting immune responses in a phase 1 trial
Pancreatic ductal adenocarcinoma (PDAC), the most common form of pancreatic cancer, is an aggressive tumor that is often diagnosed at advanced stages. Some people are at high risk of developing it due to a hereditary predisposition (10% of cases) or an injury. A new Phase 1 clinical trial has tested, in high-risk patients, a vaccine targeting several mutations in the KRAS gene responsible for more than 90% of these tumors. The vaccine has been shown to be safe and has stimulated specific immune responses, detectable in the blood up to two years later, in 90% of the study participants. The study is published in Cancer Discovery.
Manel Juan - vacuna páncreas
Manel Juan
Head of the Immunology Service
This is undoubtedly a high-quality, relevant article on a tumor with a very poor prognosis, one that opens up a new treatment option for these KRAS-mutated patients. The study is fully consistent with various previous studies targeting the same molecular target and tumor—which is why a clinical trial could be conducted, as such trials always require prior supporting evidence—but it is also applicable to other tumors.
Preventive use would be conceptually possible outside of familial cases, but it would be difficult to apply in most cases (which are sporadic).
The main limitation is that this is an initial trial primarily aimed at establishing safety and surrogate evidence of efficacy (induced responses). Efficacy remains to be demonstrated, although it may only be achieved—based on these safety findings—after combining the vaccine with other immunotherapies.
Ignacio Melero - vacuna páncreas
Ignacio Melero
Professor of Immunology at the University of Navarra, CIMA researcher and co-director of the Department of Immunology and Immunotherapy at the Clínica Universidad de Navarra.
This study involves vaccinating people with a genetic predisposition to pancreatic cancer using mutations of the KRAS oncogene, which is very frequently mutated in pancreatic cancer. The conclusion is that it is possible to elicit specific immune responses against these mutations. The study involved only 20 subjects and did not demonstrate efficacy, although there appeared to be fewer cystic lesions—a sign of probable malignancy—following vaccination.
This is an interesting immunogenicity study, but it is too early to know whether or not it will actually prevent cases of pancreatic cancer in genetically predisposed families.
Haldar et al.
- Research article
- Peer reviewed
