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On the trail of a vaccine against brain cancer

EGFRVIII marker is also found in other cancers (like breast or lung) but not in normal tissues
EGFRVIII marker is also found in other cancers (like breast or lung) but not in normal tissues
 

It is a promising new avenue for the treatment of brain tumors. A therapeutic vaccine, tested in combination with conventional therapy in twenty patients, has extended survival by about 70%. These preliminary results have been obtained by the team of John Sampson at Duke University (United States) have just been published in  the Journal of Clinical Oncology.

Studied for years in cancer (including melanoma, tumors of the kidney...), therapeutic vaccines aim to stimulate the patient's immune system to destroy tumor cells. This attractive approach has led to numerous studies worldwide, but few have yet succeeded. A first therapeutic vaccine was licensed in the United States in April for prostate cancer.

The most frequent brain tumors in adults, glioblastomas are rare: about 10,000 new cases are diagnosed annually in the United States. Conventional treatment involves surgery, radiotherapy and chemotherapy, but results are poor.

To improve prognosis, other avenues are explored, such as gene therapy. At least three to four trials of immunotherapy (therapeutic vaccines) are underway. U.S. researchers have chosen to target the EGFRVIII (epidermal growth factor receptor), a genetic variant on the surface of cancer cells in one third of patients with glioblastoma. This marker is also found in other cancers (like breast or lung) but not in normal tissues.

In this study, the vaccine was tested in 18 patients whose tumors expressed the marker EGFRVIII, in addition to conventional therapy. The injections subcutaneously, fortnightly and monthly, were continued as long as they seem effective. After 26 months, half the patients were still alive, survival nearly doubled compared to that of a group of 17 patients who only received the conventional treatment.

The vaccine strategy, which was well tolerated, has also helped increase the period of several months without recurrence. "In the majority of patients who relapsed, the tumor no longer expressed the EGFRVIII," write the authors. A therapeutic vaccine can therefore eliminate the cancer cells that express the antigen and that's encouraging.

As emphasized in the editorial of the Journal of Clinical Oncology, confirmation of these results in a large controlled trial, however, may be compromised by the high cost (about 100,000 euros per patient) of these treatments.

 
 
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