Immunotherapy Approach Leads to Complete Response in Breast Cancer Patient
News Jun 05, 2018 | Original story from the National Cancer Institute (NCI)
Left: MRI scans of a woman with breast cancer before TIL therapy show a lesion invading the chest wall (top) and metastatic lesions in the liver (bottom). Right: Scans 14 months after treatment show all lesions have disappeared. Credit: National Cancer Institute
A novel approach to immunotherapy developed by researchers at the National Cancer Institute (NCI) has led to the complete regression of breast cancer in a patient who was unresponsive to all other treatments. This patient received the treatment in a clinical trial led by Steven A. Rosenberg, M.D., Ph.D., chief of the Surgery Branch at NCI's Center for Cancer Research (CCR), and the findings were published June 4, 2018 in Nature Medicine. NCI is part of the National Institutes of Health.
"We've developed a high-throughput method to identify mutations present in a cancer that are recognized by the immune system," Dr. Rosenberg said. "This research is experimental right now. But because this new approach to immunotherapy is dependent on mutations, not on cancer type, it is in a sense a blueprint we can use for the treatment of many types of cancer."
The new immunotherapy approach is a modified form of adoptive cell transfer (ACT). ACT has been effective in treating melanoma, which has high levels of somatic, or acquired, mutations. However, it has been less effective with some common epithelial cancers, or cancers that start in the lining of organs, that have lower levels of mutations, such as stomach, esophageal, ovarian, and breast cancers.
In an ongoing phase 2 clinical trial, the investigators are developing a form of ACT that uses tumor-infiltrating lymphocytes (TILs) that specifically target tumor cell mutations to see if they can shrink tumors in patients with these common epithelial cancers. As with other forms of ACT, the selected TILs are grown to large numbers in the laboratory and are then infused back into the patient (who has in the meantime undergone treatment to deplete remaining lymphocytes) to create a stronger immune response against the tumor.
A patient with metastatic breast cancer came to the trial after receiving multiple treatments, including several chemotherapy and hormonal treatments, that had not stopped her cancer from progressing. To treat her, the researchers sequenced DNA and RNA from one of her tumors, as well as normal tissue to see which mutations were unique to her cancer, and identified 62 different mutations in her tumor cells.
The researchers then tested different TILs from the patient to find those that recognized one or more of these mutated proteins. TILs recognized four of the mutant proteins, and the TILs then were expanded and infused back into the patient. She was also given the checkpoint inhibitor pembrolizumab to prevent the possible inactivation of the infused T cells by factors in the tumor microenvironment. After the treatment, all of this patient's cancer disappeared and has not returned more than 22 months later.
"This is an illustrative case report that highlights, once again, the power of immunotherapy," said Tom Misteli, Ph.D., director of CCR at NCI. "If confirmed in a larger study, it promises to further extend the reach of this T-cell therapy to a broader spectrum of cancers."
Investigators have seen similar results using mutation-targeted TIL treatment for patients in the same trial with other epithelial cancers, including liver cancer and colorectal cancer. Dr. Rosenberg explained that results like this in patients with solid epithelial tumors are important because ACT has not been as successful with these kinds of cancers as with other types that have more mutations.
He said the "big picture" here is this kind of treatment is not cancer-type specific. "All cancers have mutations, and that's what we're attacking with this immunotherapy," he said. "It is ironic that the very mutations that cause the cancer may prove to be the best targets to treat the cancer."
This article has been republished from materials provided by National Cancer Institute (NCI). Note: material may have been edited for length and content. For further information, please contact the cited source.
Cryo-EM Reveals Interaction Between Major Drug TargetsNews
For the first time, scientists have visualized the interaction between two critical components of the body's vast cellular communication network, a discovery that could lead to more effective medications with fewer side effects for conditions ranging from migraine to cancer.READ MORE
New Ovarian Cancer TargetNews
Researchers have found a prescription drug, Calcitriol, approved by the Food and Drug Administration for the treatment of calcium deficiency and kidney diseases, may increase the likelihood of surviving ovarian cancer. This new study opens a potential avenue for treating ovarian cancer. Since Calcitriol is an FDA-approved drug, no additional research is needed before the drug can advance to human clinical trials for ovarian cancer.READ MORE
Comments | 1 ADD COMMENT
Walker Tracy | Jun 05, 2018
I am very much delighted to every viewers that is reading this,i want to inform the whole public of how me and my lover got cured from herpes simplex virus,i was diagnosed of herpes since 3 years ago and also find out that my herpes virus also effected my lover,this Virus started circulating all over our body, and we have also taken treatment from our doctor,few weeks back i came on the net to see if i will be able to get any information as to cure this Virus, on my search i saw various testimony of someone who was healed from herpes simplex virus by the great man called Dr OMOAREBUN and i told my lover about it and without any hesitation, we contacts his mail: firstname.lastname@example.org we wrote him and he guided us,we asked him for solutions and he started the remedies for the both of us and indeed 1 week after me and my lover started using the medicine, we were completely cured no doubt was found on my body and of my lover,so dear viewer why wasting your time living with this STD Virus you can contact him now any kinds of disease,contact his Email email@example.com