He triple negative breast cancer It can be associated with metastatic relapses, even at an early stage. In an experimental test, a personalized messenger RNA vaccine in 14 patients with positive results. The initial achievements of this trial are published in the journal Nature in an article in which the scientific team describes that the vaccine trained the immune cells of the patients to attack specific mutant cancer proteins, inducing strong and long-lasting immunity.
According to the researchers, 11 of the women remained free of the disease. However, these are still very preliminary results, with limitations, including the small number of participants and the absence of control groups in the clinical trial. Behind this research is the company BioNtech, the German company that developed one of the vaccines against covid-19 during the pandemic, and several hospitals in Germany and Sweden participated.
The name breast cancer includes several diseases that have different prognoses and responses to treatment, and the classification most accepted by the international community establishes that these tumors are divided into three groups. Thus, there are those who express receivers (proteins) of female hormones (hormone-dependent), those that contain exacerbated levels of the receptor HER2 y those who lack these markers (triple-negative).
The first two have a good prognosis due to the availability of specific treatments that largely eliminate tumor cells, however, the third, the so-called triple negative, remains the most aggressive. The new study evaluates a individualized mRNA vaccine in 14 patients with the latter type, after surgery and neoadjuvant therapy – treatment before surgery – or adjuvant – subsequent complementary therapy.
According to the results, in the peripheral blood of almost all patients with detected T cell responses (white blood cells) of vaccine-induced high magnitudemainly de novo, to multiple neoantigens (small new proteins that are produced when certain mutations appear in the DNA of a tumor).
No relapses up to six years after vaccination
Eleven patients remained relapse-free up to six years after vaccination. Recurrence was observed in three of them. “Our study demonstrates the clinical feasibility, “the safety and robust immunogenicity of an individualized mRNA-based neoantigen vaccine in patients with triple-negative cancer following adjuvant or neoadjuvant therapy,” the authors write in their article. It was well tolerated and consistently elicited strong neoantigen-specific T cell responses in almost all patients.
These findings demonstrate “the feasibility” of individualized RNA vaccines in triple-negative breast cancer, the authors detail, and provide insight into potential immune escape mechanisms that will guide future approaches. “The high immunogenicity of the neoantigen vaccine in the majority of patients, the durability of the induced T cell responses and the early signs of clinical activity justify further clinical studies in this population“.
The authors, including Ugur Sahin, also point out that this research in triple negative cancer expands previous discoveries in other tumor types -melanoma or pancreas- and demonstrates that this personalized vaccine approach can be widely used.