Study: Personalized vaccines may help pancreatic cancer treatment
Most relevant for: People with pancreatic cancer who have tumors that can be removed by surgery. It may also be relevant for:
- people newly diagnosed with cancer
- people with pancreatic cancer
Strength of Science: Medium-High
Research Timeline: Human Research
What is this study about?
A personalized vaccine as treatment for pancreatic cancer was tested in this study with a small group of participants. The vaccine was custom-made for patients based on the unique features of their cancer. It was given in addition to a drug that affects the immune system and standard chemotherapy, Researchers focused on patients who had surgery for their pancreatic cancer and hoped to increase the time before the cancer returned while also improving patient survival.
Why is this study important?
Pancreatic cancer typically has a low survival rate and is the third-leading cause of cancer deaths in the US. Pancreatic cancer cases have been rising in the US and worldwide. With few effective treatments available, better therapies are needed.
One promising treatment approach is , which uses the body’s immune system response to target cancer cells. Vaccines can improve the immune system’s ability to find and kill cancer cells. However, standard drugs for pancreatic cancer has not been helpful in studies to date.
Researchers wanted to see if they could create a vaccine (based on the relatively new processes also used with the COVID vaccines) that increases certain immune system cells known as CD8+ T cells in pancreatic cancer patients. This vaccine uses a substance called mRNA (messenger RNA) from the cancer to help stimulate the immune system. They hope that this vaccine will trigger a better immune response by increasing the number of CD8+ T cells that can target and kill cancer cells.
Sixteen study participants with pancreatic cancer had surgery to remove their tumors and were treated with the mRNA vaccine, an drug and chemotherapy.
The vaccine improved the immune system response.
- Half (8 of 16) of the people who received the vaccine had more CD8+ T cells after treatment than they did before the treatment. The researchers referred to these patients as “responders” because their immune systems responded to the vaccine by making more immune cells that could target their pancreatic cancer.
The vaccine extended the time before the cancer returned.
- Most responders had no return of their cancer at 18 months after treatment.
- At the time this research was reported, some responders’ cancer had still not returned.
- Among non-responders (participants whose immune cells did not increase after vaccination), cancer returned about 11 months after the end of their vaccine treatment.
- The delay in cancer recurrence was most closely tied with the amount of the immune response rather than other factors, such as features of the patients themselves, chemotherapy drugs used or tumor size.
The immune response could last as long as 2 years.
Researchers assessed the number of CD8+ T cells in participants several times after treatment:
- Responders had more CD8+ T cells for up to two years after treatment.
- The CD8+ T cells were able to attack cancer cells in the pancreas and cancer cells that had spread to other parts of the body. In one patient, a liver occurred. When it was biopsied, It found surrounded by many CD8+ T cells. Later, the disappeared on CT imaging.
Side effects associated with the vaccine were minimal.
- No participants had a serious (grade 4 or 5) or life-threatening .
- One person had a serious grade 3 fever and high blood pressure.
Most participants had low-grade side effects. The most common were chills and fever linked to the vaccine and itching linked to the drug.
What does this mean for me?
Although promising, this is an early research study involving only a few people. Vaccines and other immunotherapies to treat pancreatic cancer are currently only available through a clinical trial. The phase 2 clinical trial is enrolling participants for this drug. Larger research studies are needed to better understand the vaccine’s effectiveness and why some people respond and others do not. If you have been diagnosed with pancreatic cancer and you are interested in a vaccine for treatment, ask your doctor whether participating in a clinical trial is right for you. Some vaccine clinical trials for treating pancreatic cancer are included in this review under the tab marked “Research.”
In this small study, none of the participants tested positive for an , so it is unclear whether people with an that is linked to cancer would respond differently than other participants. Further research is needed to clarify this issue.
Rojas, L.A., Sethna, Z., Soares, K.C. et al. Personalized RNA neoantigen vaccines stimulate T cells in pancreatic cancer. Nature 618, 2023; 144–150.
Disclosure: FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.
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The following are treatment studies enrolling people diagnosed with pancreatic cancer:
- NCT04548752: Adding Pembrolizumab to to Treat Pancreatic Cancer in People with an Inherited Mutation. This study is researching whether adding the drug pembrolizumab to the olaparib works better than alone for treating pancreatic cancer in people with an inherited or mutation.
- NCT05252390: NUV-868 Alone and in Combination With PARP Inhibitors in Patients With Advanced . This study will test how safe and effective the experimental drug NUV-868 is by itself and in combination with a in people with different types of advanced cancers.
- NCT04493060: Treating Pancreatic Cancer with an Inherited or Tumor BRCA1/2 or Mutation with and Dostarlimab. This study looks at how well the and the drug dostarlimab work together in treating patients with pancreatic cancer, who have an inherited or tumor mutation in , , , , or .
- NCT04150042: SHARON: A Clinical Trial for Cancer With an Inherited or Mutation Using Chemotherapy and Patients’ Own Stem Cells. This study looks at whether melphalan, BCNU, vitamin B12b, and vitamin C, followed by autologous (self) bone marrow stem cell infusion is safe and effective for treating patients with advanced pancreatic cancer or 4, breast cancer for people with a , or .
- NCT04666740: Pembrolizumab and for Pancreatic Cancer with or Exceptional Response to Platinum Chemotherapy. This is a study for people with pancreatic cancer with a tumor test result called HRD-positive, or whose disease has responded well to or second-line platinum therapy. The study will compare the combination of the pembrolizumab and the olaparib to alone.
- NCT04858334: or in Patients with Surgically Removed Pancreatic Cancer who have a , or Mutation (APOLLO). The purpose of EA2192 / APOLLO is to compare the usual approach (observation) to treatment for one year with , in patients with a , or mutation.
- NCT04550494: Treating Solid Tumors with an Inherited or Acquired Gene Mutation Using the Talazoparib. This study is looking whether the drug is safe and effective for treating people with advanced breast, gastric, ovarian, pancreatic, or other cancers with an or an acquired mutation in certain repair genes, such as , , , , and others.
The following are vaccine studies enrolling people with pancreatic cancer:
- NCT05111353: Neoantigen Vaccines in Pancreatic Cancer in the Window Prior to Surgery. This study will look at the safety of an neoantigen vaccines in pancreatic cancer patients following chemotherapy. Participants will be placed in one of two groups. Group 1 will receive the vaccine following chemotherapy and surgery. Group 2 will receive the vaccine after chemotherapy and before surgery.
Other clinical trials for people with pancreatic cancer can be found here.
Who covered this study?
An mRNA vaccine that programs the body to fight pancreatic cancer shows early promise This article rates 5.0 out of 5 stars
Vaccine Slows Return of Pancreatic Cancer in Early Trial This article rates 4.0 out of 5 stars
New York Post
Vaccine for ‘silent killer’ pancreatic cancer shows promise: study This article rates 3.0 out of 5 stars
A Vaccine for Pancreatic Cancer Treatment? This article rates 3.0 out of 5 stars
Pancreatic Cancer Vaccine Shows Promise in Small Initial Trial This article rates 2.5 out of 5 stars
The National Comprehensive Cancer Network (NCCN) recommends the following for people diagnosed with pancreatic cancer:
- Receive treatment from a (MDT): Treatment decisions should involve an MDT that includes a team of doctors, healthcare workers, genetic counselors and mental health professionals who have expertise and experience with treating and addressing issues related to your type of cancer. MDTs are more likely to be found or affiliated with cancer centers that have experience in treating pancreatic cancer.
- Have tumors staged via imaging tests: is needed to plan and monitor your treatment. Imaging tests (e.g., tomography scans) are used to pancreatic cancer. These tests determine whether the tumor can be removed with surgery (it is resectable), if the cancer has spread to nearby organs or (locally advanced) or has spread to other parts of the body (metastasized).
- Discuss with your healthcare team whether they recommend chemotherapy before and/or after your surgery.
- Have genetic testing, using a comprehensive gene panel for (this applies to anyone who is diagnosed with pancreatic cancer).
- Genetic testing results may be used in making treatment decisions.
- Have tumor testing (for people with locally advanced or pancreatic cancer).
- Tumor testing results can also be used in making treatment decisions.
- Keep a copy of all test results (online patient portals are a great way to access test results). This will come in handy during a second opinion, if necessary.
The following organizations offer peer support services for people with or at high risk for pancreatic cancer:
- FORCE peer support
- Our Message Boards allow people to connect with others who share their situation. Once registered, you can post on the Diagnosed With Cancer board to connect with other people who have been diagnosed.
- Peer Navigation Program will match you with a volunteer who shares your mutation and situation.
- Private Facebook Group
- Virtual and in-person support meetings
- Join a Zoom community group meeting.
- American Sign Language
- People of Color
- Let's Win PC
- The Healing NET Foundation is a nonprofit organization for people with neuroendocrine cancers.
- The Neuroendocrine Cancer Awareness Network (NCAN) is a non-profit organization dedicated to raising awareness of neuroendocrine cancer and providing support for caregivers and people with NETs.