Cancer 'vaccine' shows promise in human trial of lymphoma patients

An experimental cancer "vaccine" showed promising results in a small clinical trial of patients with lymphoma, according to a study.

Researchers tested the treatment in 11 patients with lymphoma. Their results were successful enough to warrant another clinical trial in March on lymphoma patients as well as breast and head-and-neck cancer.

Researchers said some patients in the initial human trial went into full remission for months or even years.

The treatment "has broad implications for multiple types of cancer," said lead author, the director of the lymphoma immunotherapy program. "This method could also increase the success of other immunotherapies such as checkpoint blockade.

They refer to it as a vaccine because it causes a person's immune system to fight the disease, though it's not preventive like the flu shot. In this case, the treatment teaches the body to recognize tumors and attack them.

Researchers created the treatment directly inside the tumor. To do this, they injected one tumor with a stimulant to recruit immune cells, treated the tumor with a low dose of radiation then injected it with a stimulant to activate immune cells. These activated immune cells then travel throughout the body, killing tumors wherever they find them.

In three of the patients, the treatment shrunk not only the tumor that was treated but also other ones throughout the body, putting these patients into remission.

"It's really promising, and the fact you get not only responses in treated areas, but areas outside the field [of treatment with radiation] is really significant," said a Dr. who was not involved in the study and is working on a similar treatment.

While promising, the effect was observed in only three people and will need to be tested in larger trials before even going before the Food and Drug Administration for review.

The Dr. said the results are exciting but cautioned more research needs to be done. 

"It's definitely proof of concept, but larger studies are definitely needed and additional strategies to try to get more than three out of 11 patients to respond," he said,  who is also developing a lymphoma vaccine, though with a slightly different approach.

Researchers for decades have tried but failed to create cancer vaccines. New research on immunotherapy, or training a person's immune system to fight disease, has reinvigorated their efforts.
The vaccine activates dendritic cells, which are responsible for initiating immune responses. These cells then instruct T-cells to attack tumors in a person's body, like generals instructing soldiers how to fight.

"Generals don't really fight wars, they make the plans," the Dr. said.

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Experimental vaccine eliminates HPV infection

A new experimental immune-based vaccine has cleared human papillomavirus (HPV) in a third of women with cervical cancer precursors, according to clinical trial results.

The therapeutic vaccine, called Tipapkinogen Sovacivec (TS), injects a specific protein that triggers an immune system response to attack high-risk HPV types that cause nearly all cervical cancer precursors, known as cervical intraepithelial neoplasia (CIN).

HPV is a common sexually transmitted infection and causes warts in the body.

The vaccine eliminated both precancerous skin growth in the cervix, and underlying HPV infection in a third of women enrolled in the clinical trial, according to the report .

"There are few products trying to cure women with an HPV infection," said a professor. "It's exciting. This is the first time we've seen something with this success rate and that is relatively easy to implement," he said.

The study enrolled 192 women, diagnosed with precancerous skin growths, randomising 129 to receive the vaccine and 63, placebo.

Women were given three shots in thighs, one per week. Six months later, the women were treated with standard surgical procedures and the removed tissue was examined. As many as 15-36 per cent of those who were vaccinated saw their more severe precancerous skin growths eliminated, but none in the placebo group.

While "the surgical procedure removes all the tissue that is headed towards cancer, it does not remove all the HPV. You still have HPV", he said, adding the new vaccine "actually treats the cause of the disease, which is HPV".

He also noted TS is different from Gardasil9, the vaccine given to prevent HPV infection. While Gardasil9 prevents HPV infection from occurring, TS clears tissue infected with it.

The researchers envision testing TS for several other types of cancer, including head, neck and anal cancer, that are linked to HPV. 

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Pioneering trial offers hope for restoring brain cells damaged in Parkinson's

A pioneering clinical trial programme that delivered an experimental treatment directly to the brain, offer hope that it may be possible to restore the cells damaged in Parkinson's.

The study, aimed to investigate whether boosting the levels of a naturally-occurring protein, Glial Cell Line Derived Neurotrophic Factor (GDNF), can regenerate dying brain cells in people with Parkinson's and reverse their condition. 

This is something which no existing treatment can do.

A specially designed delivery system was designed to get GDNF to the brain cells that need it. In total, 41 participants underwent robot-assisted-surgery to have four tubes carefully placed into their brains, which allowed GDNF to be infused directly to the affected brain areas with pinpoint accuracy, via a port in the side of their head.

Six took part in the initial pilot study to assess the safety of the treatment approach. A further 35 people then participated in the nine-month double blind trial, where half were randomly assigned to receive monthly infusions of GDNF and the other half placebo infusions.

After the initial nine months on GDNF or placebo, all participants had the opportunity to receive GDNF for a further nine months.

While there were some encouraging signs of improvements in those receiving GDNF, disappointingly there was no significant difference between the active treatment group and those who received placebo on any assessments of Parkinson's symptoms.

However, results from brain scans revealed extremely promising effects on damaged brain cells.
After nine months, there was no change in the scans of those who received placebo, whereas the group who received GDNF showed an improvement of 100 per cent in a key area of the brain affected in the condition - offering hope that the treatment was starting to reawaken and restore damaged brain cells.

By 18 months, both groups showed moderate to large improvements in symptoms compared to their scores before they started the study.

This offers further encouragement that the treatment may have long-term beneficial effects but because everyone knew they were receiving the active treatment and there was no comparison group, these improvements need to be treated with caution.

The Principal Investigator on the GDNF trial, said, "The spatial and relative magnitude of the improvement in the brain scans is beyond anything seen previously in trials of surgically delivered growth-factor treatments for Parkinson's. This represents some of the most compelling evidence yet that we may have a means to possibly reawaken and restore the dopamine brain cells that are gradually destroyed in Parkinson's," adding, "Its failure to produce the same effect on symptoms could be for a number of reasons. It may be that the effects on symptoms lag behind the improvement in the brain scans, so a longer double-blind trial may have produced a clearer effect.'

The researchers further added that it is also possible that a higher dose of GDNF would have been more effective, or that participants at an earlier stage of the condition would have responded better.
The study author said, "While the results are not clear-cut, the study has still been a resounding success. It has advanced our understanding of the potential effects of GDNF on damaged brain cells, shown that delivering a therapy in this way is feasible and that it is possible to deliver drugs with precision to the brain."

 The lead neurosurgeon and designer of the device, commented, "This trial has shown that we can safely and repeatedly infuse drugs directly into patient's brains over months or years through a small implanted port that emerges through the skin behind the ear. This is a significant breakthrough in our ability to treat neurological conditions, such as Parkinson's because most drugs that might work cannot cross from the blood stream into the brain due to a natural protective barrier."

Another researcher said the results are encouraging, adding, "These results, particularly the brain scans show that GDNF, delivered with Convection Enhanced Delivery, has promise as a potential treatment to slow, stop or even reverse Parkinson's. However, it is critical we now concentrate on how to best support moving GDNF forward, to understand if it can be a viable treatment to potentially regenerate dopamine cells and impact the lives of people living with Parkinson's."

Another doctor commented that while the results are not as clear cut as would have been desirable, they are exciting signs of promise for Parkinson's. He added that, in particular, when the scores on three of the key assessments are combined - motor response, activities of daily living and good quality it reveals a highly significant difference between the treatment and placebo groups.

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