Trojan for cancer

A new Trojan horse cancer treatment method has shown good results with several types of tumors

Dmitry Mazalevsky, Naked Science

An innovative drug called tisotumab-vedotin (tisotumab vedotin, TV) releases a toxic substance, destroying cancer cells from the inside. The results were so positive that the scientists moved on to the second phase of tests on cervical cancer and other types of cancer.

A new type of cancer drug that acts like a Trojan horse by penetrating into tumor cells has shown promising results among patients with six different types of cancer. More than a quarter of patients with advanced, treatment-resistant tumors of the cervix and bladder and almost fifteen percent with tumors of the ovaries and lungs were susceptible to the new method.

A team of scientists from the London Institute of Cancer Research and the Royal Marsden NHS Foundation conducted a global clinical trial of the first and second phase among almost 150 patients with various types of cancer who stopped responding to standard treatment. Experts found that a significant number of patients with oncopathology were susceptible to the drug: their tumors either decreased or stopped growing. The results of the work are published in the journal The Lancet Oncology.

 "The most exciting thing about the open method of treatment is that its mechanism of action is completely new. The method is similar to the principle of the Trojan horse, penetrating into cancer cells and killing them from the inside. Our study shows that the drug is able to treat a large number of people with various types of cancer and has manageable side effects," says one of the authors of the study, Professor Johann de Bono.

During the tests, scientists observed the reaction of 27 percent of patients with bladder cancer, 26.5 percent with cervical cancer, 14 percent with ovarian cancer, 13 percent with esophageal cancer, 13 percent with non-small cell lung cancer and seven percent with endometrial cancer. The reaction lasted an average of 5.7 months, and in some – up to 9.5 months. The main side effects reported in the study were nosebleeds, fatigue, nausea and visual discomfort, although the extent of the latter was later reduced.

The drug consists of a toxic drug attached to the tail of an antibody that is designed to search for a receptor called a "tissue factor" – it is present in large quantities on the surface of many cancer cells and leads to a decrease in survival. Binding to the tissue factor involves the drug in cancer cells, where it can kill them from the inside. 

At the beginning of the study, only 27 patients participated to assess safety and determine the correct dose, and after realizing that the drug was safe, the scientists increased this number by another 120 people in order to find out whether the drug hit the right target and how exactly it affects tumors. Most of the patients participating in the study were diagnosed with late-stage cancer, spread locally or around the body, which had already been treated before, and therefore became resistant to an average of three different types of therapy.

TV is currently undergoing trials for other types of cancer, including bowel, pancreas, brain and neck, as well as in a phase two study as a second-line treatment for cervical cancer.

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