There is hope!
Researchers from the National Cancer Institute as part of the National Institutes of Health (National Institutes of Health), led by Steven A. Rosenberg, have developed a new approach to immunotherapy, which led to a complete regression of breast cancer and its metastases. The method is based on the detection of mutations in cancer cells, which are recognized by the immune system.
For this purpose, a modified form of adoptive cell transfer (APC) was developed. APC is effective in the treatment of melanoma, whose cells have a large number of somatic and acquired mutations. In other cancers with fewer mutations, it was less effective.
In an ongoing phase II clinical trial, APC was developed with tumor infiltrating lymphocytes (TIL), which specifically target mutations of tumor cells. The authors hoped that they would achieve a reduction in the size of the tumor in patients with epithelial cancer. Large amounts of TIL were grown in the laboratory and then injected back into the patient's blood. Before the injection, the patient himself should receive therapy aimed at depletion of the remaining lymphocytes in the body. This creates a stronger immune response against the tumor.
A patient with metastatic breast cancer was included in the study after treatment with various methods, including several courses of chemotherapy and hormone therapy. It was not possible to stop the progression of cancer. The researchers sequenced the DNA and RNA of cancer cells from one of her tumors, as well as normal tissue, to see which mutations are characteristic of her cancer. They identified 62 different mutations.
Then, various patient TILs were tested to find those that recognized one or more of these mutations, and TILs active against four mutant proteins were found. They were multiplied in vitro and injected back into the patient's blood. She also received pembrolizumab (Keytruda) to avoid possible inactivation of T cells. After treatment, the cancerous tumors disappeared, and after more than 22 months, no relapse was detected.
Left: A CT scan of a woman with breast cancer before TIL therapy shows a formation growing into the chest wall (top) and metastatic lesions in the liver (bottom). On the right: a scan 14 months after treatment shows that all lesions have disappeared. Source: National Institutes of Health.
Similar results were obtained in patients with liver and rectal cancer.
For patients with solid epithelial tumors, this is extremely important, because classical APC is less successful in such types of cancer with a small number of mutations. If the effectiveness of the method is confirmed in larger studies, it will be possible to expand the coverage of T-cell therapy for various oncological diseases.
The main advantage of this treatment is that it is nonspecific for a particular cancer, since immune cells target mutations that are present in any cancer cell. In other words, the very mutations that cause cancer are the target for its destruction.
The article by N. Zacharakis et al. Immune recognition of somatic mutations leading to complete durable regression in metastatic breast cancer is published in the journal Nature Medicine.
Aminat Adzhieva, portal "Eternal Youth" http://vechnayamolodost.ru According to NIH materials: New approach to immunotherapy leads to complete response in breast cancer patient unresponsive to other treatments.