What is immunotherapy?
Our immune system is a jewel of complex and competent machinery. Throughout life, it single-handedly fights viruses, bacteria and other pathogens that we encounter on a daily basis. But against cancer cells, this complex army is sometimes powerless. Assuming the appearance of healthy cells, tumors fool the soldiers of our immune system. Oncology research has tried for several years to meet this challenge by trying to help our bodies fight cancer cells. The vaccine uses parts of cancer cells as antigens to trick the immune system into attacking them. This is the principle of immunotherapy, a new personalized therapeutic weapon that is revolutionizing cancer treatment.
The Lake Geneva basin stands out as one of the key locations for cancer research. Among the different lines of work: the development of personalized anti-cancer vaccines. The Department of Oncology of UNIL-CHUV (University of Lausanne – Center hospitalier universitaire vaudois), with its Lausanne branch of the Ludwig Institute for Cancer Research, has just started two clinical trials under the direction of Prof. Lana Kandalaft, head of department of the Center of Experimental Therapies (ETC) of the department in question.
How does a cancer vaccine work?
With a therapeutic and personalized purpose according to the patient and their cancer, the vaccine consists of educating the immune system to help it fight against specific targets, typical of the tumor. This is the principle of immunotherapy. “Cancer develops differently in each individual,” explains Lana Kandalaft. For the same type of tumor, cancer cells can present very different mutations from one person to another, hence the importance of ultra-personalized treatment”.
To develop this vaccine, CTE teams must first identify the specific antigens on the patient’s cancer cells. Then, in a second step, reintroduce them into the body to train it to recognize these targets and fight them. Therefore, the cancer vaccine is not intended for the general population, but for people who are already affected by cancer.
The two clinical trials carried out by the CTE are in pancreatic cancer and lung cancer. A third project for ovarian cancer will begin shortly. “These cancers are very difficult to treat, partly because of the physiology of so-called “cold” tumors, that is, they are not recognized by T* cells, emphasizes Lana Kandalaft. The vaccine makes it possible to change the environment of the tumors to transform them into so-called “hot” tumors, which are more easily identifiable.
Through a state-of-the-art technical platform and either from a sample of antigens transformed into small proteins (peptides), or from ground material of the tumor itself extracted from the patient, Lana Kandalaft’s team manages to cultivate in the laboratory of specific and safe “radar” way to target cancer cells. Once reintroduced into the patient’s body, these will form T cells to recognize and attack the tumor.
On paper, things look easy. But the effectiveness of immunotherapy is conditioned by different parameters and the research teams follow many lines of thought. “The great difficulty, adds Lana Kandalaft, is to be able to identify the best antigen for each tumor: will it be a peptide, a combination of different peptides or a ground material from the tumor itself that will be the most effective in combating it? We also wonder about the combination of the vaccine with other cancer treatments or even about the ideal time to perform the injection.
After surgery and chemotherapy, once in remission, patients could benefit from this “tailor-made” vaccine, in order to prevent recurrence of the disease. “The hope of these trials that are currently being carried out in certain types of especially aggressive cancers is to reduce this risk of relapse and thus prolong the life expectancy of patients,” explains the researcher. With a 5-year survival rate stuck at 26% for lung cancer and 13% for pancreatic cancer, this therapeutic outlook is promising.
But if the preliminary results have been able to demonstrate the efficacy and safety of the vaccine, its development is, however, with certain limits. The nerves of war, as always: time and money. The development of a targeted vaccine requires expensive technologies and requires human time. The ETC laboratory manages to produce around four vaccines per month, but has set a goal of doubling this output in the short term. “Today the tools have been improved, we know the immune system better and better, we know how to do the treatment and we understand how it works”, concludes Lana Kandalaft optimistically. We have never been closer to bringing these vaccines to market.”
A bridge between the laboratory and the bedside
Extensive research platform integrated into the University Hospital Center of Vaud (CHUV) since 2014, the Center for Experimental Therapies (CTE), created and directed by Prof. Lana Kandalaft, works as a bridge between, on the one hand, laboratory research around personalized cell therapies and, on the other hand, the establishment of concrete and rapid therapeutic perspectives for patients.
With 180 employees, covering 750 mtwoBecoming one of the largest academic T-cell manufacturing facilities in continental Europe, the CTE has established itself as a world leader in the transition of research programs towards new treatments and care techniques, from the laboratory to the patient.