Could “personalized” treatment be the answer to curing mesothelioma?
That question was the center of the latest Mesothelioma Guide podcast, which featured a unique clinical trial currently enrolling patients of various types of cancer.
Dr. Ezra Cohen, of the University of California San Diego Medical Center, is the lead investigator in the Phase 1B trial. The study is titled “Personalized Immunotherapy in Adults With Advanced Cancers” and aims to treat each cancer patient’s disease in a specialized way.
Dr. Cohen joined the podcast to explain how he and other scientists are creating a unique vaccine for “literally one person in the entire world.” Then they create one for another patient, and so on. The trial also involves pembrolizumab, which is the organic name for the immunotherapy drug Keytruda.
While the study does not focus solely on mesothelioma patients, Dr. Cohen confirmed that the trial could include such a patient as a participant and can help future treatment of this rare cancer.
“The type of cancer doesn’t really matter,” Dr. Cohen said on the podcast. “We know cancer is a disease of mutations, and those mutations, at least some of them, are revealed to the immune system.”
A mesothelioma patient’s immune system, at times, does not recognize mesothelioma cells due to T-cell suppression. T-cells are the immune system’s top defense mechanism against diseases, but mesothelioma cells can go undetected. They have a protein called PD-L1, which interacts with a T-cell protein called PD-1. When this merger occurs, T-cells assume the mesothelioma cells are harmless.
Some immunotherapy drugs, such as pembrolizumab, prevent the protein interaction and make the mesothelioma cells susceptible to immune response.
“The immune response (usually is) not robust enough to eliminate the cancer,” Dr. Cohen said. “So we devised a methodology to identify how the immune system responded and a therapy to boost those specific T-cells against the cancer and eliminate the disease. We felt we needed something to augment that, and that’s where the pembrolizumab comes in.”
In the current phase, testers are analyzing the toxicity and safety of the trial. The next phase will test the effectiveness of specialized vaccines and dosages. If the trial survives the United States Food and Drug Administration’s approval process, then it could be a game-changer for mesothelioma patients.
“The FDA has been open to these types of novel concepts,” Dr. Cohen said. “We’re really not approving a drug. We’re approving a methodology.
“It’s identifying the neoantigens and creating the vaccine. That methodology is identical in every patient we treat. … The end products, the actual sequences going into the vaccine, are individualized and only go into one person on earth. But the process is the same, and the process is what the FDA is looking at.”
Dr. Cohen believes Phase 1B will conclude by the end of 2019 or early 2020. Then he expects a potential Phase 2 to begin in the first half of 2020.
Enrollment is still available for this clinical trial, along with many others. If you’re an early-stage mesothelioma patient looking for a clinical trial, reach out to the Mesothelioma Guide patient advocate team. Our registered nurse, Jenna Campagna, can assist you in finding a study that matches your specifications. Email firstname.lastname@example.org for help.
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