Pancreatic Cancer: A New Hope with mRNA Vaccines

In 2020, Barbara Brigham's life took a dramatic turn when a routine scan revealed pancreatic cancer. She was determined to fight it, especially since her husband had recently passed away and she wanted to spend more time with her children and grandchildren. Her journey began at Memorial Sloan Kettering Cancer Center, where she had been a patient for years due to a non-cancerous cyst. Dr. Vinod Balachandran, a surgical oncologist, offered Brigham a unique opportunity. He was running a clinical trial that combined standard treatments with a personalized mRNA vaccine. This vaccine was designed to help the immune system recognize and attack the cancer. Brigham, with her son's support, decided to join the trial. The goal was simple: extend her time with her loved ones. The inspiration for this trial came from a small group of long-term pancreatic cancer survivors. Researchers noticed that these survivors' immune systems could naturally recognize and fight the cancer. The challenge was to teach other patients' immune systems to do the same. This led to a phase 1 clinical trial involving 16 patients with early-stage pancreatic cancer, including Brigham. The trial focused on patients whose cancer was confined to the pancreas and could be removed surgically. The vaccine targeted specific mutations caused by the cancer. These mutations act as red flags for the immune system, helping it identify and attack cancer cells. The trial showed promising results. Eight out of 16 patients had strong immune responses, and none of these patients saw their cancer return within 18 months. This is a significant improvement compared to the average recurrence time of a year or less for early-stage pancreatic cancer patients treated with standard methods. However, the trial also highlighted an important factor: the role of the spleen. Patients who had their spleen removed did not show strong immune responses. This suggests that the spleen plays a crucial role in the immune system's ability to fight cancer. New research published in Nature followed up with the same patients 3. 2 years after treatment. The results were encouraging. Only two of the eight patients with strong immune responses saw their cancer return. In contrast, seven out of eight non-responding patients had recurrences. This suggests that the vaccine may be effective in helping the immune system fight pancreatic cancer. Dr. Suneel Kamath, a gastrointestinal oncologist at the Cleveland Clinic, praised the trial as a proof-of-concept study. It showed that mRNA vaccines can create a lasting immune response in pancreatic cancer patients. A larger clinical trial is now underway to confirm these findings and explore the role of the spleen further. mRNA vaccines are gaining attention for their potential in cancer treatment. They can be customized quickly, making them suitable for targeting various cancers. This flexibility is crucial because cancer is not a single disease but a collection of different targets. Researchers are now focusing on which cancers are best suited for mRNA vaccines. Pancreatic cancer, with fewer mutations, is a challenging but promising candidate. For Brigham, the trial was a success. She gained more than four years with her family, celebrating milestones like her son's first child and her brother's 60th wedding anniversary. She manages her diabetes, a side effect of the surgery, but considers the trial a "wondrous thing" that renewed her life.