Doctors in the New England Journal of Medicine on Wednesday seem to have found experimental treatment to be successful in stopping the development of advanced pancreatic cancer in a woman.
Significant success of therapy involving the attack of immune cell genes on tumor cells could be a major step forward in the treatment of not only pancreatic cancer but also other cancers.
“I’m so excited for this,” the doctor said. Carl June discovered another type of immune therapy for some blood cancers more than a decade ago. June did not participate in the new report.
Katie Wilkes, 71, of Ormond Beach, Florida, was diagnosed with pancreatic cancer in early 2018. He first underwent at least eight rounds of chemotherapy, as well as an operation called Whipple to remove radiation and part of the pancreas.
But within a year, the cancer had spread to her lungs.
“When I talked to my oncologist in my hometown and asked him what to do, he had only one answer, and that was chemotherapy. “That’s not my answer,” Wilkes told NBC News.
He found a report in 2016 published in the New England Journal of Medicine, which described how an experimental form of gene therapy aimed at a cancer mutation called KRAS G12D helped a person with advanced colon cancer.
“I thought,‘ The trial I want. I learned that this was a trial that would save me and save my life. I just felt that way, ”Wilkes said.
With that in mind, he turned to the report’s author, Eric Tran. Tran was at the National Institutes of Health while treating a patient with colon cancer, but has since transferred to the Providence Cancer Institute in Portland, Oregon. There he found her and asked for the same type of therapy.
Wilkes was found to have a genetic mutation in colorectal cancer, despite various forms of cancer. Tran, who has been involved in his therapy, is also the author of a recent report in the New England Journal.
The experimental method involved taking a sample of Wilkes’s T cells, a type of immune cell that attacked invaders in the body. The researchers then genetically modified these cells and reprogrammed them to recognize and attack tumor cells.
The T cells were multiplied billions of times in the laboratory and then delivered back to Wilkes’ body by a single intravenous injection.
This approach is reminiscent of CAR-T therapy, a form of treatment developed in June at the University of Pennsylvania.
“It could be a one-time treatment,” the doctor said. Rom Leidner, author of the new report and co-director of the Providence Institute for Cancer Treatment for Head and Neck Cancer, spoke about the new therapy.
Wilkes’ infusion took place on June 14, 2021. Within a month, her lung tumors had shrunk by more than half, the report said. Six months later, the tumors had shrunk by 72% from their original size.
However, it is unknown how long the treatment will last.
But the new therapy is a “living medicine,” said Leidner, who treated Wilkes, meaning that the modified T cells must continue to grow and multiply within the immune system, and care must be taken if they return to cancer.
Wilkes said his cancer remains stable, but he will undergo an additional test this month and be scanned as part of the annual update.
Pancreatic cancer is one of the most dangerous forms of the disease. It is rare before it spreads, so it is more difficult to treat. According to the American Cancer Society, only about 11% of patients are expected to survive five years after diagnosis.
Another patient with pancreatic cancer received similar treatment at the Providence Cancer Institute. It is not clear why the treatment is successful in one person and unsuccessful in another.
“We’re trying to answer that question,” Tran said. “If we understand the mechanism, it will help us develop better therapies.”
Wilkes’ doctors targeted a tumor called a KRAS. Although most pancreatic cancers have a KRAS mutation, Tran said that about 4% of patients with pancreatic cancer have a mutation, and that there is a specific molecule on the cell surface that is necessary for it to be suitable for therapy.
But the mutation is not limited to pancreatic cancer, Dr. said. Eric Rubin, editor-in-chief of the New England Journal of Medicine. Therapy, therefore, according to him, can be used against various cancers.
“This particular mutation is common in tumors caused by epithelial cells such as lung, ovarian and pancreatic cancers,” Rubin told a media briefing on Wednesday. “For the first time, we have an approach that allows CAR-T cells to treat a wide variety of tumors, in addition to the small number of tumors that can be used in a particular form of immunotherapy.”
However, Rubin emphasized caution. “It was a gratifying result, but it’s definitely far from a cure,” he said.
Of course, more research is needed, experts agree. Tran and Leidner are now recruiting patients for a Phase 1 clinical trial to continue investigating therapy.
One of the potential factors explaining Wilkes’ positive results was that his pancreatic cancer had spread to his lungs, not his liver, the doctor said. Ryan Carr is a pancreatic cancer expert at the Mayo Clinic in Rochester, Minnesota. Carr, who did not treat Wilkes, said that in his experience, patients with lung cancer had better outcomes than patients with liver cancer, which is a common site of metastasis.
“In most cases, when we have these lung metastases, they don’t cause symptoms in the patient,” Carr said. “It’s still a bad prognosis, but we know they have something different and they’re a little better than those who have spread to the liver.”
June said she had a similar experience.
As such details have been developed, both June and Carr believe that the new therapy is a major step forward in the treatment of pancreatic cancer.
“I think cancer research is reviving and relying on that,” said June, director of the Parker Cancer Immunotherapy Institute at the University of Pennsylvania. “The real question is not when this type of therapy is now becoming a reality in curing patients with fatal cancer.”
TO FIX (June 1, 2022, 22:45 ET) An earlier version of this article incorrectly indicated which patients responded to gene therapy. They are not patients with a subtype of the KRAS mutation, but patients with a KRAS mutation that has a specific molecule on the cell surface.
This story originated in the beginning NBCNews.com.