Doctor, What About Immunotherapy?

Life – Terror. Ecstasy. Fight. Denial. Flight. Failure. PAIN. Forgiveness. Reconciliation. Hope. Love. Peace – Death

As a cancer sufferer I am increasingly frustrated by the lack of availability (access) to any of the ground-breaking ‘new’ treatments that are widely published?

Almost exclusively, such treatments, often clinical trials, are only available to those near to the end of their prostate cancer journeys for example patients who have become resistant to, all, standard treatment options.

Surely treatments, delivered earlier, would be more effective with cure and or life extension rather than wait for a last chance saloon scenario?

Currently, efforts in regards to immunotherapy development are focused on the advanced disease, the metastatic disease. Within the metastatic disease, there is a spectrum of clinical trials looking at different stages of the disease.

There are a lot of different treatment approaches being explored based on an individual patient’s course of disease, time of diagnosis. Apparently?

There are actual, now mainstream, options available in the USA. For example it is standard practice in the USA for prostate cancer patients to have full Geno mapping, in order to inform their treatment.

At what point should someone say, “Doctor, what about immunotherapy?”

A new platform built around recombinant overlapping peptides (ROPs) promises quicker and cheaper production of more effective therapeutic vaccines and diagnostics for cancer and viral infections.

Immunotherapy is a fast-growing approach for cancer treatment and the prevention of infections based on manipulation and direction of the patient’s own immune system. It is a targeted therapy that is less toxic than chemotherapy and is usually suitable for combination with other treatments.

Vaccination against a cancer or pathogen can be achieved through injection of a preparation containing antigens that direct and stimulate T cells to attack anything bearing those antigen markers.

However, there are two immune responses: one that produces antibodies and helper T cells, and another that produces killer T cells. For cancer, the killer T cell approach has been found to be much more effective. Unfortunately, many cancer vaccines are based on full-sized proteins produced by a tumour, which tend to generate antibodies and helper T cells rather than killer T cells.

So far this pioneering treatment has proven expensive. Oxford Vacmedix are developing a cheaper, more viable ‘version’. Fragments, with an enzyme cleavage site between them, are linked into a single molecule encoded by a single gene for expression as a single protein. Once expressed, the protein can easily be split into the individual ROPs by enzyme cleavage ( in vitro or inside cells), which makes it easy to both deliver and manufacture.

The peptides can be produced synthetically but this can be slow and expensive. ROP production takes only 2–3 days at a time—a great improvement on synthetic production. “Vaccine can be designed and scaled up much more quickly, it is also more suitable than the pooled peptides strategy for applying for FDA [US Food and Drug Administration] registration, manufacturing overlapping peptides using a natural expression system is a thousand times cheaper and has the potential to significantly reduce the cost of vaccine development.

Oxford Vacmedix is currently developing two therapeutic vaccines. The first ‘human’ trials are now recruiting (see link below). OVM-100 is a first-in-class human papillomavirus (HPV) vaccine aimed at cervical cancer, with an estimated market size of over £1 billion.

OVM-200 is a first-in-class cancer vaccine that targets survivin, a protein that is expressed at high levels in many solid tumours, such as breast, lung, ovarian, prostate and colorectal, as well as blood cancers—a huge potential market.

Data so far are compelling, with vaccinated mice showing greatly extended survival in tumour model systems. OVM is developing a large-scale good manufacturing practice (GMP)- compatible production process in China prior to transferring production to a contract manufacturing organization (CMO) in Europe. Wide availability could follow.

“We are the first company to not only prove that overlapping peptides stimulate both helper and killer T cells, but also propose using them as vaccines to stimulate T cell immunity,” said Jiang. “Our high-performing ROP vaccines are easier and cheaper to design, scale up and quality-control than existing approaches—the potential impact on health care is enormous.”

Thanks for Reading

Hope & Peace, Brothers

https://www.nature.com/articles/d43747-020-00345-4

Immune Vaccine Trials https://clinicaltrials.gov/ct2/show/NCT05104515?cond=Prostate+Cancer&cntry=GB&city=Liverpool&dist=300&draw=3&rank=121