ASCO 2010 Annual Meeting, 4—8 June 2010, Chicago
Interview with Dr Gregory Beatty (University of Pennsylvania, USA)
An immunotherapy approach to pancreatic cancer
The project that we’ve been working on at Penn is an immunotherapy approach to pancreas cancer. So the idea is to really re-educate the immune system to recognise the cancer and use it as a way in which to attack the cancer.
What cancer are you targeting with this treatment?
The process that we’re working at here is looking at pancreas cancer and the way the idea here is that we’re combining it with chemotherapy and it’s based off a pre-clinical work which has demonstrated that a combination of chemotherapy and an antibody that targets the immune system, it’s called an antibody against CD40 that’s on the immune system. When you use chemotherapy you basically alert the immune system to where the cancer is and then, by coming in with an activating antibody, you can now turn the immune system on and it will find the cancer. And it tends to be a lot of the approaches at the moment are looking at chemotherapy for pancreas cancer and it was recently demonstrated in Science magazine 2009 that it may be very hard for chemotherapy to get into the tumour. So the novel approach here is the fact that the immune system is already coming in to the tumour - you can see it all over the place. And so what we’re trying to do is re-educate it now not to help the cancer grow but actually prevent it from growing.
What chemotherapy drug was used in this trial?
We’re using Gemcitabine because it’s a standard of care. But Gemcitabine also appears to be immunomodulatory and so it may also help change the immune system so that it’s not one that actually helps promote the cancer. So by combining Gemcitabine now with our antibody, our immunotherapy approach, we’re working to see whether or not this will deliver responses.
How successful has the trial been?
We’re at the completion of the phase I study, there are a few patients that are continuing on treatment at this point in time. We’ve had three partial responses which is impressive for a small study of only about 21 patients. Our approach at this point is based on the pre-clinical models that we’ve had, it’s not quite to the level of efficacy that we would have expected but it’s promising. And so we’re turning back to looking in the laboratory how to make this even better.
What is the key message that patients should take from your study?
The message here is the fact that there are new therapies that are coming out and they don’t have to be toxic therapies. One of the most important things for patients is the fact that this is a disease for which the outcome is poor and we know this and the last thing you want to do is provide therapies that are going to make their quality of life worse. The optimistic point here is that our therapy seems to be prolonging progression free survival but it also is not doing that at the compromise of the patient’s quality of life. The immunotherapy is not very toxic at all, in fact it’s received once a month and patients have a little bit of chills around the time of the treatment and some shakes, like you get with the ‘flu, but they disappear and you don’t experience anything else for the rest of the month. And so there are approaches that are now being developed that can help these patients and it’s from an immune based perspective. It may not have the same level of toxicity that other targeted therapies and chemotherapy have had.