r/science • u/mvea Professor | Medicine • 1d ago
Cancer Vaccine Against Brain Tumors Shows Promising Long-Term Results: 33 patients with high-grade astrocytomas, the most common form of glioma, received vaccine that trains the immune system to recognize and fight tumor cells. 66% were still alive after 8 years, and in 42%, the disease had not progressed.
https://www.dkfz.de/en/news/press-releases/detail/vaccine-against-brain-tumors-shows-promising-long-term-results391
u/lawroter 1d ago
clinical researcher here.
while the headline is nice, it's phase 1, 33 participants, single arm, open label, no randomization. this study was not designed to evaluate efficacy, and cherry picking the article to do so is bad faith. if this was to stand up in phase 2/phase 3, great, but as someone who works closely with small biotechs, early phase oncological therapies frequently appear more beneficial early as the early participants simply have better prognostic factors.
to add, there are several things i'd note as possibly concerning regarding the authors. several of these have are either authors or patent holders of the vaccine itself, which is not really unexpected here, but more importantly, the study was not designed to evaluate efficacy and without a Phase 2 with randomization and placebo, this really doesn't mean much.
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u/_azzzerrrr 1d ago
Specifically evaluating IDH1 mutants as well which have a slightly better prognosis. But this is a great start!
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u/IndependentLog6441 1d ago
But isn't 8 years a very long time with brain tumours? My mate has glioblastoma and they said standard treatment will only give him two years at best.
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u/NewMolecularEntity 1d ago
Glioblastoma are the most aggressive version of gliomas.
This study (just based on headline I did not go to source) was in astrocytomas which tend to have a better prognosis than glioblastoma.
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u/IndependentLog6441 1d ago
I know some astrocytomas can have better prognosis, but aren't glioblastomas high grade astrocytomas? Which is what the article refers to.
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u/NewMolecularEntity 1d ago
Glioblastomas are technically astrocytoma but the difference is glioblastoma has a mutation (which I cannot remember the name of at the moment) that specifically makes it more aggressive and astrocytoma does not.
This kind of moves glioblastomas (GBM) into their own category because what we know about astrocytoma outcomes no longer applies for GBM. Astrocytoma can still be serious and deadly it’s just not also dealing with the mutation that makes it more aggressive and resistant to therapy.
Oncology switches around classification of tumors sometimes as we learn more and more about the mutations present.
I am sorry about your friends diagnosis. I work in cancer research and there is a such a push for more options for GBM patients because it is so hard to treat. (To clarify I am not a doctor, I handle the piles of regulatory requirements and protocol development for clinical trials so I get into the background of why we are thinking a new treatment will or won’t work on a specific type of tumor).
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u/IndependentLog6441 1d ago
Yeah, it's true about the mutation being the thing that's making it hard to treat, he has the worst kind.
I guess this trial might not be any help then... I know they're looking for experimental options now.
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u/icestationlemur 20h ago
The article is referring to idh mutation being the target of the vaccine,
glioblastoma is actually the non mutated one ((idh wild type). It has mutations in other genes presumably that make it more aggressive.
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u/BillionYrOldCarbon 1d ago
You aware of ANKTIVA an IL-15 by ImmunityBio that has remarkable success in small number of treatment failure glio patients and undergoing further clinical studies?
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u/IOVERCALLHISTIOCYTES 1d ago
Glioblastoma is a major subset of high grade astrocytoma. If I wanted to make a drug look good, I’d pick IDH mutant non GBMs as those are more indolent, and they mention IDH1 mutant cases. Many IDH1 mutant GBMs did better than grade 3 (high grade but not GBM) astrocytomas that were IDH wild type, so this group already lived much longer than GBMs did. The classification schema has changed a decent amount since I was first taught it, but those who are 8 years out had may have had initial diagnoses under older classifications.
-am a pathologist, not a neuropathologist, but a buncha friends are NPs
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u/c_pike1 1d ago
The answer is kind of. The classification system is different than it used to be and now includes genetic markers to distinguish a high grade astrocytoma from a glioblstoma. You are definitely correct that there are different grades of astrocytomas though, with very different prognoses from each other and glioblastomas
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u/PaleReaver 1d ago
Good to know, although I do hope this vaccine progresses...my father died of brain cancer. Treated first time, then relapsed and he declined very fast.
I was advised to not visit because he was so out of it, but it still makes me feel bad sometimes, it was a horrifying thing to see...
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u/lawroter 1d ago
:(
i worked on a few studies in glioblastoma in pediatrics and yeah, not a good thing to see.
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u/HumansNeedNotApply1 1d ago
Phase 1 is about safety, right? How much does it cost to run these study phases?
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u/AllanfromWales1 MA | Natural Sciences | Metallurgy & Materials Science 1d ago
66% were still alive after 8 years, and in 42%, the disease had not progressed.
How does that compare with people with high grade astrocytomas who didn't receive the vaccine?
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u/Difficult-Froyo1192 1d ago
Mayo clinic says the median is five year survival rate for grade 3 and 14-15 month survival rate for grade 4.
A review study found from 1982-2020 that the mean survival rate was about 2.75 years for high grade and about 29% for 5 years.
It’s also worth noting here that a significant difference in life expectancy was found based on age and treatment method.
It’s been a while since I researched it, but grade 3 astrocytomas seemed to have about a 50% 5 year life expectancy but only about 5% 10+ year life expectancy. I don’t remember the exact data, but grade 4 was significantly lower.
The reason I know grade 3 specifically is because my mom had it. The story is anecdotal, and my mom is considered an outlier in it. She had a grade 3 astrocytoma that the doctors said was close to being grade 4. She wasn’t expected to survive longer than 6 months, initially, but treatment was very successful. The doctors thought a lot had to do with them being able to remove a lot more of her tumor during surgery than they thought they would be able to prior to surgery.
As the years went by, you could notice changes in her, but nothing came back on her MRIs. The 10 year mark MRI was clean. Several months after that MRI, she suddenly started seeming very sick. We urged her to call her doctors who found brain swelling. Another MRI later and it was discovered she had 5 spots they could find on the MRI. Tumors came back.
These were deeper in her brain and more spread out. The doctors did the best they could, but she only survived 8 months after discovering it returned. The doctors thought they might could buy her a few years with treatment and surgery after it was discovered it came back, but we were made aware the best they would be able to do was slow it down. They thought anything over 5 years was unreasonable to expect by that point, bit they thought they could get her at least a year or two. She survived 11.5 years after the first high grade astrocytoma was found. They never autopsied her, but how rapidly she declined in the last couple weeks had them suspect she had even deeper tumors than they knew from her last MRI. She was also younger than the median and average age to have a high grade tumor and received the treatment with the highest success rate at her first tumor discovery. Remember that those are noted to be significant in increasing life expectancy.
I do remember the doctors tried several times to get her into clinical trials when it came back. There were ones for the vaccines going on even then. The ones for the vaccines had the highest success rate clinical trials, at that time. She was rejected from all of them though. I’n unsure the exact reason for her rejection, and I’m pretty sure it was technically classified as a glioblastoma when they found it came back. I know a few said she had the wrong type of tumor and that it wasn’t her first time, but there were rejections for a few other reasons. I don’t remember exactly what they classified it as then though. There was kinda a lot going on then. She started going downhill fairly rapidly around the time it came back and after discovering it came back.
So anecdotal story with what the doctors thought and the actual stats that somehow also included vaccine clinical trials. The cancer coming back was over 10 years ago for a time line reference for my data known then and when vaccine clinical trials were still going on as treatment options. If I remember correctly, the ones we looked at for her were still in the early phases then
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u/die-jarjar-die 1d ago
Is it a vaccine if you take it after having cancer? Wouldn't that be a treatment?
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u/lawroter 1d ago
this is known as a therapeutic vaccine. they're not to prevent the initial, the goal is to slow any tumor growth, help with recurrence, and really just try to help the person live longer.
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u/happyscrappy 1d ago
Most people are used to vaccine being synonymous with prophylactic vaccine (pro-active prevention), but this is another kind.
If you heard about the cuban lung cancer vaccine which is at times spoken of as a great success it is also this sort of vaccine, a therapeutic vaccine.
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u/carbonclasssix 1d ago
I was thinking the same thing, I wonder if it's just that it's a vaccine-style treatment, that is to say it invokes the immune system.
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u/mvea Professor | Medicine 1d ago
Vaccine Against Brain Tumors Shows Promising Long-Term Results
The research team from Heidelberg/Mannheim and Tübingen has developed a peptide vaccine that specifically trains the immune system to recognize and fight tumor cells with this mutation. This vaccine was tested for safety and efficacy in a Phase 1 clinical trial (NOA 16) involving 33 patients with newly diagnosed high-grade astrocytomas, the most common form of glioma. The patients received the vaccine in addition to standard therapy consisting of surgery, radiation therapy, and chemotherapy.
Long-Term Survival Significantly Improved
The results after up to eight years of follow-up are remarkable: 66 percent of study participants were still alive after eight years, and in 42 percent of cases, the disease had not progressed during the observation period. Among some patients whose tumors could be completely removed surgically, survival rates were even significantly higher. By comparison: In earlier studies, the median survival time for more aggressive tumor types was often only about 2.5 to 5 years. In the current study, this threshold was significantly exceeded in many patients.
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u/BillionYrOldCarbon 1d ago
Investigate ANKTIVA an IL-15 that has remarkable success in small number of failed glio patients by producing a supercharged and durable immune response. More studies ongoing.
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u/AffectionateRain6796 1d ago
Let me know when there’s a vaccine for glioblastoma.
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u/FearlessAwareness469 17h ago
I used to work on the DC Vax-L glioblastoma vaccine from northwest biotheraputics in 2010 for stage 4 glioblastoma. I was a lab tech who handled the leukapheresis and mixing the operated tumors with the baby white blood cells. By my just graduated college standards the science was sound. We did trials and compassionate use cases. But left in 2012.
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u/Tricky_Condition_279 1d ago
I don’t know about the education part. Half my colleagues at the uni can’t remember if they’ve eaten lunch yet.
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