These randomized clinical trials are specifically aimed at patients who have been diagnosed with stage II or III non-small cell lung cancer and who have undergone surgery.
“Stage II or III cancers are curable, but there are often micrometastases [qui nous échappent]explained Dr. Jonathan Spicer, of the MUHC. For 75% or more of these patients, there are cells that will lodge in the brain, in the bones, in the adrenal glands and elsewhere, and the majority [des patients] are going to do it again.”
This is why, he added, “we are trying to add other treatments which will attack these micrometastases”, especially since the progress made in lung cancer screening make it possible to identify more and more patients whose disease is at these stages.
“We do not want to overtreat patients who will recover, but we try to prevent [un retour du cancer] in high-risk patients,” said Dr. Spicer.
All patients who participate in these clinical trials are treated with chemotherapy and immunotherapy either before or after surgery to remove their tumor.
After surgery, the tumor is analyzed in the laboratory to identify its genetic characteristics and the proteins that derive from them (called neoantigens). This makes it possible to develop an mRNA with sequences specific to these neoantigens which is then injected into the patient.
This strategy is part of “precision medicine” or “personalized medicine”, which sees treatments being developed tailor-made for a patient based on their genetic characteristics and/or those of their disease.
Immunotherapy, Dr. Spicer explained, helps the immune system find and destroy residual cancer cells that may be hiding in the body after surgery and other treatments. The answer, however, is not perfect. Researchers hope the new individualized therapy will propel the immune system to new heights of effectiveness.
“We add a vaccine to patients’ immunotherapy,” he explained. This activates the immune system so that it can recognize [les néoantigènes]. We hope that this will reduce recurrences, increase survival rates and so on.
Vaccines developed during the pandemic
Messenger RNA entered popular lingo during the COVID-19 pandemic, when the technology led to the development of vaccines against SARS-CoV-2.
The clinical trials being carried out today at the MUHC are directly dependent on the dazzling progress made during the global health crisis, said Dr. Spicer, since this led to the development of anti-cancer vaccines which have already shown their effectiveness against melanoma.
We now hope that the same will be true for lung cancer.
“There is no doubt that we have learned a lot about these technologies [pendant la pandémie]he explained. And now we’re applying them not only to infectious diseases, but to diseases like cancer, and we already have preliminary evidence that it can work. And if it can work in the context of lung cancer, it would be enormous progress in the face of a cancer which is very common and which still kills many people.
