Hepatocellular carcinoma (HCC) is the most common form of liver cancer, accounting for more than 80% of cases. Immunotherapy is a newer treatment option for HCC, but not everyone responds to it. Researchers at Johns Hopkins Kimmel Cancer Center found that combining immunotherapy with a personalized anti-tumor vaccine led to increased tumor shrinkage compared to immunotherapy alone. The results of a preliminary clinical trial showed that individuals with HCC who were treated with this combination were twice as likely to experience tumor shrinkage compared to those receiving immunotherapy only.
Liver cancer is the sixth most common cancer worldwide, with an estimated 905,700 people diagnosed in 2020 expected to increase to 1.4 million by 2040. HCC is the most common type of liver cancer, with the majority of cases being this form. Immunotherapy is a treatment that uses a person’s immune system to fight cancer, but only about 15-20% of HCC cases respond to immunotherapy and 30% may be resistant. The GNOS-PV02 vaccine, a personalized DNA vaccine created by Geneos Therapeutics, was used in combination with the immunotherapy drug pembrolizumab in the clinical trial. The FDA approved pembrolizumab for HCC treatment in 2018.
GNOS-PV02 is a personalized vaccine that aims to educate the immune system to recognize and attack cancer cells by encoding unique antigens found in an individual’s cancer. The vaccine is created by sequencing the cancer DNA from a biopsy and manufacturing a vaccine that includes these unique antigens. The rationale behind combining the vaccine with pembrolizumab is to prevent vaccine-induced T cells from becoming exhausted and increase efficacy. The results of the study showed that almost one-third of participants experienced tumor shrinkage, with some showing no evidence of a tumor after treatment.
Dr. Anton Bilchik, a surgical oncologist, expressed astonishment at the results of the trial, stating that HCC has been traditionally difficult to treat. Immunotherapy has shown promise, but response rates have not been significant. The personalized vaccine approach in this study doubled the response to immunotherapy and showed promise for patients who had failed first-line treatments. Dr. Martin Gutierrez, director of Phase I research at the John Theurer Cancer Center, described the study as encouraging and emphasized the need for larger Phase II trials in first-line therapy. The future of cancer treatment may include more personalized vaccines, utilizing advanced technology and artificial intelligence to predict immune system recognition of cancer cells.
The combination of immunotherapy and a personalized anti-tumor vaccine showed promising results in treating HCC, with an increased likelihood of tumor shrinkage compared to immunotherapy alone. Larger randomized clinical trials are needed to confirm the efficacy of personalized cancer vaccines and define optimal treatment sequences. Future research may focus on larger Phase II trials in first-line therapy for HCC. The use of advanced technology and artificial intelligence to create personalized cancer vaccines represents a potential future direction in cancer treatment, offering hope for improved outcomes for patients with difficult-to-treat cancers like HCC.
