A new breakthrough in the fight against cancer is based on stimulating the patient's own defence system against the tumour. Prof Dr Stefaan Van Gool and his team have succeeded in obtaining effective results: patients with malignant brain tumours have a chance of recovering thanks to immunotherapy. The therapeutic vaccinations are made specifically for each patient from their own white blood cells and tumour proteins. The experience built up is now being extended and the technology can be offered to patients with renal cell cancer, uterine cancer and pancreatic cancer. In the immunotherapy platform, science and technology come together to prolong the survival of patients with malignant brain tumours, renal cell cancer, uterine cancer or pancreatic cancer while maintaining the quality of life.

BACKGROUND

Every year, 4 adults in 100,000 develop a malignant brain tumour. The median survival of these patients is only 15 months despite maximum surgery and the combination of radiotherapy and chemotherapy. Practically all patients relapse after the treatment, and then the survival is only one and a half years at the most. The incidence of renal cell cancer is greater and amounts to 15 people per 100,000 per year. High-risk tumours that can be removed completely have a 40% chance of recurrence. Patients with recurrence and patients with metastasised disease have a 5-year survival of less than 10%. For brain cancer and renal cell cancer, we notice a disquieting increase in the incidence, but no significant breakthrough in improving the prognosis.
The prognosis of patients with pancreatic cancer is very gloomy indeed with a one-year survival rate of only 15%. Chemotherapy and radiotherapy do not offer a solution. This too is a tumour with a fairly rare incidence: 9 patients per 100,000 adults per year.
The incidence of uterine cancer is 20 patients per 100,000 women per year. Because the tumour is relatively insensitive to chemotherapy or radiotherapy, the prognosis in patients with a relapse and/or metastases is very poor.

BREAKTHROUGH IN MEDICAL UNDERSTANDING

We have discovered that the patient's own defence system can be stimulated with a therapeutic vaccine against their own malignant brain tumour and thereby slow down or prevent tumour growth. To do this, blood cells from the patient are differentiated in the laboratory to dendritic cells, which are then loaded with proteins obtained from tumour tissue. The patient-specific living cell product is finally injected into the patient's skin. In the last ten years, experience has been built up in hundreds of patients with brain tumours. From eighteen countries inside and outside Europe, patients come to Leuven University Hospital for this treatment, forming world-wide the largest series of patients that have been treated with immunotherapy. The abrupt change from 100% mortality in patients with a recurrent malignant brain tumour to multiple patients who now survive tumour-free for years points to the efficacy of the therapeutic vaccine with a high level of evidence 1c (Oxford criteria: www.cebm.net).

IMMUNOTHERAPEUTIC PLATFORM

The technology has been perfected for patients with malignant brain tumours, and the efficacy of the therapeutic vaccines has been demonstrated by means of displacements of the survival curve. The data clearly show that immunotherapeutic strategies in patients with renal cell cancer, pancreatic cancer and uterine cancer can likewise extend life expectancy. In order to offer this treatment at Leuven University Hospital for patients with renal cell cancer, pancreatic cancer and uterine cancer, the immunotherapeutic platform is being established, which will be guided in its operations by Professor Van Gool's team. This team has an extensive knowledge in preclinical research with cells and cell lines, together with mouse models. The team also has the specific expertise in making the therapeutic vaccines in accordance with the state-of-the-art guidelines in a Good Manufacturing Practice facility. In the immunotherapeutic platform, the oncologists involved introduce patients from their own practices according to the inclusion criteria established, and exchange their experiences and results with the other groups within the platform. In this way, the therapeutic vaccines are produced for the various oncological specialties by one single and very experienced team. Knowledge and expertise are brought together and thus made available to a large and diverse group of patients. In the organisation, innovative immune modalities of the vaccination treatment that are discovered in the preclinical research are also made immediately available for use in research into a range of oncological conditions. This is a unique but achievable model for making innovative, tailor-made treatment developed from original academic scientific research available to each patient, in order to prolong cancer survival while maintaining quality of life.

Financing

Devising this immune platform means a rational approach with a minimum of resources making available a maximum of expertise for a broad group of patients with different oncological conditions. The translation from the lab to clinical application is furthest advanced for patients with brain tumours. Many results from research and development can now be applied for renal cell cancer, pancreatic cancer and uterine cancer. The clinical development in these conditions is not so far advanced.

The Olivia Hendrickx Research Fund provides financing of the operation of the platform in all facets of research and development, and subsequently, its application to the different patient groups.

For the clinical application for patients with brain tumours, a special subsidy, based on the clinical results obtained, has in the meantime been obtained via RIZIV-INAMI, the Belgian National Institute of Sickness and Invalidity Insurance, based on the convention article 56 of the law of 14/07/1994.