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After Giving Up on Cancer Vaccines, Doctors Start to Find Hope


Marilynn Duker knew her family tree had many relatives with cancer. So when a genetic counselor suggested testing to see if she had any of the 30 cancer-causing gene mutations, she readily agreed.

Testing found a mutation in the CDKN2A gene, which makes people who carry the gene more susceptible to pancreatic cancer.

“They call and say, ‘You have this mutation. There’s really nothing you can do about it,” recalls Miss Duker, who lives in Pikesville, Md., and is the CEO of a senior living company.

She started getting regular scans and endoscopy to check her pancreas. They revealed a cyst. It hasn’t changed in the past few years. But if it develops into cancer, treatment is likely to fail.

Dr. Elizabeth Jaffee, deputy director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, said patients like Ms Duker don’t have many options. A person with more advanced cysts might be able to avoid cancer by having their pancreas removed, but that would immediately expose them to severe diabetes and digestive problems. The drastic surgery may be worthwhile if it saves their lives, but many precancerous lesions never develop into cancer if left alone. However, if the lesions turn cancerous – even if the cancer is detected at an early stage – the prognosis is poor.

But it also offers an opportunity to produce and test a vaccine, she added.

In pancreatic cancer, explains Dr. Jaffee, the first change in normal cells on the pathway to malignancy is almost always a mutation in a well-known cancer gene, KRAS. Other mutations followed, with six gene mutations driving the cancer development of pancreatic cancer in the majority of patients. That insight has allowed the Hopkins researchers to devise a vaccine that can train T cells – the white blood cells of the immune system – to recognize cells with mutations. there and destroy them.

Their first trial, a safety study, in 12 patients with early-stage pancreatic cancer who were treated with surgery. Even though their cancer was discovered soon after it appeared and despite the fact that they were treated, pancreatic cancer patients often have a 70% to 80% chance of recurrence in the next few years. When pancreatic cancer comes back, it metastasizes and causes death.

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