“That would be my dream” – a Finnish company has come to the heart of destroying cancer

A Finnish company has promising results in developing a new cancer drug. The founder of the company, Akseli Hemminki, a professor of oncology, explains what is expected of the new drug.

Cancer touches almost all of us in one way or another, and one in three of us will get cancer ourselves at some point in our lives. Cancer is not always detected in time or treatment does not work as expected, and the cancer can spread.

According to current understanding, cancer can begin to spread, that is, cancer cells can already start moving from the original tumor to other parts of the body. This may occur before the original tumor is detected by current methods.

For example, due to vague symptoms, ovarian cancer always has time to spread before it is detected.

Ovarian cancer spreads to lymph nodes in the pelvis and abdominal cavity, to the peritoneum, and grows around internal organs.

The CEO of drug development company TILT Biotherapeutics says it is largely impossible to spread cancer with current methods. Akseli Hemmingi.

Hemmingki also serves as a professor of oncology at the University of Helsinki.

– We have 290 cell types, any of which can cause cancer. Most all cancers are diagnosed when they have spread, and current treatments are usually no longer curative. Instead, localized cancers have been cured for thousands of years.

That’s why, according to Hemming, new types of treatments are needed, especially in widespread cancers, such as ovarian cancer, lung cancer and melanoma. In total, hundreds of thousands of people worldwide and thousands of people in Finland die from these cancers every year.

According to cancer researcher Akseli Hemming, the development of an oncolytic virus has now reached human studies because of persistence. – You can continue to progress until you wake up after various setbacks. Resilience is required. Mico Huisco

From flu virus to cancer killer

The Hemming-led company’s virus-based cancer drug is now being developed for metastatic cancers. A drug on the market has a long way to go, but the results are promising.

This technology is based on oncolytic adenovirus. Adenoviruses are common causes of the common cold.

Cancer treatment is because the virus is modified so that it does not infect other cells, but only destroys cancer cells.

Hemminky says seven different modifications have been made to the TILT-123 virus. With their help, an attempt was made to make it more selective and improve the immune response against the tumor. The surface of the virus has also been modified so that it can be administered intravenously and find its way to cancerous tumors.

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All this is based on decades of research.

Hemmingke has been conducting cancer research since 1993. Already between 2007 and 2012, he treated 290 patients with ten different oncolytic adenoviruses. These treatment findings are also the basis of a new study.

– For one reason or another, oncolytic adenovirus works particularly well on three types of cancer: ovarian cancer, lung cancer and melanoma. An important factor in the choice is that current treatments for ovarian cancer and lung cancer are poor at the stage of spread.

Why oncolytic adenoviruses are effective in these three types of cancer is still a mystery.

– Our guess is that, for example, in ovarian cancer, it is easier for T cells to influence the tumor because it grows along the wall and the abdominal cavity is a large immune organ. However, we still have a lot to learn about what the root cause is, how treatment works at the tissue level, and what the patient-specific differences are.

Akseli Hemmingki, professor of oncology, explains how a modified flu virus destroys cancer cells. Mico Huisco

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From bacteria to viruses

Historically, the idea that microbes can destroy cancer cells is thousands of years old, says Hemmingi.

– For example, there are novel discoveries that treat a cancer tumor by making a small incision and then applying a bandage over it. Microorganisms may have entered the tumor from the dirt from the incision site, and the tumor may have reddened, swollen, and then gone.

Later, doctors documented cases of patients with microbial infections associated with the disappearance of cancer.

Viruses began to be identified only in the 1960s.

– However, even a hundred years ago, there were attempts to infect cancer patients with fever. Influenza was used first, followed by hepatitis virus and West Nile virus. When already sick cancer patients were infected with these viruses, you can imagine how bad the effects were.

In the 90s, viruses became selective, i.e. selective for cancer cells (oncolytic), so they no longer damage normal cells. According to Hemming, this is precisely the nuance of oncolytic viruses.

– Through research we now know that an oncolytic virus can exist in large amounts in the body and can reach normal cells, but it does not damage them.

Increase the characters

Now the Hemming-led company has advanced to the stage of clinical trials, where the drug’s safety is being tested.

The drug has been administered to more than 70 cancer patients in countries like Finland, Denmark, France and the US. They all have cancer that cannot be cured in any other way.

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According to Hemming, the treatment has so far proven to be very safe, both alone and in combination with other types of immunotherapy, such as immune response modifiers and T-cell therapy.

Even at this stage, there are promising signs of efficacy: in some patients, the tumors have shrunk significantly or completely disappeared.

In 64 percent of ovarian cancer patients who participated, the disease stopped progressing or the colonies began to shrink.

– No treatment or dose limiting side effects. The most common side effects are flu-like symptoms: fever, chills and fatigue, Hemmingke says.

According to Hemming, the results give us hope that the research can continue into a second phase. A recently raised 12 million fund from a network of private investors will also help it.

In the study, some patients’ tumors shrank significantly or disappeared completely. Mico Huisco

In the next step, the effectiveness of the drug in the treatment of ovarian cancer will be better studied. There are more patients, they are healthy, their immune system is in good condition and the size of the cancerous tumors is small.

– The results are expected to be even better than the results of the first phase, Hemmingke believes.

If all goes according to plan, the drug could be licensed within 3-4 years, says Hemmingi.

His company focuses on the first two phases of research. Marketing approval requires a phase III study, which already includes hundreds of patients. They are manufactured by big pharmaceutical companies. Because there is more clinical experience with the drug, healthy patients can be included in the studies.

– The earlier the cancer can be effectively treated, the better the results, says Hemmingki.

The long-term goal is to bring the drug to market and obtain marketing approval in collaboration with the partner.

– If everything goes as expected, sales of the drug will begin in 2032, says Hemminky.

In the next phase of research, the effectiveness of oncolytic adenovirus will be investigated in more detail. Mico Huisco

How will cancer be treated in 10 years?

If promising results are still available, what does Hemminky think cancer treatment will look like in ten years?

– Fighting cancer is very difficult, which is why current drugs are definitely still needed.

According to him, the treatment of metastatic cancer depends on cytostats. They can shrink tumors, some even for longer periods of time.

– In widespread cancer, unfortunately, they are usually not curable.

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Hemmingke believes that cytostats can remain secondary as new drugs such as targeted drugs and immunotherapy become available.

According to Hemming, immunotherapy has been shown to work in many cancers and seems to have a long-term effect.

– Many current immunotherapies have the limitation of hiding tumors from the immune system. However, the drug we developed can expose them to the immune system and attract protective cells to the site.

Another advantage of immunotherapy drugs is that they are generally much better tolerated than cytostatic treatments, which are fraught with side effects.

– Some patients say that Cytostat treatment is worse than the disease. That’s why it will be a great moment when we get rid of them.

Sometimes one type of cancer can be cured at a time. However, much more remains to be done.

– It is my dream and my life’s work to participate in the development of a drug that can completely cure someone with metastatic cancer.

In addition to drug development work, Akseli Hemmingke still treats cancer patients as an expert in oncology and radiation therapy. – I want those skills to be maintained. Mico Huisco

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“Everyone should have rights”

Funding for cancer research has been steadily decreasing for over ten years, as state research money and funding from the Academy of Finland have been decreasing year by year.

This is also reflected in the decrease in the number of clinical drug trials.

– Private foundations have kept the wheels turning, says an oncology professor and founder of drug development firm TILD Biotherapeutics. Akseli Hemmingi.

In the early 2000s, according to Hemming, Finland was one of the best countries in the world in conducting cancer research.

– Now academic researcher-based medical drug research has completely disappeared. Immunology research is very expensive, and researchers cannot afford it due to lack of funding. Today, drug development is a corporate activity.

Accepting this, Hemmingke also founded his first company.

Clinical drug trials are needed because they play an important role in the development of new cancer treatments and at the same time can help the individual patient.

– Hemmingki says that everyone with cancer that cannot be cured by current treatments should consider participating in at least one trial of a new treatment.

There are two ways to get an experimental treatment: one is an individual treatment trial and the other is participation in a clinical study.

– In an individualized treatment trial, the patient sometimes has to pay the costs themselves, while in a clinical drug trial the patient pays nothing.

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