More than 18 rounds of chemotherapy and three abdominal surgeries have failed to slow the tumor that doctors discovered after Tamara Strauss felt a suspicious lump in 2015.
Strauss was the first of 10 clinical trial patients to receive a personalized vaccine with the potential to do in just a few months what conventional treatments have failed to accomplish in three grueling years.
Unlike the scorched earth approach of chemo, cancer vaccines are exquisitely refined, containing immune system-activating molecules custom-made for each patient based on the specific genetic mutations present in their cancer cells.
Accepting patients with solid tumors of all types, the trial represents a significant new hope for the 59-year-old jewelry artist whose advanced cancer is rare and difficult to treat. But doctors hope to see progress, either halting the tumor's growth or reducing its size, in three to six months.
The effort is a collaboration of UC San Diego Moores Cancer Center and the La Jolla Institute of Allergy and Immunology and employs a basic approach just starting to show promise in small trials at other top-flight cancer centers worldwide.
But the local effort has its own special tweak that the San Diego researchers involved think will deliver greater precision in targeting the unique features of each patient's cancer cells.
The approach builds on basic research from the labs of immunologists Stephen Schoenberger and Bjoern Peters at the allergy institute and was brought to the bedside under collaboration with Dr. Ezra Cohen, director of translational science at Moores.
"The current method that everybody's using, it's highly-educated guessing but guessing all the same," Schoenberger said. "Our process does take longer on the front end, but that's because we're taking the time to verify, rather than guess. We think it's going to make a big difference in our ability to be exactly on target."
Before slowly pressing the plunger forward, sending the first custom-crafted dose into Strauss's upper arm on Oct. 4, Cohen made it clear that the four years of collaboration necessary to arrive at that gives him confidence that the trial has a significant chance of success.
"I think this is a moment where history is happening, and we know it's happening," Cohen said.
The trial is made possible through a $1 million donation from well-known philanthropists and art collectors Matthew and Iris Strauss, who are Tamara Strauss's parents.
It is among a growing number of trials nationwide that capitalize on recent advances in genetic sequencing, bioinformatic analysis and manufacturing to craft vaccines loaded with molecules made to activate each patient's immune system against their tumor's specific genetic fingerprint.
Outside experts seem to agree that the approach moving forward at Moores in La Jolla is novel.
Microbiologist Fred Ramsdell, vice president of research at the Parker Institute for Cancer Immunology, a collaboration of high-flying cancer programs such as Harvard's Memorial Sloan Kettering Cancer Center, Stanford University, UCLA and MD Anderson Cancer Center, said the screening idea that the team in San Diego is putting into practice takes the cancer vaccine target selection process to a deeper level.
"One of the big things that Ezra and Stephen are doing is taking an approach where they actually look for T-cell responses in the lab before making a vaccine," Ramsdell said. "Most everybody else makes their vaccines based on computational prediction alone."
