Patients were injected with a drug that was a weakened form of the herpes virus – herpes simplex – that has been modified to kill tumors. Although more research is needed, it could be a lifesaver for those living with advanced cancer. Krzysztof Wojkowski, 39, a builder from West London, went from end-of-life care to cancer-free after taking part in the trial. Mr Wojkowski was diagnosed with mucoepidermoid carcinoma, a type of salivary gland cancer, in May 2017. Despite multiple surgeries, he was told there were no treatment options left before he was given the chance to take part in the RP2 trial at The Royal Marsden in 2020. He said: “I was told there were no options for me and I was receiving end-of-life care, it was devastating, so it was incredible to be given the opportunity to take part in the trial at the Royal Marsden, it was my last lifeline. . “I had injections every two weeks for five weeks which completely eradicated my cancer. I have been cancer free for two years, it is a real miracle, there is no other word to describe it. “I could go back to work as a builder and spend time with my family, there’s nothing I can do.” The genetically modified virus, which is injected directly into tumors, is designed to have a dual effect – it replicates inside cancer cells to break them up from the inside and also blocks a protein known as CTLA-4, releasing the brakes on the immune system and increasing its ability to kill cancer cells. Image: Image: Salivary gland carcinoma. Credit: Nephron, CC BY-SA 4.0, via Wikimedia Commons Rare to see such promise in early testing Three out of nine patients treated with RP2 saw their tumors shrink. Seven of the 30 patients who received both RP2 and nivolumab immunotherapy also benefited from the treatment. In this group, four out of nine melanoma patients with skin cancer, two out of eight patients with uveal melanoma eye cancer and one out of three patients with head and neck cancer saw the growth of their cancer stop or shrink. Of the seven patients who received the combination and saw benefit, six remained progression-free at 14 months. It is rare to see such a good response rate in early-stage clinical trials, according to study leader Professor Kevin Harrington, professor of biological cancer therapies at The Institute of Cancer Research, London and consultant oncologist at The Royal Marsden NHS Foundation Trust. . He said: “Our study shows that a genetically engineered cancer-killing virus can deliver a one-two punch against tumors – directly destroying cancer cells from the inside while simultaneously calling on the immune system to attack them. “It is rare to see such good response rates in early-stage clinical trials, as their primary goal is to test the safety of the treatment and they involve patients with very advanced cancers for whom current treatments have stopped working. “The initial findings of our trial suggest that a genetically modified form of the herpes virus could potentially become a new treatment option for some patients with advanced cancer – including those who have not responded to other forms of immunotherapy. “I’m eager to see if we continue to see benefits as we treat increased numbers of patients.” Exploiting the characteristics of viruses Professor Kristian Helin, Chief Executive of the Institute of Cancer Research London, said it is possible to exploit some of the characteristics of viruses. They said: “Viruses are one of humanity’s oldest enemies, as we have all seen during the pandemic. But our new research shows that we can exploit some of the features that make them difficult opponents to infect and kill cancer cells. “It’s a small study, but the initial findings are promising. I’m very hopeful that as this research expands, we’ll see patients continue to benefit.”
