Stories: Voices from the frontline
Charles Cobbs, M.D.
It’s vaccine season at Swedish. While our caregivers are busy inoculating the public against COVID-19, our team at The Ben & Catherine Ivy Center for Advanced Brain Tumor Treatment is preparing to study an experimental vaccine for patients with glioblastoma. This vital research continued despite the pandemic thanks to your support of the Seattle Brain Cancer Walk.
We caught up with Charles Cobbs, M.D., the Gregory Foltz, M.D., Endowed Director of The Ivy Center, to find out more about how it could upend the way we treat this aggressive form of cancer, and how your support makes innovative treatments possible.
What can you tell us about this new vaccine?
We are working with a colleague in Australia who has developed a panel of T-cells, or immune cells that can be made into a vaccine. The T-cells attack cytomegalovirus, or CMV, the virus found in many cases of glioblastoma, a very aggressive brain cancer. His preliminary evidence suggests that the vaccine can help patients fight their cancer. That’s why we’d like to bring the next phase of the trial to the Northwest with a trial at Swedish within the next year or two.
Since vaccines are on our mind right now, can you explain how this vaccine for glioblastoma might work as compared to COVID-19 vaccines?
The current Pfizer and Moderna COVID-19 vaccines use mRNA to teach your immune system, including T-cells, to go after the coronavirus. The problem is that patients with glioblastoma often have inherently poor immune function as a result of their tumor compared to healthy people. So their own T-cells are not able to work against CMV, even with good instructions.
This new vaccine for glioblastoma contains T-cells from donors that are distilled into a series of injections. When a patient comes along with a glioblastoma, we can match the T-cells in the vaccine to their immune system.
How is the glioblastoma vaccine made?
Most people who get CMV recover fully, and their immune system is primed to fight another infection. It’s only a small percentage who go on to develop brain cancer, but healthy donors can provide a trained team of T-cells in a process similar to donating blood.
In a petri dish, the donor T-cells are mixed with additional CMV proteins as well as cytokines, which are drugs that make the T-cells react and get better at fighting the virus. The resulting T-cells are supercharged and able to work in place of the patient’s non-functioning immune system to attack infected tumor cells.
How have patients responded to similar glioblastoma vaccine trials at other institutions?
We have some preliminary evidence that patients with recurrent glioblastoma live longer with the vaccine. And it seems to be that their survival is related to the amount of T-cells and how well they are functioning. Further trials at Swedish will help us better understand how to make the best possible vaccine, while offering patients a treatment that could extend their life.
Could a vaccine be a cure for glioblastoma?
I’ve seen patients with glioblastoma who had a huge immune response against CMV which resulted in their tumor literally disappearing. It's a rare thing, but I think that it’s got the potential to help other patients. The problem is that these tumors suppress the immune system so that the patient’s own T-cells don’t function. That’s why we think a vaccine that replenishes the supply of healthy T-cells can help patients fight their cancer.
Has this changed your plan to develop your own vaccine for glioblastoma?
No, we are going to continue our research to develop a vaccine tailored to work against the exact strain or strains of CMV that accelerate glioblastoma growth. But since there is clinical evidence from other centers like Duke University that the T-cell vaccine works, I think we're going to continue developing our vaccine in parallel with trials of the existing vaccine. That way, patients will have access to these kinds of treatments sooner, while we work on fine-tuning our own vaccine.
How has the COVID-19 pandemic affected research at The Ivy Center?
Last spring, our research had to slow down to comply with public health regulations. It was frustrating, but our researchers found ways to keep working on projects from home. Within a few months, we were all back in the lab with safety precautions in place.
COVID is a horrific, world-wide problem that has unfortunately affected all kinds of research. I hope that one year from now we will have vaccinated a majority of the United States and the world's population and put the pandemic behind us. But brain cancer will still be affecting families in our community and around the world. It's a disease that seems to hit young, healthy people in the prime of their lives. So it's something we still need to go after full force. And with the community’s support, my colleagues and I can keep doing just that.
Innovative research at The Ivy Center is made possible thanks to support from donors like you. To learn more about brain cancer research at Swedish or schedule a tour of The Ivy Center, contact Mallory Higgins at 206-386-6108 or [email protected].