CIMAvax-EGF is a therapeutic tumor vaccine. It carries recombinant human epidermal growth factor (EGF), which, when injected, induces the body to produce specific antibodies against EGF.
EGF binds to its receptor (epidermal growth factor receptor, EGFR), which promotes tumor angiogenesis, proliferation, and migration. The “resistance” to EGF can block these effects and achieve anti-tumor effects.
The vaccine, developed in Cuba, is the world’s first vaccine for lung cancer, and clinical trials are underway in Europe, the United States, Japan, and other developed countries.
Safe and effective treatment for post-chemotherapy stage IIIb/IV NSCLC
A phase III clinical study comparing the efficacy of CIMAvax-EGF with placebo in patients with stage IIIb/IV NSCLC who had stable disease after first-line chemotherapy showed that patients who received at least one dose of CIMAvax-EGF had a median survival of 10.83 months; this was prolonged compared to the control group (8.86 months); while those who received a standardized, patients who received at least four CIMAvax-EGF treatments had a median survival of 12.43 months, significantly longer than the control group of 9.43 months.
Further analysis found that the survival benefit correlated with the titer of anti-EGF antibodies in the serum after vaccine treatment, with patients who had significantly higher titers having a better outcome and a median survival of 14.90 months.
The most common adverse events in current clinical trials of the CIMAvax-EGF vaccine include mild to moderate headache, injection site pain, chills, chills, fever, nausea, and vomiting.
Another study found that CIMAvax-EGF was more effective in patients who received a low dose of cyclophosphamide, a chemotherapy drug, which may be related to cyclophosphamide relieving the body of tolerance to EGF and raising anti-EGF antibody titers.
Patients with high levels of EGF, squamous lung cancer, men, and smoking benefit more from CIMAvax-EGF
The analysis found that patients with high serum EGF concentrations had a longer median survival (14.66 months) after treatment with this vaccine. In addition, the study found more benefit in patients with squamous lung cancer, male patients, and patients who smoked.
May work better in combination with other lung cancer vaccines
After CIMAvax-EGF, another therapeutic lung cancer vaccine with a different target of action, Racotumomab, has been developed and is being used.
Preliminary studies have found that the combination of CIMAvax-EGF and Racotumomab is safe and reliable in patients with refractory advanced lung cancer who have received first-line chemotherapy, with adverse reactions being mainly localized at the vaccine injection site. In contrast, the vaccine combination produced higher titers of EGF antibodies in patients than previous studies with CIMAvax-EGF alone, and 50% of patients achieved partial remission after the vaccine combination, predicting that the vaccine combination may lead to better treatment outcomes.
More studies explore new directions for CIMAvax-EGF
CIMAvax-EGF has been available for many years in some South American countries, and the next directions to explore in lung cancer treatment are:
(1) Should CIMAvax-EGF therapy be continued in patients with advanced lung cancer that has progressed after first-line chemotherapy?
(2) Can CIMAvax-EGF be used directly in patients with advanced lung cancer who are not candidates for first-line chemotherapy?
(3) Does the combination of an immune checkpoint inhibitor with CIMAvax-EGF enhance the efficacy?
(4) Can CIMAvax-EGF be combined with Racotumomab in patients with lung cancer who are not candidates for first-line chemotherapy?
Summary
The CIMAvax-EGF vaccine is a novel tumor immunotherapy that brings benefits to patients without causing serious adverse effects. It has been available for many years in countries such as Cuba and Peru, and clinical trials are ongoing in other developed countries.