After opening its new tumor bank, Biotherapy International remains committed to informing patients about the importance of cryopreserving tumor tissue, preferably upon the initial diagnosis. Access to a well-preserved tumor sample can open new therapeutic avenues in the future based on experimental treatment with anti-cancer vaccines, should they become necessary.
Tumor tissue cryopreservation refers to the practice of deep-freezing samples of tumor tissue. These are stored at special ultra-cold refrigerators at a temperature of -80°C or in liquid nitrogen at -196°C.
Cryopreserved tumor samples contain all the elements that can serve as targets for a patient’s immune system, including DNA and RNA information that identifies them. However, some of these elements are very fragile, and unless properly cryopreserved, they often degrade, break down, and become unusable.
Cryopreserved tumor tissue provides researchers with complete access to all patient’s own tumor’s components, including genetic information about recognizable mutations. In this way, this can then be used to guide the oncologist to customized treatments against a patient’s unique cancer.
Anti-cancer vaccines are a form of immunotherapy: they are intended to activate a patient’s adaptive immune responses to fight otherwise non-immunogenic cancer cells.
The purpose of anti-cancer vaccines is to teach a patient’s immune system to recognise cancer cells as different from normal cells, in order to induce an immune response against slightly modified cancer antigens. Once a response is induced against modified cancer antigens, a systemic immune response will also target remote cancer cells. In other words, the purpose of using anti-cancer vaccines is to break the unresponsiveness or tolerance that exists between a patient’s immune system and cancer, which enables unperturbed cancer proliferation and propagation.
When a patient’s immune system recognizes that cancer cells are different from normal cells belonging to the same tissue, circulating lymphocytes will fight and block replication or eliminate such cancer cells around the body, just as if they were infectious organisms.
In order to maximize the chance that the vaccine-activated immune response will induce anti-cancer effects, anti-cancer vaccines can be administered in parallel with other medications such as checkpoint inhibitors or cytokines such as interferons and interleukin 2 (IL-2).
Since no two tumors are exactly the same, the unique feature of anti-cancer vaccines prepared from a patient’s own malignant cells is their capacity to induce fully personalized responses targeted against the patient’s cancer cells. Accordingly, the anti-cancer vaccine should be made from a patient’s modified cancer cells or from lysates of the same cancer cells, containing all the components that exist and can be expressed by a patient’s cancer cells.
This is why we recommend keeping a portion of every cancer tissue removed by surgery or biopsy during the initial diagnostic or therapeutic procedure. These cells should be cryopreserved in liquid nitrogen (-196°C or at -80°C), and kept readily available for the preparation of personalized anti-cancer vaccines if such treatment becomes inicated. Alternatively, tumor cells can be also isolated from a malignant fluid (pleural effusion or ascites). Circulating tumor cells (CTC) or circulating tumor DNA and RNA (ctDNA) can also be isolated from the blood of patients with heavy tumor load.
Once tumor tissue, CTC or ctDNA are available, we have methods available to turn non-immunogenic cancer antigens into immunogenic cancer cells or cancer antigens. As such, a patient’s immune system, which ignored cancer cells to start with, may be forced to react against cancer elements now expressing foreign stimulating antigens. Furthermore, the reaction against cancer cells previously recognized as “self” can be recognised as “modified or altered self” by successful anti-cancer vaccines, thus resulting in an induced immune response against previously ignored cancer cells. As indicated above, the overall activity of the immune response against cancer can be further amplified by available drugs that can activate patients’ immune system.
Although the connection between immunity and cancer has been known for decades, many of its details were not fully understood until recently. Initially, anti-cancer vaccines were based on loading cancer antigens, peptides or extracts on antigen-presenting cells known as dendritic cells. These were injected in order to stimulate the patient’s immune system to react against antigens processed by dendritic cells. Unfortunately, these early attempts did not yield efficient therapeutic effects.
Instead, Biotherapy International advocates for the activation of a patient’s “autoimmune-like” attack selectively against cancer antigens with modified antigenicity. As such, our vaccines can train a patient’s immune system to respond to unique mutations expressed within a patient’s own tumor cells. Obviously, this procedure depends on whether cryopreserved tumor cells or any other tumor-derived components are available.
Non-immunogenic cancer cells, cancer cell lysates, ctDNA, cancer derived extracellular vesicles (EV) or exosomes can be modified at Biotherapy International using one of three methods:
Treatment with anti-cancer vaccines is user-friendly and safe. Injection of anti-cancer vaccines can be best accomplished by intradermal or subcutaneous injections, preferably near the axillary or inguinal draining lymph nodes.
Antigen-presenting cancer cells, the dendritic cells that process the cancer antigens and present them to lymphocytes located in the lymph nodes (T cells) are activated in parallel by subcutaneous injection of commercially available Leukine (GM-CSF). It is always advisable to administer repeated boosters of anti-cancer vaccines every 2 weeks and the number of vaccinations that can be prepared depends on the amount of cancer tissue available.
Cryopreserving a tumor sample at ultra-cold temperature ensures it stays as close as “fresh” as possible. This keeps all the information stored in the tumor’s DNA intact.
If standard anti-cancer treatments (such as chemotherapy or radiotherapy) fail, the cryopreserved tumor sample can help us prepare a customized anti-cancer vaccine. This will teach your immune system to recognize the DNA in your tumor as “non-self” and aggressively fight it as it would fight an infection
If the tumour is not in an easily accessible location, or if it was already removed, it is also possible to use blood-derived cancer components. Blood samples often contain circulating tumour cells, excretory extracellular vesicles or exosomes. These can all be used as a source of cancer antigens, and then be used to manufacture an anti-cancer vaccine.
Ideally, blood samples will need to be harvested and cryopreserved before initiating any conventional oncological treatment (like chemotherapy). This will increase the chances of finding cancer antigens amidst the blood tissue.
It is impossible to know from the start whether cancer will become recurrent or if it will metastasize. Most cancers respond well to conventional treatments. When they don’t, additional rounds of chemotherapy or radiotherapy are mainly ineffective in eliminating cancer to the last cell.
When a patient is first diagnosed with cancer, we all expect advanced treatments like immunotherapy won’t be necessary. If they do, having a tumor sample stored in a tumor bank can make a massive difference in the range of treatments available.
Contact us using the form below. One of our team members will contact you and schedule a video call with you and your attending physician. During this call, we will explain the necessary procedure to reserve a tumor sample during a biopsy, store it, and send it to our tumor bank.
It is important to begin the process before the initial biopsy or cancer-removal surgery. The surgeon needs to be notified ahead of time in order to preserve as much of the original tumor tissue as he can.
The tumor sample can be stored in 2-ml or 5-ml sterile tubes, made from a material that can withstand cryopreservation. If this is not available, the surgeon can also use a 50-ml tube with a small amount of saline solution.
Then, the tumor needs to be transported to Tel Aviv via our courier. During the journey, it should be kept on cold ice at ultra cold temperatures (either a deep-freeze refrigerator at -80°C, or a liquid nitrogen refrigerator at -196°C).