Despite mixed outcomes, the Vance study marks significant progress in precision treatment for solid tumours.
The conclusion of the Vance study, the largest immunotherapy trial targeting solid tumours like nasopharyngeal cancer (NPC), has set a precedent for advanced cancer care. Conducted across five countries, the trial showcased Singapore’s leadership in groundbreaking T-cell therapy.
Transformative Goals and Findings
Led by Singapore clinician-scientist Professor Toh Han Chong of the National Cancer Centre Singapore (NCCS), the study aimed to improve survival rates for NPC patients using EBV-specific T-cell therapy alongside chemotherapy. While the trial did not achieve its primary goal of demonstrating an overall survival benefit, subgroup analyses revealed that patients in Singapore, Taiwan, and the U.S. responded better to the combined therapy than chemotherapy alone.
The Fight Against NPC
Nasopharyngeal cancer, common among men in Singapore and Southern China, is closely linked to the Epstein-Barr virus (EBV). Traditional treatments like radiotherapy and chemotherapy are effective for early stages but offer limited options when the disease spreads.
Recognizing EBV as a target for immunotherapy, the Vance study treated 330 patients with precision-targeted T-cells—over one billion per patient—engineered from their blood. These “re-educated” cells were trained to recognize and attack cancer proteins without severe side effects.
A Technical and Logistical Feat
The trial required sophisticated coordination to manufacture, store, and deliver high-quality T-cells worldwide. Assistant Professor Jens Samol of Tan Tock Seng Hospital likened the process to training soldiers, with T-cells undergoing preparation to become highly effective against cancerous cells.
“This was a monumental achievement that highlights Singapore’s capacity to execute complex cell therapy on a global scale,” said Prof Toh.
Future Directions in Immunotherapy
Insights from the Vance study are now driving the exploration of biomarkers to refine patient selection and enhance outcomes. The trial demonstrated the potential of polyclonal, multi-targeting T-cells to significantly extend survival for certain groups.
“This research underscores the power of collaboration across disciplines and institutions, laying the foundation for more targeted cancer therapies,” Prof Toh emphasized.
A Promising Path Ahead
Efforts to build on the study’s findings include new trials and advanced biomarker studies. The commitment to improving immunotherapy for NPC and other cancers continues, positioning Singapore at the forefront of precision medicine.
