A drug to treat metastatic kidney cancer, still incurable? This idea sprang up in 2008 « on the edge of the lab bench » from Dr Gilles Pagès, now director of research at the National Institute for Health and Medical Research (Inserm) first class and team leader within from the Cancer and Aging Institute (Ircan) in Nice. And it is to go to the end of this project that he will receive, this Friday, the price of the Amgen France fund for Science and the Human, selected from 90 applications. Dr Pagès returns with 20 minutes on the considerable advances he has made with his team, doctors and chemists, on the optimization of the treatment of kidney cancer, and even others.
What treatments exist today for metastatic kidney cancer?
Before 2008, the life expectancy of a patient was three months. Little by little, we managed to reach an average of three years. We gained years and quality of life. First, through a drug that targeted the component VEGF, which makes blood vessels. It was first imagined for colon cancer, then lung cancer, breast cancer and finally, for kidney cancer. It was a revolutionary treatment because it made it possible to lengthen life expectancy. But doctors realized that it was not effective for all patients, sometimes it even caused the opposite effect. Then there was immunotherapy, which also delayed death, but only in 20% of patients. In reality, there are as many tumors as there are patients.
Why is kidney cancer so difficult to cure?
You should know that kidney cancer is the cancer where the most drugs have been developed in recent years. In fifteen years, there has been almost one approved treatment per year for this disease. It is a very active field because the disease is associated with particular mutations. For example, the VEGF protein, uses hypoxia to grow. It then makes blood vessels to supply the cancerous tumor with nutrients and oxygen.
After fifteen researches on the subject, where are you?
After all these years of research, patent filings, strong collaborations, in particular with the Nice Institute of Chemistry, we have developed a molecule in order to create a new drug. This molecule is redundant with that which targets the VEGF protein and inhibits tumor growth. It is also effective for tumor models unresponsive to immunotherapy [qui vise à induire ou amplifier la réponse immunitaire anticancéreuse]. Our treatment, combined with those that already exist, will hopefully make this disease curable. But just being able to make it a chronic disease and allow patients to live is a source of immense pride.
Can this molecule be used for other cancers?
By being part of the Lacassagne center, which is a reference in Europe for the treatment of certain cancers, we have actually discovered that our molecule could be effective for other diseases. Especially on uveal melanoma, which develops in the eye and is very aggressive. The 30% of patients who escape radiation treatment could live on the drug we created. It is also possible for cancers of the ENT sphere.
When can this medicine be used?
To make the process go faster, we decided to create our own start-up, Roca Therapeutics, in April 2021, which has collected all the possible awards and funding from the academy and which is even an i-Lab winner. . We are currently in the regulatory toxicology phases, which will be finalized by the end of 2022, or even the beginning of 2023. Then, we must submit the treatment to the health authorities of the European Medicines Agency, with a first clinical trial in 2023 Depending on its validation, without toxicity in a patient, we move on to phase 2 with more patients then phase 3 and the blind trial. In short, it’s tomorrow! (laughs)
What will the Amgen France fund bring you?
It is already the recognition of our peers because there were doctors and researchers in the jury. It is very important to see that our work has been recognized by these professionals. But it is also essential to be recognized by the pharmaceutical industry, without which it is impossible to carry out clinical trials. From a financial point of view, it was crucial because it is difficult to obtain research funding today. We must knock on all doors to prevent all these years of work for this program from stopping now.
How did your program stand out?
If we won this prize, among more than 90 applications, it is also thanks to our originality in offering personalized treatment according to the patient. We are entering a new era of molecular diagnostics. And then, we tested and compared our molecules with developed compounds that had already been released, notably at GSK. We were able to patent because ours were better. It is the result of an adventure sometimes punctuated by failures, but by partnerships between researchers, doctors and chemists. And this virtuous circle will perhaps make it possible to bring our building block to the treatment of kidney cancer. Once again, it is a very great pride.