Future Metastatic Prevention
RhoVac® is a pharmaceutical company dedicated to immuno-oncology, signifying that the body’s own immune system is stimulated to identify and destroy cancer cells. The primary focus of RhoVac® is to develop a cancer therapy that targets metastatic cells to prevent cancer recurrence and progression after primary tumour therapy.
RhoVac® was founded as a private company in Denmark 2007. In the following years the first steps in terms of development of the drug candidate, RV001, were taken. In 2015 the Swedish RhoVac AB, now headquarters, was founded, and in 2016 the company was listed at “Spotlight Stock Market”. RhoVac® has now passed the early stages of development. In 2018 a clinical phase I/II in prostate cancer was concluded demonstrating excellent safety and tolerability for the drug candidate RV001. In addition, the study indicated that treatment with RV001 caused the expected strong and long-lasting immune response (read the peer-reviewed paper here). It is this immune response that will be used against the metastatic cells. Therefore, in the fall of 2019, Rhovac started a major clinical phase IIb study which has included more than 180 patients with prostate cancer. The study results of which will be reported towards the end of the first half 2022, is designed to produce statistically significant results on RV001 efficacy in preventing disease progression in prostate cancer after surgery or radiation therapy to the primary tumour. In November 2020, RhoVac received a so-called “Fast Track Designation” for the development of RV001 in prostate cancer from the US Food and Drug Administration (FDA).
During the fall 2021, the World Health Organization WHO approved the scientific name (INN) – onilcamotide – for the active substance in the drug candidate RV001.
Targeting metastases to prevent cancer recurrence and progression
Cancer can occur when cells in the body suffer from mutations that inhibit their proliferation control. Cells multiply uninhibitedly and form a solid lump (a primary tumour). If the tumour is allowed to continue growing it can infiltrate and harm nearby tissue. Also, importantly, a particular type of cancer cells (metastatic potential cells) can migrate out of the primary tumour and spread widely to several regions of the body with the aid of blood circulation or through the lymphatic system. If they succeed in doing so, they can infiltrate tissue far away from the primary tumour and form multiple site secondary tumours, called metastases.
Actually, in very few cancers the primary tumour has the capacity to kill. Primary tumours can often be removed surgically or treated effectively with radiation. But, if the cancer spreads in the shape of metastatic cells infiltrating vital organs, it becomes more difficult to reach with targeted treatment, and therefore it also becomes more deadly.
However, it has been discovered that a protein called RhoC is over-expressed in all potential metastatic cells. It is actually this protein that lends to the metastatic cells their ability to migrate. In 2019 a review article (Thomas et al. Journal of Experimental & Clinical Cancer Research (2019) 38:328) was published that demonstrated the multifaceted role in the development of therapy resistant metastatic cancer:
The article calls out for therapy directed at RhoC and RhoVac® is the only company in the world to have advanced a RhoC targeted therapy into clinical phase. The company has developed a drug candidate, RV001, that triggers the body’s immune defence to attack and destroy cells that feature this over-expression of RhoC, and as this is a feature unique to metastatic type cells, these are the only cells destroyed. Of course, this means that one has to use other therapy for the primary tumour first, as RV001 targets only metastatic cells. But as stated above, the primary tumours can often be effectively dealt with through surgery or radiation therapy. It is after this primary tumour treatment that RV001 can be put to good use, targeting metastatic cells to prevent cancer recurrence and progression in its more lethal, metastatic, form. The thing is after all, that at the time when the primary tumour is treated, there is no way of knowing for sure if isolated metastatic cells have not already migrated out of the tumour, and as such pose a latent threat of cancer recurrence in its metastatic form.