Rebecca Arend M.D. (left), and Ben Buelow M.D. (right) are testing a treatment designed to redirect a patient’s own immune system to attack cancer cells, potentially opening a new chapter in ovarian cancer treatment. Up to 70 percent of women with high-grade ovarian cancer see their cancer return after surgery and platinum-based chemotherapy. A new clinical trial at the University of Alabama at Birmingham is testing an investigational treatment that could eventually offer a new way to fight the disease.
The BiTE trial, which stands for the Bispecific T-cell engager, is led by Rebecca Arend, M.D., associate professor in the Department of Obstetrics and Gynecology and O’Neal Cancer Center, and Ben Buelow, M.D., Ph.D., the CEO of 92Bio Inc. This trial is testing an investigational drug called NTB-928. The treatment is designed to redirect a patient’s own immune system to attack cancer cells, potentially opening a new chapter in ovarian cancer treatment.
The problem with platinum resistance
When the disease stops responding to platinum drugs altogether, patients enter a category called platinum-resistant ovarian cancer, or PROC, where there is currently no standard therapy.
Many new PROC drugs work by attaching chemotherapy to an antibody, which then homes in on the tumor and delivers the chemotherapy directly to cancer cells. Many target a protein called folate receptor alpha, or FRα, which is found in high amounts on PROC cells.
“Because PROC is often resistant to chemotherapy and exhibits a more aggressive disease biology, clinical responses to antibody-drug conjugates have generally been shorter and less complete than initially anticipated,” Arend said.
A new chapter in ovarian cancer treatment
Instead of delivering chemotherapy to the cancer cells, the BiTE trial is testing NTB-928, a T-cell engager, or TCE, designed to redirect a patient’s own immune system to attack the tumor. TCEs have already produced long-lasting responses in some blood cancers, but they are only beginning to be tested in ovarian cancer. The treatment is designed to help the immune system recognize and attack cancer cells while limiting its impact on healthy cells.
The hope ahead
When mobilized effectively, the immune system is a remarkably powerful weapon against cancer. For decades, front-line ovarian cancer treatment has not significantly changed patient survival outcomes. Arend and Buelow hope that agents such as NTB-928 can open a brand-new chapter for ovarian cancer and allow patients to preserve their quality of life, not just extend it.
“It’s early, and this trial exists precisely to find out whether that hope is warranted,” Arend and Buelow said. “But even asking the question with a genuinely new approach is progress for a disease that has waited a long time for one.”
The BiTE trial represents years of research, careful science and a team willing to ask hard questions in pursuit of real answers. UAB’s collaborative research environment and Arend, Buelow and their teams have helped make the study possible, bringing together the researchers, clinicians and patients needed to test this new approach.