Project Epine: testing receptivity to immunotherapy
Research Fellow atInserm, Julien Faget heads the Epine project, which aims to develop predictive tests capable of determining whether lung cancer patients will respond to immunotherapy treatment. This is a promising avenue of research and a considerable time saver in terms of setting up protocols, as this treatment is only effective in 30% of cases.
Currently in the launch phase of the University Innovation Cluster (PUI), the Epine project could give a significant boost to research into immunotherapies. Led by Julien Faget, a research fellow at the Regional Cancer Institute in Montpellier (IRCM), this project has just won the support of the Montpellier Innovation Booster (BIM) jury, one of the PUI's flagship tools designed to promote scientific discoveries and forge links between researchers and the business world.
A blind spot
The story of this project begins at the end of a scientific dead end. Every year in France, around 40,000 people are diagnosed with lung cancer. Since 2011, immunotherapy has shown promise for patients who cannot be treated with chemotherapy. The principle behind it is to remove the brakes on the immune system so that it attacks diseased cells. "The immune system is like a big monster that spends its time getting angry but is kept on a leash. The idea is to cut that leash to make it more aggressive. The diseased cells will then be the first to be killed. With immunotherapy, we use the patient's own resources to fight cancer, " explains Julien Faget.
While this treatment can work wonders, only a third of patients respond to it. "When it works, it cures them even though they only had six months to live... But today, oncologists have no way of knowing in advance whether it will work or not." And it is precisely this blind spot that Julien Faget is in the process of eliminating. Both so that oncologists can adapt treatments as early as possible, and so that future drug candidates can eventually be tested on patients who are already known to be receptive to them...
First in the world
Julien Faget has already helped to unravel part of the problem in the past. During research conducted in the late 2010s, he realized that the presence of "neutrophil" cells in the lungs plays a major role in the effectiveness of treatment. "When there is damage to the patient's bones, neutrophils move to the lungs and enter the tumor. They are what prevent the treatment from working,"he explains. The second part of the problem is therefore to find an ingenious way to examine these white blood cells in a hospital setting without delay.
In his laboratory at the IRCM (Inserm), Julien Faget and his two colleagues applied their strategy to around 60 test patients. The team started with 850,000 parameters to test. After several years of research, the spectrum has been narrowed down to just six, and current trials show an efficacy rate of over 90%. "We will continue to work to improve, " says Julien Faget. " We are not the only ones working on neutrophils, but we are the first in the world to have a testing capability that can be transposed into clinical practice on the day of diagnosis."
Make a tangible contribution to society
Thanks to BIM and the €20,000 grant they have been awarded, Epine is currently recruiting a new engineer who will be responsible for conducting new tests and validating their results. This new stage gives them access to a cohort of 150 patients from the Montpellier Regional Cancer Institute and 45 patients from the University Hospital. At the same time, this initiative also allows Julien Faget to work on creating a start-up in collaboration with an industrial partner. "Economic players and BIM are convinced that we have an idea that can bring something concrete to society in a short time. But it's a different profession, and we need help to do it properly while continuing our research work." In the process of being patented via Inserm Transfert, the innovative test developed by the Epine project could be operational within three years.
He is currently also involved in the development of a new drug candidate. This collaboration is still in its infancy, but should ultimately boost the emergence of new treatments. "The immunotherapy market in 2026 will be worth €64 billion per year worldwide. In France, it will be worth €4 billion, but only €1.5 billion will benefit patients. The other €3 billion will expose them to side effects and deprive them of an effective strategy," he argues .
Julien Faget, former BIM winner, will speak at the "Booster innovation Montpellier" webinar webinar on December 10, 2024, to share his experience and exchange ideas with participants.