Epine Project: Testing Responsiveness to Immunotherapy
Research Fellow at theInserm, Julien Faget leads the Epine project, which aims to develop predictive tests capable of determining whether lung cancer patients will respond to immunotherapy. This is a promising avenue of research and could save considerable time in implementing treatment protocols, as this therapy is effective in only 30% of cases.
Currently in the launch phase of the University Innovation Hub (PUI), the Epine project could give a major boost to research on immunotherapies. Led by Julien Faget, a research fellow at the Regional Cancer Institute in Montpellier (IRCM), this project has just won the approval of the jury for the Montpellier Innovation Booster (BIM), one of the PUI’s flagship initiatives designed to promote scientific discoveries and build bridges between researchers and the business world.
A blind spot
The story of this project begins at the edge of a scientific impasse. Every year in France, approximately 40,000 people are diagnosed with lung cancer. Since 2011, immunotherapy has shown promise for patients whom chemotherapy cannot cure. The principle behind it is to remove the brakes on the immune system so that it can attack the 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 one-third of patients respond to it. “When it works, it cures them even though they had only 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 addressing—both so that oncologists can tailor treatments as early as possible, and so that future drug candidates can, eventually, be tested on patients who are already known to be responsive to them…
Number One in the World
In the past, Julien Faget has already helped unravel part of the problem. Through research conducted in the late 2010s, he came to understand that the presence of “neutrophils” in the lungs plays a major role in the treatment’s effectiveness.“When there is bone damage in patients, neutrophils migrate to the lungs and enter the tumor. They are what prevent the treatment from working,”he explains. The second challenge, therefore, is 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 about 60 test patients. The team started with 850,000 parameters to test. After several years of research, the field has narrowed down to just six, and current trials show an efficacy rate of over 90%. “We’re going to keep working to improve,” says Julien Faget. “We’re not the only ones working on neutrophils, but we’re the first in the world to have a testing capability that can be applied clinically on the day of diagnosis.”
Make a tangible contribution to society
Thanks to BIM and the 20,000-euro grant they received, Epine is currently recruiting a new engineer who will be responsible for conducting new tests and validating their results. This new phase 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 launching a startup in collaboration with an industry partner. “Business leaders and the BIM are convinced that we have an idea that can deliver tangible benefits to society in a short amount of time. But this is a different line of work, and we need help to do it properly while continuing our research.” Currently in the process of being patented through Inserm Transfert, the Epine project’s innovative test 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 early stages, but it is expected to ultimately spur the emergence of new treatments. “The immunotherapy market in 2026 will amount to 64 billion euros spent annually worldwide. In France, that figure is 4 billion euros, but only 1.5 billion of that actually benefits patients. The remaining 3 billion exposes them to side effects and deprives them of an effective treatment strategy,” he argues .
Julien Faget, a former BIM award winner, will speak at the "Booster Innovation Montpellier" webinar on December 10, 2024, to share his experience and engage with participants.