Erectile dysfunction drugs and flu vaccine may work together to help immune system fight cancer after surgery

May 17, 2018, The Ottawa Hospital
New research shows that erectile dysfunction drugs and flu vaccine may work together to help the immune system fight cancer after surgery. Credit: The Ottawa Hospital

A new study suggests that a common treatment for erectile dysfunction combined with the flu vaccine may be able to help the immune system mop up cancer cells left behind after surgery. The study, published in OncoImmunology, shows that this unconventional strategy can reduce the spread of cancer by more than 90 percent in a mouse model. It is now being evaluated in a world-first clinical trial.

"Surgery is very effective in removing solid tumours," said senior author Dr. Rebecca Auer, surgical oncologist and head of research at The Ottawa Hospital and associate professor at the University of Ottawa. "However, we're now realizing that, tragically, surgery can also suppress the immune system in a way that makes it easier for any remaining to persist and spread to other organs. Our research suggests that combining drugs with the may be able to block this phenomenon and help prevent cancer from coming back after surgery."

The current study investigated sildenafil (Viagra), tadalafil (Cialis) and an inactivated influenza vaccine (Agriflu) in a mouse model that mimics the spread of cancer (metastasis) after surgery. The researchers evaluated these treatments by counting the number of metastases in mouse lungs. They found an average of:

  • 37 metastases with cancer alone
  • 129 metastases with cancer cells and surgery
  • 24 metastases with cancer cells, surgery and one of the erectile dysfunction drugs
  • 11 metastases with cancer cells, surgery, one of the erectile dysfunction drugs and the flu vaccine
Sex, viruses and cancer
Surgery is very effective in removing solid tumors, but researchers now know that it also changes the immune system in a way that allows tiny cancers (metastases) to grow and spread. Credit: Rebecca Auer, Lisa MacKenzie

Dr. Auer is now leading the first clinical trial in the world of an erectile dysfunction (tadalafil) and the flu vaccine in people with cancer. It will involve 24 patients at The Ottawa Hospital undergoing abdominal cancer surgery. This trial is designed to evaluate safety and look for changes in the immune system. If successful, larger trials could look at possible benefits to patients.

"We're really excited about this research because it suggests that two safe and relatively inexpensive therapies may be able to solve a big problem in cancer," said Dr. Auer. "If confirmed in clinical trials, this could become the first therapy to address the immune problems caused by cancer surgery."

Using a variety of mouse and human models, Dr. Auer's team has also made progress in understanding how erectile dysfunction drugs and the flu vaccine affect cancer after surgery. Normally, immune cells called natural killer (NK) cells play a major role in killing metastatic cancer cells. But surgery causes another kind of immune cell, called a myeloid derived suppressor cell (MDSC), to block the NK cells. Dr. Auer's team has found that erectile dysfunction drugs block these MDSCs, which allows the NK cells to do their job fighting cancer. The flu vaccine further stimulates the NK cells.

"Cancer immunotherapy is a huge area of research right now, but we're still learning how best to use it in the time around ," said first author Dr. Lee-Hwa Tai, former postdoctoral fellow in Dr. Auer's lab and now assistant professor at the Université de Sherbrooke. "This research is an important step forward that opens up many possibilities."

Dr. Auer noted that although erectile dysfunction drugs and the flu are widely available, people with cancer should not self-medicate. Any changes in medication should be discussed with an oncologist.

Explore further: What men need to know about ED drugs and anesthesia

More information: Lee-Hwa Tai et al, Phosphodiesterase-5 inhibition reduces postoperative metastatic disease by targeting surgery-induced myeloid derived suppressor cell-dependent inhibition of Natural Killer cell cytotoxicity, OncoImmunology (2018). DOI: 10.1080/2162402X.2018.1431082

Related Stories

What men need to know about ED drugs and anesthesia

June 26, 2017
(HealthDay)—Men who take erectile dysfunction drugs need to alert the anesthetist before having surgery or other medical procedures, hospital experts say.

Could viruses take cancer immunotherapy to the next level?

January 3, 2018
Immunotherapy, which helps the body's immune system attack cancer, has revolutionized treatment for cancers such as melanoma and leukemia. However, many other kinds of cancer remain resistant. A new study led by researchers ...

For aggressive breast cancer in the brain, researchers clarify immune response

April 17, 2018
Once it has begun to spread in the body, approximately half of patients with an aggressive breast cancer type will develop cancer in the brain. Researchers at the University of North Carolina Lineberger Comprehensive Cancer ...

Technology holds personalised cancer vaccine breakthrough

April 10, 2018
University of Queensland researchers have developed a vaccine delivery technology that enables treatment to be tailored precisely for different cancers.

Stem cell vaccine immunizes lab mice against multiple cancers

February 15, 2018
Stanford University researchers report that injecting mice with inactivated induced pluripotent stem cells (iPSCs) launched a strong immune response against breast, lung, and skin cancers. The vaccine also prevented relapses ...

Metastatic lymph nodes can be the source of distant metastases in mouse models of cancer

March 22, 2018
A study by Massachusetts General Hospital (MGH) investigators finds that, in mouse models, cancer cells from metastatic lymph nodes can escape into the circulation by invading nodal blood vessels, leading to the development ...

Recommended for you

In zebrafish, a way to find new cancer therapies, targeting tumor modulators

September 21, 2018
The lab of Leonard Zon, MD, at Boston Children's Hospital has long been interested in making blood stem cells in quantity for therapeutic purposes. Looking for a way to test for their presence in zebrafish, their go-to research ...

What can salad dressing tell us about cancer? Think oil and vinegar

September 20, 2018
Researchers led by St. Jude Children's Research Hospital scientists have identified another way the process that causes oil to form droplets in water may contribute to solid tumors, such as prostate and breast cancer. The ...

Novel biomarker found in ovarian cancer patients can predict response to therapy

September 20, 2018
Despite months of aggressive treatment involving surgery and chemotherapy, about 85 percent of women with high-grade wide-spread ovarian cancer will have a recurrence of their disease. This leads to further treatment, but ...

Testing fluorescent tracers used to help surgeons determine edges of breast cancer tumors

September 20, 2018
A team of researchers with members from institutions in The Netherlands and China has conducted a test of fluorescent tracers meant to aid surgeons performing tumor removal in breast cancer patients. In their paper published ...

Cancer immunotherapy might benefit from previously overlooked immune players

September 20, 2018
Cancer immunotherapy—efforts to boost a patient's own immune system, allowing it to better fight cancer cells on its own—has shown great promise for some previously intractable cancers. Yet immunotherapy doesn't work ...

New way to target advanced breast cancers

September 20, 2018
A cytokine signature found in certain kinds of breast cancer cells can not only serve as a diagnostic tool for HER2-negative cancers but also offer an effective treatment target.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.