the 5 keys to the new cancer vaccines

It is the first program in the world that arises with such an ambitious objective: to find a permanent cure and custom made for each patient in just a few weeks. Those who meet the eligibility criteria and agree to have a blood test and a sample of their cancerous tissue analyzed will gain immediate access to clinical trials of the new vaccines.

In parallel, the United States drug and health technology regulatory agency The Food and Drug Administration (FDA) has approved a therapeutic cancer vaccine based on messenger RNA (mRNA). The company that develops it, WestGene, has also been quick to call the achievement “historical“.

Both announcements have happened in a very short period of time. But could these “historical” vaccines really be used for all cancers? Which patients would be the first to benefit from them? Do they serve to end cancer or prevent it from recurring in people who have already had it?

How do vaccines work?

Cancer vaccines have been researched for years. However, the turning point did not occur until the appearance of trading platforms. messenger RNA. They probably look familiar to you, as they were used in Covid-19 vaccines.

“These vaccines work by using a small messenger RNA sequence that contains instructions for the body’s cells to produce a specific protein which, in the case of cancer, is usually a tumor-associated protein,” he explains. Rodrigo Sánchez-Bayonaoncologist at Hospital 12 de Octubre in Madrid. “Through these vaccines, our body is able to give instructions to the immune system to attack those cells that could harm us.”

The scientific secretary of the Spanish Society of Medical Oncology (SEOM) also values ​​that this technology has not only shown promise in clinical trials, but has also accelerated the research and development of new immunological therapies against cancer, offering new hope for more effective treatments and specific.

What tumors are they used for?

Researchers are studying different types of vaccines against cancers, since there will not be a single one that can cure them all. What’s more, the most advanced ones do not prevent primary cancer but rather try to prevent its reappearance.

To date, it is believed that they could be effective in various types of cancer, such as colorectal, lung, bladder, pancreatic and kidney cancer. In Spain it is already being tested the V940 vaccine for melanoma, also based on mRNA technology and developed by the companies Moderna and MSD.

Jonathan Kwok, director of Infinitopes, a start-up from the University of Oxford and Cancer Research UK (the largest non-profit organization for cancer research in the United Kingdom), assured in this interview with EL ESPAÑOL that some cancer vaccines are “easy wins“, as happens in the case of melanoma: “Immune checkpoint inhibitors work so well because they stimulate the response to the tumor.”

However, Kwok predicts that the antidotes will be able to target many different types of cancers. “In the case of the recent vaccine approved by the FDA, a new possibility of treatment opens up for patients who have cancers related to the Epstein-Barr virus,” adds Sánchez Bayona.

Which patients does it benefit?

The National Health Service (NHS) has already recruited dozens of patients through the pioneering Cancer Vaccine Launch Pad. Health authorities hope to offer access to thousands of people over the next yearsince around thirty British hospitals have already signed up for this project.

NHS chief executive Amanda Pritchard acknowledged that they are in “a unique position” to carry out this type of world-class research on a large scale: “And as these trials get underway in hospitals across the country, our matching service will ensure that the greatest number of eligible patients have the opportunity to access them.

In this case, the selection criteria have not been made public. Although, as is evident, not all patients meet the characteristics required to participate in a trial. For the V940 vaccine, for example, patients with melanoma that has been surgically removed but have high risk of tumor recurrence (in phase III those with a somewhat lower risk have also been included).

What is the current situation?

For Sánchez Bayona, research into cancer vaccines “has made notable progress” in recent years; especially, in therapeutic and preventive vaccines. The latter have proven to be “highly effective” in the prevention of tumors related to viruses such as HPV or hepatitis B, such as cervical cancer or of liver.

Even so, their therapeutic use is not widespread in the majority of vaccines designed as treatment: “They are in the development phase in clinical trials. Although some tumors, such as melanoma or prostate cancer, are more advanced in this regard,” indicates.

Personalized therapies, however, pose a series of problems. First, the heterogeneity of tumors makes the design of these mRNA-based vaccines difficult. The tumor microenvironment can also suppress the immune response on certain occasions. Added to this is the high cost they could have. “Despite this, the identification of specific cancer antigens suggests a promising future, with potential for treatments that could transform the fight against cancer“.

When will they be ready?

It is the eternal question that always arises when this issue is discussed. There is no doubt that the facts will end up giving us the answer. Although in the absence of them, sensations vary depending on who you ask.

The principal investigator of the trial being carried out in the United Kingdom, Queen Elizabeth Hospital Birmingham oncologist Victoria Kunene, acknowledges that currently “more data and recruiting suitable patients for the trial are needed to establish the body’s response to the vaccine.” “.

Kwok, for his part, ventured to estimate that by the end of this decade we will have several cancer vaccines ready. The scientists and founders of BioNTech, the company that partnered with Pfizer to manufacture the first mRNA vaccine against Covid, agree on the forecast: “The cancer vaccine could be ready before 2030.”