Anti-cancer vaccine: off-the-shelf cure for cancer to become the norm

by Antonia Alalitei


An infamous fatal disease is on the way to be cured as easily as the common flu, with a cancer vaccine based on immunological therapy said to hit the market in less than a decade. Might sound hard to believe, after so many years in which cancer has been feared by the world due to its incurability. But just as humanity has eradicated so many diseases throughout history, research advancements are bringing us one step closer to the long-awaited cancer-free era.

You might think to yourself: “Wait, a vaccine? How would a vaccine heal cancer? It is not an external pathogen that should be targeted by the immune system, is it?” Even though cancer does not represent an external infection to be targeted, cancerous tumors are formed by cells that go unnoticed by our immune system. If we can make the immune system detect cancer, it will start eliminating it just as it would eliminate a flu virus, without harming our healthy cells. Let’s see how that might work!


What is immunology therapy?

Traditional cancer treatments, either surgical removal of tumors or chemotherapy, radiotherapy and others, have the main focus on removing the cancer cells directly, with the two main and well known risks of harming healthy cells of the body, as well as incomplete removal of affected tissue, which has potential to continue spreading through the body.

This approach came to a drastic change in the 90s, after James P. Allison, chair of the department of immunology at MD Anderson Cancer Center in Houston, Texas and Tasuku Honjo, professor at the Kyoto University Institute for Advanced Study in Japan, made separate breakthrough discoveries about the immune system that made them pioneers of the immunotherapy field, as well as bringing them the Nobel Prize for Medicine/Physiology in 2018.

What generally makes cancel spread uncontrollably is how it can deactivate a certain type of white blood cells, the T-cells, and shutting down the body’s immune response. Allison and Kyoto managed to each discover a different type of switch on the T-cells, called an immune checkpoint, which the cancer cells use to deactivate them. By blocking these checkpoints with special drugs, the immune system is thus capable of targeting and killing cancer cells effectively.


Recent promising improvements

The innovative cancer treatment proposal published as a paper in “Nature Immunology” just a couple of months ago, comes from the Mayo Clinic of Yale University, where Sidi Chen, assistant professor of genetics and her collaborators, have created a new type of immunotherapy termed multiplexed activation of endogenous genes as an immunotherapy(MAEGI).

There are many types of immunotherapies that have been developed since the 90s, which could differ from the checkpoint-based ones that pioneered the field. What they all have in common is that, in one way or another, they manage to recognize mutant abnormalities generated mutant genes of the cancer cells. However, cancer cells are agile enough to downregulate the expression of these abnormalities to escape the scrutiny of the immune system.

What the MAEGI technique does, by combining viral gene therapy and a certain DNA family called CRISPR which is used to cleave certain DNA sequences, is that it finds cancer-related gene expressions and highlights them, as well as amplifying their signal. When the threat on the immune system is not big enough, the system is not alerted. Thus, by amplifying the alert of the presence of cancer cells, T-cells are recruited and activated around marked target, regardless of whether they are in the vicinity of the original cancerous tumour or somewhere else.



Clinical trials and future prospects

The therapy has potential of treating a variety of types of cancer. However, Florida resident Lee Mercker became the first patient to benefit from the clinical trial of a new vaccine against breast cancer, based on the MAEGI technique. The 12-week trial is supposed to trigger the patient’s immune system and cure the cancerous cells. However, she was required to undergo mastectomy to make sure the entire mutant tissue was removed. Researchers will also analyze the breast tissue to assess the progress of the vaccine in treating the affected areas.

Another patient undergoing the trial showed positive responses, as well as trials conducted on patients with different stages of the disease showed improvements. Slowly but steadily, it is hoped that, as test results consistently show progress, an off-the-shelf vaccine option will become available in the future, thus categorizing cancer as a disease as harmless as the flu or pneumonia.

Cancer symptoms manifest early in the body, however they remain undetected due to only later manifestations of sickness. With steady progress in medical research, it is expected to reach a future where not only we will be treating cancer, but we will be working on prevention, by early detection of cancer markers in the body. However, only time will come to tell when this will actually materialize.