Last Updated on 17 June 2024
Can cancer vaccine be universal? Or, rather, can this innovative treatment be suitable to treat any types of cancer? Of course, it would be wonderful we could prevent or defeat cancer through a simple injection. This guide is born just for that! Namely: to give a reliable answer to the just mentioned question. First, we must understand what is a cancer vaccine and what is the difference with the classical vaccine to fight infectious diseases. To discover more, keep reading.
Cancer Vaccines: How They Work?
Unlike the vaccines for infectious diseases, cancer vaccines don’t prevent the cancer disease. They are developed to cure it. Cancer vaccines are in fact used to treat metastatic cancer. They, in fact, aim to boost the immune system to recognize, attack and cure the disease. For this important feature, they are also called therapeutic cancer vaccines and are included in the field of cancer immunotherapy.
The latter involves the immune system and aims to avoid the traditional and, sometime, toxic chemotherapy. The only vaccine that prevents cancer is the one against the HPV, the virus which causes cervical cancer.
The effectiveness of the vaccine against cervical cancer is by now demonstrated all over the world, even in developing countries, such as Philippines, where, unfortunately, it is still hard to get the vaccine for the second cause of death among the Filipino women. However, in this Country, women can get the HPV vaccine for free at the Government hospitals and barangay health centers.
I really hope that a Filipino blogger deepens this matter very soon, because here, I can only discuss about the international implications of vaccines to treat any kinds of cancer, namely: universal cancer vaccine.
Cancer Vaccine Today
The topic of vaccines against cancer has risen just in the time of the Covid-19 vaccine. Many patients wonder because the introduction of the latter has been quicker than the one against cancer? Is a pandemic more severe of cancer? From another side, there is also the risk of a rise of cancer cases after a pandemic is over. Due to the risk of contagion, people overlooked cancer prevention tests. All that will result in a possible rise of several forms of cancer. Hence, if cancer vaccines were available, we could save many lives.
Provided that these vaccines work. The most relevant results in this field are in Germany and the United States, but also in China, where are the seats of pharmaceutical companies which have worked just on the early vaccines against Covid. Many of these cancer vaccines are only the direct consequence of covid vaccine. As the latter, cancer vaccines are not developed upon existing parts of bacteria or viruses, but on a genetic sequence. The most of tumors, indeed, are not the result of an infectious disease, but derive from a gene mutation in the DNA of cells.
Cancer Vaccines History
The first studies and trials for cancer vaccines started in 1988 for melanoma. This vaccine was tested to treat metastatic melanoma. The name of this vaccine was Melacine, it contained allogeneic melanoma lisates cells (tumor cells from a donor with membrane broken down) along with an adjuvant. The adjuvant was interferon, a natural body protein stimulating our immune system against tumors and infections. Studies and trials continued until 1995 and, afterward, until 2004, when the NCI Surgery Branch used 541 cancer vaccines to treat 440 patients who had metastatic cancer. That was the time when scholars, clinicians and oncologists started talk about cancer immunotherapy and monoclonal antibodies.
These were innovative antibodies that had to block the mechanisms which helped cancer cells grow. I heard about them, for the first time, in 2003, when I and my beloved dad, who had a metastatic colorectal cancer, sought for a vaccine or treatment to defeat his metastatic tumor.
Unfortunately, those early treatments were very toxic, because delivered along with chemotherapy and radiotherapy. When I called the oncologist, an Italian in the United States, on the phone, he suggested me that the treatment would have been pointless for the advanced cancer of my dad. I was ready to do everything, at that time, even to fly from Italy to the United States, to save my father.
The conclusion was very sad: my sweet and loved dad passed away on March, 3, 2004. We never took that flight, because oncologists said that the patient would be died anyway, even with the immunotherapy and monoclonal antibodies. These treatments, in fact, would have killed him, instead of saving him. The patient was already too weak to bear further treatments.
Many years passed from then and today, the development of cancer vaccines is outstanding. Hence, I prefer going ahead with this post. In 2010, FDA approved the therapeutic cancer vaccine Provenge, used to treat surgery resistant prostatic cancer. In 2017, a cancer vaccine based on a neoantigen, showed to be effective to treat melanoma. Therapeutic cancer vaccines are, indeed, based on tumor antigens. Antigens, in turn, are cell substances which trigger an immune response against an agent of disease, it may be a virus or a tumor. Tumor antigens are always the main signal of the presence of cancer.
Types of cancer vaccines based on tumor antigens
There are three types o of cancer vaccines based on tumor antigens:
- Dendritic cell vaccines
- Peptide vaccines
- Genetic vaccines
Dendritic cell vaccines contain antigens. These are cells that communicate the immune system the presence of cancer. Cancer vaccines based on dendritic cells aim to trigger the immune response through the T cells.
Peptide vaccines contain the sequence of the proteins produced by a pathogen, such as viruses or bacteria. Peptide cancer vaccines contain, instead, the sequence of the amino acids of tumor antigens. These vaccines are often synthetic and developed through a software which elaborates a series of digital sequences.
Genetic vaccines are the most recent and innovative weapon against cancer. They are based on the genetical sequence of DNA or RNA, namely on the nucleic acids with the instructions to produce important molecules for the good functioning of our body. Genetic vaccines bring these instructions to cells, where they get turned into proteins and antigens. These substances, in turn, become the target of the immune system. Genetic vaccines, indeed, aim to trigger a strong immune response against a pathogen, such as viruses and even cancer!
These vaccines represent the new frontier of cancer treatment, but also against a pandemic. The Covid-19 vaccines, for example, are genetic vaccines based on mRNA, namely on a genetical sequence of the RNA of a virus! How do they work for cancer? Read below to find the answer.
mRNA Cancer Vaccines
mRNA cancer vaccines contain the genetical sequence of the mRNA of cancer cells. Every cancer cell, indeed, has a mutation in the sequence of DNA and RNA. The DNA of cancer cells has altered instructions that induce cells to grow and form a tumor. mRNA is the acronym of messenger RNA, namely the portion of the nucleic acid that provides cells with instructions to produce proteins. In the case of cancer cells, these proteins are antigens (markers) of cancer. mRNA cancer vaccines contain just the sequence of mRNA of cancer cells.
These vaccines are injected to patients in the same way as the vaccine against Covid-19. The treatment pushes the immune system to recognize cancer through its proteins (antigens) and destroy it. In the past years, scientists tested DNA cancer vaccines, also, but these injections proved to be ineffective because had a scarce duration in the human cells. Unlike mRNA vaccines, the ones based on DNA contained just the DNA sequence of cancer cells. These vaccines are not tested on humans, yet, but only on mice, along with chemotherapy.
To be effective, genetic cancer vaccines had to be administered along with an adjuvant. Usually, the latter is a gel which ties the vaccines to cells, increasing its permanence in the human body. Even mRNA cancer vaccines have the same problem, they are frequently degraded by the enzymes of our body. To fix this problem, scientists tested mRNA cancer vaccines with hydrogel. This adjuvant avoids the enzymatic degradation of mRNA. mRNA cancer vaccines proved to reduce melanoma in mice.
Cancer vaccines are nowadays based on mRNA, in the same way as the Covid-19 vaccine. They are easier and practical to develop and test, as just happened for those vaccines produced to defeat the Covid -19 disease. Hence, from the tragical experience of a pandemic, Mankind may find the key to defeat every type of cancer.
That is why scientists, oncologists and patients talk about universal cancer vaccine. With this term, they mean a vaccine that may be used to treat and heal the several types of tumors. However, if MRNA vaccines are likely to work for infectious diseases, this likelihood is not so granted for cancer. Why? To find the answer, read the subsequent paragraph.
From Universal to Customized Cancer Vaccine
If the universal cancer vaccine should theoretically prevent and cure every type of cancer, customized cancer vaccines are treatments personalized on each of patients. We are unique, indeed, and our DNA is unique. Hence, even the same type of cancer is different from person to person, because every person has a different DNA. Genetic vaccines, especially those with mRNA, must contain the specific genetic mutation of the specific tumor of a given patient. In metastatic cancer, the damaged DNA of cells produces always further mutations in the new cells, and this feature makes really challenging to detect a universal vaccine which is effective for every kind of cancer.
Customized cancer vaccine, instead, is developed only by the genetic mutations of the DNA of the patient. Since the tumor of a patient has several genetic mutations, customized cancer vaccine must contain several sequences of these same mutations. Pharmaceutical companies such as Moderna, the same that produced the Covid-19 vaccine, developed customized mRNA cancer vaccines with 20 genetic mutations. Customized cancer vaccines are more effective if the sequences of these mutations match with the mutations of the cancer of the patient.
It seems a predictive therapy, but seen that the sequence of the vaccine is obtained by the mutation of the same patient, the probability of effectiveness is very high. Moderna researchers are in fact working to increase the number of mutations contained in the sequences of the vaccine.
Another pharmaceutical company based in Germany, Biontech, which, along with Pfizer, produced one of the vaccines to defeat a pandemic, has been working on cancer immunotherapy and on the preparation of the universal cancer vaccine since 2008.
We owe these discoveries just to the German scientists. They developed a therapeutic strategy to boost immune system, using encapsulated RNA molecules covered with fat acids.
These nanoparticles, injected in the patients, reach the cells of immune system, and provide instruction to recognize and kill the tumor. To know the several facets of cancer vaccine and immunotherapy, you can read this detailed book released by Cambridge University Press with the namesake title.
To further deepen the topic, you can see here, where is a comprehensive list with books exploring the matter of the evolution of vaccines to fight cancer. These volumes are suitable for doctors, students and for those people who want to better understand this topic.
If vaccines worked for every type of cancer, they would be be defined “universal”, but this result has still to come. Cancer vaccine today is tailored for individual patients, because each of them has, as already said, different tumors and different cell mutations. That is why, German scientists talk about individualized cancer vaccine or individualized cancer therapy.
What a Type of Cancer May Be Treated with Cancer Vaccines?
Cancer vaccine trials regard several types of tumors, such as:
- Brain cancer
- Breast cancer
- Bladder cancer
- Colorectal cancer
- Kidney cancer
- Melanoma
- Leukemia
- Myeloma
- Lung cancer
- Prostate cancer
- Pancreatic cancer
Currently, trials also regard patients affected by mesothelioma.
For aggressive forms of tumors, such as the pancreatic one, cancer vaccines are often combined with chemotherapy, as shown by a trial performed at University Department of Molecular Biotechnology and Health Sciences of the Research Center in Experimental Medicine (CeRMS) of the City of Health in Turin. The study, published on the Journal for Immunotherapy of Cancer of BMJ group, showed that DNA vaccine with chemotherapy reduced pancreatic cancer in mice.
Results are encouraging, especially for those vaccines already tested on patients in the framework of individualized cancer therapy. Melanoma, for example, showed to get reduced thanks to cancer vaccines applied to immunotherapy. For the so called “killer cancer”, instead, such as pancreatic ductal adenocarcinoma, trials have been performed on mice only.
When Does Universal Cancer Vaccine Really Arrive?
There is no official date about the global release of universal cancer vaccine. Many of these treatments are still undergone to trials and tests on animals and humans. As said, these vaccines work in the field of immunotherapy, leveraging the natural and innate capacity of our immune system to promptly recognize and neutralize cell mutations that trigger cancer.
Therapeutic cancer vaccines serve just to increase this capacity and everybody hopes they will cure every malignant and metastatic tumor in the future. Vaccines, immunotherapy, and other medications are often combined among them to slow the progression of cancer and increase the survival rate of patients. This way, cancer is turned into a chronic disease that allows to conduct a normal life. This combined approach has been used since 2019.
Cancer Vaccines Side Effects
Cancer vaccines may also have side effects. These are common in the world of vaccines. They include malaise, fatigue, symptoms alike flu, pain, fever, nausea, headache, chills, anorexia. Usually, these effects are mild and transient. During the early clinical trials, some of cancer vaccines caused an inflammatory reaction. The latter was linked to the genetic vaccine to boost immune system.
If the immune reaction was very strong, the cells released many cytokines, the protein molecules that our immune system uses to fight diseases. These have the role to promote the grow, differentiation, and death of cells. In the case of cancer cells, this side effect could also help the growth of the tumor. Many of these severe side effects have been fixed using the so called “immune checkpoint inhibitors”.
These are drugs that block proteins called checkpoints and reduce the strong reaction of immune system. These medications may have side effects, as well. One of these ones has been discovered by a Danish study. The study, indeed, revealed that cancer immunotherapy may be toxic for heart. Cardiac damage has been more frequent in patients with melanoma treated just with immune checkpoint inhibitors. The number of affected patients is, anyway, low, 7.5%, a percent, which scientists, however, consider higher than the expected results.
Conclusion
Writing this article has not been fun. While I was writing it, I thought of all those people I lost: my beloved dad, my brilliant and young friends, unfortunately killed by aggressive and merciless forms of cancer. They weren’t even 45 years old. When I remember these cases, I still cry, because I consider these deaths a biggest injustice. Against this injustice, we need effective treatments and a bigger hope: universal cancer vaccine. It is the final step of the fight against cancer. The new strategy is the one to develop a universal cancer vaccine containing several genetic mutations that are common in every type of cancer, regardless the type of cell and organ affected.
These therapies are already in an advanced stage of development. Within a few years, a unique molecule will cure every cancer, making this disease easy to defeat and forget. This perspective is not so far away. We’ll have soon a universal cancer vaccine for everybody. The same molecule will be released in the entire world, in the UK, India, Kenya, Japan, Europe, United States and so on.
Every child will be easily treated with no side effects. Even cats and dogs will be given a simple pill to cure their cancer. Yes, a single pill for everybody, to cure metastatic cancer, the real enemy of the previous cancer treatments. I look forward to writing and publishing the news about the universal cancer molecule. I hope it will happen soon. Cancer vaccine will be so way, the ultimate victory of Science.
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