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Cancer vaccines – a new frontier in immuno-oncology

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Cancer vaccines – a new frontier in immuno-oncology

7 April, 2022

Ever since their discovery more than 200 years ago, vaccines have helped revolutionise healthcare, especially when it comes to combatting deadly infectious diseases. As vaccine technology continues to advance, scientists are finding ways to implement it in the fight against one of the deadliest illnesses: cancer.

In the 18th century, as the smallpox epidemic raged across Europe, scientists found that people who had previously been infected with cowpox, a milder version of smallpox, became resistant to the deadly disease. This observation led to the development of the world’s first vaccine by British physician and scientist Edward Jenner.

Jenner called this solution Variolae vaccinae (smallpox of the cow). From that moment onward, the term vaccine stuck for any form of biological inoculation meant stimulate a person’s immune system as protection from deadly disease.

Can vaccines work against cancer?

Since Jenner’s publication in 1798, vaccine technology has evolved and greatly improved. However, most of today’s vaccines target infectious diseases – illnesses caused by a pathogen like a virus or a bacterium. They activate antibodies in a person’s immune system able to identify markers – antigens – specific to the pathogen in question and mount an immune response against it when the body encounters it. These are considered preventative vaccines.

Today, BioStock takes a closer look at whether similar vaccine solutions exist to combat cancer – a disease that remains one of the leading causes of death worldwide killing 10 million people each year.

The rise of immuno-oncology

For decades, primary cancer treatments consisted mainly of chemotherapeutic agents and radiation therapy to eliminate tumour cells. Despite offering substantial benefits, lingering cancer cells become resistant to these treatments, and the disease relapses, spreading to other organs and forming so-called metastases. This is the stage of the disease that is considered the most deadly, because it is the most difficult to treat.

To counter the problem, a new frontier in cancer therapy emerged: immuno-oncology – a field of drug therapeutics aimed at enhancing a patient’s immune system to recognise the cancer and stop it in its tracts before it’s too late.

Some of the most popular cancer immunotherapies are checkpoint inhibitors, generating billions of dollars in revenue every year. However, in many patients their benefits are still marginal, so the need for new treatments is still significant. And this is where cancer vaccines come into the picture.

Therapeutic vs preventative vaccines

As already alluded to, vaccines against infectious diseases are considered preventative – they are given before a person comes in contact with a specific pathogen. The vaccine teaches the immune system to attack this pathogen if it were to invade.

However, with cancer, this is more challenging because cancer cells are not perceived as foreign by our immune system. In fact, cancer cells derive from normal cells that begin to grow and divide exponentially because of genetic mutations. Therefore, as of today, cancer vaccines currently in development are not preventative.

Rather, cancer vaccines are considered therapeutic – they are constructed in a way that enables the immune system to recognise when cancer grows back after a first tranche of treatment. This generates an immune response, which can be further stimulated if the vaccine is given in combination with other immunotherapies.

Expanding cancer vaccine market

The promise of cancer vaccines is leading to stronger competition among innovators to develop new technologies in the field. According to Allied Market Research, the global cancer vaccines market is projected to reach 7 billion USD by 2027 from 4 billion USD in 2019. That translates to an annual growth rate of 12.6 per cent.

Many players in the biotech sphere are betting heavily on cancer vaccines, including prominent names like Moderna, known for its mRNA Covid-19 vaccine. The American company is investing in the potential to use its mRNA technology to develop individualised therapeutic cancer vaccines to deliver a drug that is tailor-made to the patient’s needs.

At this year’s American Association of Cancer Research (AACR) Annual Meeting, Moderna presented data from a phase II trial evaluating their vaccine combined with Merck’s checkpoint inhibitor Keytruda. According to the data, the vaccine can cut the risk of melanoma recurrence by 44 per cent when compared to Keytruda alone. Moderna expects to begin phase III trials by the end of 2023.

In the Nordics, companies like Ultimovacs, Evaxion and Mendus are working on their own cancer vaccine technologies. All three companies have their respective lead candidates in phase II of clinical evaluation, with prospects of commercialisation intensifying.

As the competition heats up, there is new hope that a breakthrough in therapeutic cancer vaccine technology could come soon – by 2030, some experts believe. Investors are watching closely, and so are cancer patients across the globe.

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