Short read: Can We Prevent Cancer With a Shot?

Cancer survivorship has remarkably increased over the past couple of decades given the significant strides in medicine. Yet, it remains one of the key risks for life expectancy and quality of life in old age. So, it is encouraging to see possibilities of a vaccine for prevention.

There are of course vaccines already available for prevention of certain types of cancer. Indeed, the Indian government earlier this year launched a drive to vaccinate girls between the age of 9 to 14 to prevent cervical cancer. However, cancer types like cervical for which vaccines are available are triggered by infections and hence the vaccines work much like vaccines for other infectious diseases i.e., “..traditional vaccines, which often contain weakened pathogens or noncontagious pieces of them. That mimics an infection, teaching the immune system to later quickly recognize and attack the real threat.”

But apparently, most cancers are not triggered by infections: “They start with mutated cells that blend in with healthy tissue. Researchers are testing proteins those cells produce as they become cancerous as potential targets for vaccines. The goal is to introduce those proteins to the body and flag them as dangerous. That would train the immune system to hunt down those abnormal cells, similar to attacking an infection. 

Many consider cancer vaccines to be a form of immunotherapy, a kind of treatment that has revolutionized cancer care by using the immune system to beat back cancer cells. Some of those therapies release the brakes on the immune system. Cancer vaccines, by contrast, are meant to boost the immune response and direct it where to go.

“Cancer cells and even pre-cancer cells know how to hide from the immune system,” says Dr. Neeha Zaidi, a medical oncologist at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. “It needs that help from a vaccine.”

Zaidi is targeting mutated proteins connected to a gene called KRAS, which can malfunction and spur tumor growth for lung, pancreatic and other cancers. She and her team designed a vaccine that uses pieces of mutated KRAS proteins and a drug meant to activate immune cells. 

The shot showed promise in an early trial with 15 people at high risk for pancreatic cancer. At four months, all the participants had generated immune responses against the KRAS proteins, with no safety concerns. 

While some are using protein pieces in the shots, others are taking advantage of mRNA and DNA technologies. They send snippets of genetic material to act as a blueprint for our bodies to make those target proteins ourselves—with the aim of generating an immune response against them.

At Penn Medicine, researchers are testing a DNA vaccine followed by a small electric shock to propel the DNA into cells. There, the DNA is used to make an enzyme called telomerase, which creates a protein that is overabundant in many cancers. The shot also includes a drug meant to alert the immune system to the threat.

It is being tested for people with inherited BRCA gene mutations, which increase the odds of breast and ovarian cancers, among others.”

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