Breakthrough in Cancer Treatment: Personalized Vaccines Hold Promise

Researchers are creating personalized cancer vaccines to train the immune system to detect and destroy tumor cells more quickly. At Mount Sinai, a computational pipeline has been set up in order to detect cancer-specific mutations known as neoantigens in each patient's tumor tissue.

One vaccine study demonstrated promising results for preventing high-risk melanoma recurrence, while America learned of messenger RNA technology during the pandemic that could make these vaccines even more effective.

Personalized Cancer Vaccines

Personalized cancer vaccines work by stimulating a patient's own immune system to attack tumors, unlike chemotherapy that weakens it further. Instead, personalized cancer vaccines encourage their bodies to attack tumors directly and build a long-lasting response against cancer.

Vaccines designed to target tumor-specific proteins or antigens are currently undergoing rigorous trials across many forms of cancer, with promising early results from treatments by the University of Arizona Cancer Center and Banner-University Medicine for treating head and neck cancer. Out of 10 patients given this vaccine, five experienced clinical responses; two even achieved complete responses after treatment (i.e. no detectable disease present).

Moderna has designed a vaccine to target specific mutations within patients' tumors. The company conducts this analysis by sequencing mutated DNA extracted from tumor cells and comparing it to healthy DNA present in blood, then loading this information on messenger RNA molecules that inform immune cells such as T-cells to target and destroy those tumors that contain mutations.

Studies are being done now to test the efficacy of this type of neoantigen vaccine, including two trials on melanoma vaccines and one in people with the hereditary condition Lynch syndrome who are at a high risk for cancer. These exciting studies show how individually tailored cancer vaccines can create an effective immune response and greatly diminish tumor recurrence risk.

Personalized Radiation Therapy

Radiation therapy--or radiotherapy as it's more commonly known--is an integral component of cancer treatments. The goal is to destroy cancerous cells while sparing healthy tissue from harm; radiation may also reduce side effects from chemotherapy treatments; newer technologies allow more radiation doses to be delivered more rapidly through fewer sessions.

One option for cancer therapy is personalized radiation, in which the amount of radiation received depends on factors related to tumor location and other considerations. This approach may also be used in tailoring other forms of therapy like surgery, chemotherapy and immunotherapy.

Personalized cancer vaccines are an emerging immunotherapeutic tool. They are tailored specifically for each patient's tumor mutations - known as neoantigens - which stimulate the immune system into sending out T cells that seek and destroy tumor cells.

Moderna and Merck successfully demonstrated their DNA-based vaccine for advanced melanoma in a small clinical study of people. The results provided hope to cancer vaccine researchers, who have struggled to demonstrate benefits over decades.

The mRNA vaccine is currently being evaluated in larger studies on hard-to-treat cancers such as pancreatic ductal adenocarcinoma and brain cancer glioblastoma, where its results could reduce chances of returning or spreading--and perhaps prolong patient lives.

Personalized Chemotherapy

As cancer researchers gain more knowledge on how cancers form and spread, they're developing novel approaches to targeting them with drugs - often with fewer side effects than standard treatments.

T-DXd, for instance, targets specific mutations within tumors of patients by combining an antibody that recognizes these mutations with chemotherapy drugs that eliminate cancerous cells without harming healthy ones. A recent study demonstrated that people who received T-DXd treatment were significantly more likely to survive than those receiving standard chemotherapy therapy alone.

Another promising approach is "training" the immune system to recognize cancer as dangerous. For this, doctors remove T cells from a patient's body and reprogram them so they will hunt down and destroy cancerous cells - one such therapy, called Chimeric Antigen Receptor T-Cell Therapy or CART T, has already been approved to treat certain blood cancers and melanomas.

Vaccines designed to target neoantigens found within cancerous tumors are also being explored, with early trials showing they can stimulate vaccine-specific T cells and, at least in melanoma cases, shrink tumors. Researchers use powerful DNA sequencing technologies, predictive modeling tools, and machine learning algorithms to identify neoantigens which could serve as effective vaccine targets - potentially giving patients customized vaccination regimens tailored specifically for their tumor types.

Personalized Immunotherapy

Your immune system acts as an invaluable security team, regularly checking for cells that could turn into cancerous tumors and eliminating them before they develop into cancerous growths. Unfortunately, cancer cells have found ways to avoid detection by turning off our natural anti-cancer response; immunotherapies that target these off switches in order to reactivate our body's attack on cancer cells have shown great promise against various forms of cancers.

CAR T cell therapy involves genetically engineering some of a patient's T cells to recognize specific antigens on cancer cells and returning them back into his or her body where they can identify and latch onto cancerous ones. It has proven itself successful against certain blood cancers; scientists continue their efforts in perfecting and expanding it's reach into additional cancer types.

A research team at UCSF recently used genome editing to enhance the efficiency of engineered T cells that detect cancer antigens more readily and latch onto them more quickly. Furthermore, they are working on creating a drug that would remove another form of resistance used by cancer cells to hide from immune attacks.

Moderna and Merck have developed personalized vaccines as another immunotherapy. Instead of starting from T cells from individual patients, their vaccines target each cancer's mutation fingerprint; clinical trials for such vaccines have already started, including trials for both melanoma and breast cancer risk reduction in those at greater risk for both diseases.