Fast technological developments could deliver vaccines for cancer and other diseases by the end of the decade
Thanks to the breakthroughs of mRNA technology in creating COVID-19 vaccines, the method is being put to the test for other diseases that have plagued humanity for millennia. And the fast rollout necessitated by a global pandemic has compressed 10 or 15 years of progress into a brief period. Developers at Moderna, Pfizer, and BioNTech are optimistic they can create effective vaccines for cardiovascular, autoimmune, and several respiratory diseases and individual cancers. They might even be able to develop vaccines for diseases that have so far resisted treatment.
The nature of mRNA-based vaccines makes them more effective than previous vaccines because they teach human cells to make proteins they don’t naturally make. In the case of a potential mRNA cancer vaccine, that means immune systems could recognize proteins on cancer cells and then attack those cells while leaving healthy ones alone.
“We will have that vaccine and it will be highly effective, and it will save many hundreds of thousands, if not millions of lives,” Moderna chief medical officer Dr. Paul Burton told the Guardian. “I think we will be able to offer personalized cancer vaccines against multiple different tumor types to people around the world.”
Moderna and Merck have been trialing an mRNA cancer vaccine on melanoma patients in combination with the immunotherapy Keytruda. After 18 months, 78.6% of participants who received both were cancer-free, compared to 62.2% of participants who received Keytruda alone. The companies plan to begin Phase 3 trials this year, expanding to lung and other cancers.
“The profound observed reduction in the risk of recurrence-free survival suggests this combination may be a novel means of potentially extending the lives of patients with high-risk melanoma,” said Dr. Kyle Holen, Moderna’s head of development for therapeutics and oncology.
Shareholders and financial observers are maintaining a cautious optimism but are wary of getting their hopes up in the wake of “a long history of failures in this space,” as Wolfe Research analyst Tim Anderson put it in a note.
Triple-Negative Breast Cancer
Triple-negative breast cancer accounts for a high percentage of breast cancer deaths and “is the form of the disease for which we have the least effective treatments,” Dr. G. Thomas Budd of the Cleveland Clinic’s Taussig Cancer Institute said.
Budd’s work might help change that. He’s the lead investigator on a study of a vaccine aimed at preventing triple-negative breast cancer. The clinic is partnering with Anixa Biosciences on Phase 1 trials that have thus far been “incredibly promising,” Anixa CEO Dr. Amit Kumar told NBC.
Women produce a protein called alpha-lactalbumin after giving birth. When they stop lactating, their bodies stop making the protein. But in 70% of triple-negative breast cancer cases, the protein has returned.
“If we could immunize women, or vaccinate women, and enable the immune system to target that protein, then when those cancer cells arise, the immune system would destroy those cells, making it impossible for those cells to eventually become a large tumor or mass that you could see in a mammogram,” Kumar said.
The next phase of trials is slated to begin in 2024.
Treating Rare Diseases
One consequence of the COVID pandemic was the rapid spread of RSV infections as people gathered together after so much time apart. Moderna announced in January that its mRNA RSV vaccine was 83.7% effective at preventing at least two symptoms in patients 60 and older. Burton thinks Moderna will be able to develop a single vaccine for several respiratory illnesses, including COVID, RSV, and the flu.
Pfizer and BioNTech have an mRNA-based flu vaccine in late-stage trials and are targeting shingles and other diseases next.
“The learnings from the Covid-19 vaccine development process have informed our overall approach to mRNA research and development, and how Pfizer conducts R&D more broadly. We gained a decade’s worth of scientific knowledge in just one year,” a spokesperson told the Guardian.
That technological acceleration has made drugmakers confident they can fight rare diseases for which we currently have no drug treatments.
“I think we will have mRNA-based therapies for rare diseases that were previously undruggable, and I think that 10 years from now, we will be approaching a world where you truly can identify the genetic cause of a disease and, with relative simplicity, go and edit that out and repair it using mRNA-based technology,” Burton said.
That could prove to be the best thing to come out of the devastation COVID wrought.