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Cancer vaccines represent a revolutionary new form of therapy that has the potential to fundamentally change the treatment of cancer, because they mobilize the body's own immune system specifically against cancer cells.
How do cancer vaccines work?
Cancer vaccines work by stimulating the immune system to recognize cancer cells as a threat and destroy them. This is done by introducing tumor antigens - such as specific proteins or peptides that are exclusively present on cancer cells. These antigens can either be injected directly or introduced into dendritic cells, which present them and trigger an immune response.
There are two main types of cancer vaccines:
In cancer therapy, preventive and therapeutic vaccines differ in their objectives and application.
Preventive vaccination in cancer therapy
Preventive vaccinations aim to reduce the risk of cancer by protecting against infections that may be associated with the development of cancer. They are administered before a person develops cancer, i.e. usually long before a possible disease. A well-known example is the HPV vaccine, which is effective against the human papillomavirus and prevents cervical cancer.
Therapeutic vaccinations in cancer therapy
Therapeutic vaccinations are designed to activate the immune system to recognize and destroy existing cancer cells in the body. There is currently only one approved therapy, while others are in development. In the future, these vaccinations will be an important part of modern treatment strategies and will be used in combination with other therapies such as chemotherapy or immunotherapy. Their aim is to positively influence the course of the disease by triggering a targeted and specific immune response against the tumor cells.
mRNA-based cancer vaccines: an innovative approach
Among the various approaches to therapeutic vaccination, mRNA-based cancer vaccines represent a particularly innovative development. While mRNA vaccines have already received a lot of attention due to the COVID-19 pandemic, their greatest potential may lie in the future fight against cancer.
Unlike traditional vaccines, which contain attenuated or inactive forms of pathogens, mRNA vaccines are based on genetic instructions. These vaccines use messenger RNA (mRNA) to transmit the genetic code of specific tumor antigens to the immune system. After vaccination, this code enters healthy body cells, where it is read in order to produce the corresponding protein and present it on the surface for a while. The immune system recognizes this so-called spike protein as foreign and develops a targeted immune response against cells that produce this protein - in this case against the cancer cells.
The mRNA technology is characterized by its exceptional flexibility, as mRNA vaccines can be quickly adapted to specific tumor mutations. Compared to traditional vaccines, which have difficulty adapting to new viral variants, this rapid adaptability is particularly advantageous in cancer treatment, as tumors often undergo rapid genetic changes.
Companies at the forefront of research
There are numerous companies and research institutions around the world that are working intensively on these innovative therapeutic approaches. Companies such as BioNTech, Moderna and CureVac are leaders in the development of mRNA vaccines.
Thanks to the successful use of mRNA technologies in the COVID-19 pandemic, BioNTech and Moderna have the necessary resources and expertise to drive forward the development of cancer vaccines.
Current developments
BioNTech's mRNA cancer vaccines: progress in clinical trials
BioNTech is currently working on several promising mRNA-based cancer vaccines. Just a few days ago, the first patients in the phase II trial of BNT116 were treated with the first vaccine dose at 34 research centers in seven countries (including the UK, USA and Germany). The active substance is to be tested on a total of around 130 patients with non-small cell lung cancer. Another significant advance in the clinical research of mRNA cancer vaccines is the collaboration between BioNTech and the British National Health Service (NHS). The two partners have launched the first large-scale, comprehensive efficacy trial of the BNT122 cancer vaccine, enabling thousands of patients in the UK to gain early access to the innovative treatment for bowel cancer. A key element of this study is the Cancer Vaccine Launch Pad, which accelerates the identification of suitable patients for personalized treatments. As part of this trial, the first patients in the UK have also received their first dose of vaccine in recent months. These developments could pave the way for a new era of personalized medicine that may be able to fight cancer preventively.
Moderna: Promising data on mRNA therapy
Moderna has presented impressive results from a landmark mRNA therapy study - mRNA-4157 (V940) - at the ASCO Congress (June 3, 2024) in Chicago. The study, which lasted almost three years and thus represents the longest observation period to date for an mRNA therapy against cancer, examined over 150 patients with particularly aggressive malignant melanoma. The combination of the customized mRNA vaccine and the antibody Keytruda showed that the risk of relapse or death was reduced by 49 percent compared to the control group that received Keytruda alone. The risk of distant metastases was reduced by 62 percent. Almost 75 percent of the patients who received mRNA therapy were still alive after two and a half years, while only just under half of the patients in the control group survived. These findings demonstrate the effectiveness of the therapy and mark a significant advance in cancer treatment.
Challenges and future prospects
The development of mRNA cancer vaccines is making promising progress and could open up new avenues in cancer treatment. BioNTech and Moderna are engaged in an exciting neck-and-neck race for initial approval. Both companies are optimistic: Moderna is aiming for accelerated approval in the USA and possibly in the EU by 2025, while BioNTech is targeting approval by 2026. Despite all the progress, researchers continue to face challenges, such as the complexity and high cost of personalized vaccine development and the need for extensive clinical trials to guarantee efficacy and safety. Despite all the challenges, the progress made so far gives reason to hope that mRNA technology could revolutionize cancer therapy in the near future.
Quellen:
Hautkrebs: Moderna-Studie weckt Hoffnungen auf den weltweit ersten mRNA-Krebsimpfstoff - DER SPIEGEL
Krebs: Kommt der erste mRNA-Impfstoff? - SWR Wissen
Moderna will 2025 Impfstoff gegen schwarzen Hautkrebs auf den Markt... (aerzteblatt.de)
NHS England » Thousands of NHS patients to access trials of personalised cancer ‘vaccines’
World-first lung cancer vaccine trials launched across seven countries | Lung cancer | The Guardian