Logan Reed
Cancer vaccines are designed to treat cancer rather than prevent it. There are two main types of cancer vaccines: therapeutic vaccines and preventive vaccines. Therapeutic vaccines train the body to protect itself against its own abnormal cells, including cancer cells, by exposing the immune system to antigens associated with a specific type of cancer. Preventive vaccines, on the other hand, boost the body's natural ability to defend against foreign invaders like bacteria and viruses, thereby reducing the risk of cancer. While there is no single vaccine for cancer, certain preventive vaccines can protect against viruses that increase the risk of cancer, such as the hepatitis B vaccine for liver cancer and the HPV vaccine for cervical cancer. Therapeutic vaccines, such as Sipuleucel-T (Provenge), aim to treat existing cancers by killing cancer cells and preventing tumour growth and spread.
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What You'll Learn
Preventative vaccines
Preventative cancer vaccines are a form of immunotherapy that educates the immune system about what cancer cells "look like" so that it can identify and eliminate them. These vaccines boost the body's natural ability to defend against foreign invaders, like bacteria and viruses.
There are currently four preventative cancer vaccines approved by the FDA. Two of these are the HPV and hepatitis B vaccines. HPV, or the human papillomavirus, is a common virus that nearly all sexually active people get at some point in their lives unless they receive the HPV vaccine. Chronic HPV infection can cause several types of cancer, including cervical cancer, head and neck cancers, anal cancer, penile cancer, vaginal cancer, and vulvar cancer. The HPV vaccine greatly reduces the risk of these cancers. The hepatitis B vaccine reduces the risk of liver cancer.
Other preventative cancer vaccines are currently being evaluated in clinical trials. For example, researchers are exploring the use of nanoparticles to deliver "intel" to the immune system about what cancer "looks like." This approach could enable immune responses to be directed precisely against patients' tumour cells while sparing their healthy cells, thus preventing side effects.
While preventative cancer vaccines are an important tool in reducing the risk of certain cancers, they are not traditional vaccines that prevent disease. Instead, they focus on clearing active disease and boosting the immune system to find and kill cancer cells.
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Therapeutic vaccines
Therapeutic cancer vaccines are used to treat cancer after it occurs, rather than to prevent it. They work by training the body to protect itself against its own damaged or abnormal cells, including cancer cells. These vaccines expose the immune system to molecules called antigens, which are associated with a specific type of cancer. This enables the immune system to recognize and destroy cancer cells.
Therapeutic cancer vaccines consist of specific antigens combined with another immune system trigger called an adjuvant. They can be used to stop a tumour from growing or spreading, and to destroy cancer cells that remain in the body after treatment, such as surgery or radiation therapy. However, cancer cells produce molecules that suppress the immune response, which can make it difficult for the vaccine to work effectively. Even if a vaccine can switch on immune cells, those cells may not be able to enter the tumour area, or they may be shut down by the cancer cells.
Therapeutic cancer vaccines have undergone a resurgence in the past decade, due to a better understanding of tumour-associated antigens and the development of novel technologies for antigen delivery. The goal of therapeutic cancer vaccines is to induce tumour regression, eradicate minimal residual disease, establish lasting antitumour memory, and avoid non-specific or adverse reactions. However, tumour-induced immunosuppression and immunoresistance pose significant challenges.
Several therapeutic cancer vaccines have been approved by the U.S. Food and Drug Administration (FDA) and are in use for different cancers. For example, Sipuleucel-T (Provenge) is used for the treatment of people with advanced prostate cancer. It was developed by removing some immune cells, exposing them to a molecule from prostate cancer cells, and then infusing them back into the body. Bacillus Calmette-Guérin (BCG), a tuberculosis vaccine, is another example of a therapeutic cancer vaccine used to treat early-stage bladder cancers. It is made from inactivated tuberculosis bacteria and helps stimulate immune system cells, which then attack the bladder cancer cells.
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DNA vaccines
However, DNA vaccines have had limited success in producing therapeutic effects against most cancers due to poor immunogenicity. DNA vaccines have been most successful against cancer models where the etiological oncogenic agents are of foreign viral origin, such as human papillomavirus-associated malignancies. Most tumors arise from normal body tissues and express endogenous antigens that are either not recognized by or are only weakly reactive to the immune system.
To enhance the vaccine-induced immune response and treatment efficacy, DNA vaccines could be improved by using two different strategies. The first strategy is to increase their immunogenicity by selecting and optimizing the best antigen(s) to be inserted into the plasmid DNA. The second strategy is to combine DNA vaccines with other complementary therapies that could improve their activity by attenuating immunosuppression in the tumor microenvironment or by increasing the activity/number of immune cells.
Recent developments in immuno-oncology have opened an unprecedented avenue for the emergence of vaccine strategies. Therapeutic DNA cancer vaccines are now considered a very promising strategy to activate the immune system against cancer. Several clinical trials using plasmid DNA vaccines have demonstrated a good safety profile and the activation of a broad and specific immune response.
Neoantigen DNA vaccines are safe, feasible, and induce neoantigen-specific immune responses in triple-negative breast cancer patients. A phase 1 clinical trial was performed on patients with persistent disease following neoadjuvant chemotherapy, a patient population at high risk of disease recurrence. Neoantigen DNA vaccines were administered via electroporation following surgical removal of the primary tumor and completion of standard therapy. Vaccines were monitored for safety and immune responses, and neoantigen-specific T cell responses were induced in 14 out of 18 patients.
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Neoantigen vaccines
Neoantigens are exclusive to cancer cells and are not found in healthy cells. They are recognised as foreign by the immune system, triggering a robust immune response. This makes them an attractive target for cancer immunotherapy.
Recent advances in neoantigen research have accelerated the development of cancer vaccines, with early clinical trials showing promising outcomes. Personalised neoantigen-based vaccines have been developed, tailored to individual patients, demonstrating unprecedented levels of vaccine-specific immune responses.
However, despite the enthusiasm for neoantigen vaccines, there are challenges to their implementation. Neoantigen selection, adjuvants, and the immunosuppressive tumour microenvironment can limit their efficacy. Additionally, the costs and time involved in developing personalised immunotherapies need to be improved.
Nevertheless, with further research and advancements in next-generation sequencing and bioinformatics, neoantigen vaccines hold significant potential for inducing long-lasting tumour control and improving clinical efficacy against advanced solid tumours.
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Side effects
Cancer vaccines are substances made in the lab that strengthen the body's natural defence mechanisms to protect itself. There are two main types of cancer vaccines: preventive vaccines and therapeutic cancer vaccines. Preventive vaccines boost the body's natural ability to defend against foreign invaders, such as bacteria and viruses. Therapeutic cancer vaccines, on the other hand, are used to treat cancer after it occurs. They train the body to protect itself against its own damaged or abnormal cells, including cancer cells.
Therapeutic cancer vaccines expose the immune system to molecules called antigens that are associated with a specific type of cancer. The immune system can then recognize and destroy the cancer cells. However, it can be challenging to find antigens that are cancer-specific. If the antigen exists on both normal and abnormal cells, the vaccine may attack the healthy cells as well, leading to unwanted side effects.
Additionally, the size of the tumour can impact the effectiveness of therapeutic cancer vaccines. Larger tumours have more immune-suppressive cells, which can hinder the ability of immune cells to attack them. As a result, vaccines may be combined with other treatments to improve their effectiveness. Furthermore, some individuals with weakened immune systems, such as older people or those with cancer, may not respond adequately to a vaccine, even if the immune cells receive the vaccine's signal.
While cancer vaccines have shown promising results, it is crucial to closely monitor side effects during treatment. Patients should promptly report any changes or unusual symptoms to their cancer care team for early intervention and management.
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Frequently asked questions
The 4 types of cancer vaccines are preventive vaccines, therapeutic vaccines, DNA vaccines, and mRNA vaccines.
Preventive cancer vaccines work by killing viruses that may lead to cancer. They boost the body's natural ability to defend against foreign invaders, like bacteria and viruses. Examples include the HPV and HBV vaccines.
Therapeutic cancer vaccines train the body to protect itself against its own damaged or abnormal cells, including cancer cells. They expose the immune system to molecules called antigens that are associated with specific types of cancer, enabling the immune system to recognize and destroy cancer cells.
DNA vaccines are made with bits of DNA from cancer cells. They are designed to make the immune system better at reacting to and destroying cancer cells by stimulating the body to produce antibodies against them.
Yes, mRNA-based cancer vaccines are currently being tested in clinical trials, with one entering phase III. Building on the success of mRNA vaccines during the COVID-19 pandemic, mRNA cancer vaccines hold great promise.
