From cancer vaccines to new generation radio-therapy: the breakthroughs that could save millions

Had we not had the Covid pandemic, thousands of cancer patients may still be waiting for the breakthrough in medicine which would save their lives. As it is, thirty hospitals have so far signed up to the Cancer Vaccine Launch Pad which will match patients with vaccine trials drawing on mRNA technology used to create current Covid jabs.

Designed to prime the immune system to recognise and destroy any remaining cancer cells and reduce the risk of the disease recurring in years to come. More than 200 patients in the UK, Germany, Belgium, Spain and Sweden will be recruited to the trial and will receive up to 15 doses of the personalised vaccine. The study is not due to be completed until 2027, but Dr Victoria Kunene, trial principal investigator from Queen Elizabeth Hospital Birmingham, told the BBC: “I think this is a new era. The science behind this makes sense.”

The truth is, cancer has never been so survivable. The facts speak for themselves. In the 1970s, only one in four people in the UK survived their cancer for a decade or more. Today, at least half of cancer patients will do the same. Figures from 2020 show that more than 75 per cent of people with cancer survived at least one year after diagnosis. And thanks to astonishing scientific breakthroughs, things will only get better.

As one in two of us will face a cancer diagnosis in our lifetime, this is very good news. Professor Kristian Helin, chief executive of The Institute of Cancer Research London (ICR), says: “We are living in an era of incredible scientific and technological innovation. We can now see the disease in unprecedented detail, uncovering how it changes and evolves and discovering potential new routes to treatment.

“Smarter and faster diagnostics are bringing dramatic improvements in early detection and artificial intelligence is revolutionising our ability to analyse complex scans and spot subtle abnormalities that could signal cancer.”

With treatments rapidly advancing – personalised medicine based on genetic testing, targeted drugs and tailored immunotherapies, and cutting-edge radiotherapies that spare healthy tissue surrounding tumours – you can see why more people are feeling hopeful.

Kevin Harrington, honorary consultant oncologist at the Royal Marsden and St George’s Hospital in London says, “In 20 years, I confidently expect we will cure substantially larger numbers of cancer patients with far smarter and kinder treatments than current approaches.”

Dame Kate Bingham, the pandemic vaccine tsar, recently said that she envisaged a future in which people will be able to get a blood test to look for signs of early cancer, then a vaccine to cure it. Science fiction? No.

With the current trials now underway, experts believe these vaccines could be widely available to all within the next decade. We tend to think of vaccines as jabs we have when we are healthy to prevent diseases from ever occurring. But a more accurate definition of a vaccine is a treatment that teaches our immune system to fight specific diseases. And these diseases now include cancer.

The cancer vaccines currently being developed and trialled employ the same mRNA technology made famous by Covid-19 vaccines. A trial of the world’s first “personalised” mRNA vaccine is now underway in the UK and will be completed in 2027.

Cancer Research UK is also funding another trial of a vaccine dubbed “LungVax”, which is the world’s first vaccine to prevent lung cancer in people with a high risk of the disease. Trials are also underway for patients with liver, kidney, bladder, bowel, pancreatic and breast cancer.

In the same way that traditional vaccines use part of a virus to train our bodies to fight disease, cancer vaccines use harmless proteins from the surface of cancer cells, known as neoantigens, as a target. The vaccine teaches the immune system to recognise these neoantigens on abnormal cells, so it can kill the cells and then recognise any stray remaining cancer cells and destroy them and so improve the chances of him being cancer free in years to come.

“Cancer is a disease of our own bodies and it’s hard for the immune system to distinguish between what’s normal and what’s cancer,” said Professor Tim Elliott, research lead for the LungVax project.

“If we can replicate the kind of success seen in trials during the pandemic, we could save the lives of tens of thousands of people every year in the UK alone.”

Cancer often kills when it recurs after initial treatment. The ultimate hope is that vaccines will train the immune system to destroy cancer cells before they have a chance to develop into tumours.

In 2022, news broke of another vaccine success story from the US. Author and poet Stephanie Gangi, 68, who lives in New York, was first treated for breast cancer in 1999, but her cancer returned. In 2021, a tumour the size of a grapefruit appeared on her adrenal gland. At this stage breast cancer is called metastatic and normally considered incurable. Yet today, scans show Gangi is cancer-free, thanks to a bespoke experimental vaccine that first destroyed the tumour and then taught her immune system to recognise and attack tumour cells in her body.

A new type of immunotherapy that targets non-cancerous cells could help prevent the growth and spread of breast cancer tumours, according to new research funded by the charity Breast Cancer Now and developed at the Toby Robins Research Centre at the ICR.

Scientists have found that targeting a protein called endosialin disrupts a tumour’s “food” or blood supply. The novel aspect of this treatment is that it doesn’t attack the cancer cells themselves, but the structures they need to survive.

This treatment may also have fewer side effects than traditional chemo and in experiments with mice, targeting endosialin successfully reduced the breast cancer’s growth and spread. The treatment has also been tested on lung cancer tumours with similar results, and other types of cancer could benefit in future. Being developed further, the hope is that this treatment can soon be tested in clinical trials.

A drug derived from oleic acid – which naturally occurs in olive oil – has shown promise for patients with an aggressive brain cancer called glioblastoma who often die one year after diagnosis.

Cancer cells are unique in having the ability to communicate via electrical signals that trigger deadly growth. This new drug alters the walls of cancer cells, preventing cells from “talking” to each other. It is the first new gliobastoma drug to be developed in 20 years and is currently being trialled in a global study on newly diagnosed patients.

Talk about artificial intelligence’s dangers has often overshadowed its lifesaving potential. But, a computer algorithm can process far more images far faster than any human, and as Prof Helin puts it: “Artificial intelligence is revolutionising our ability to analyse complex scans to spot subtle abnormalities that could signal cancer.”

In the process, it can learn to recognise tiny changes so cancer can be diagnosed earlier. A study published in The Lancet Oncology showed that AI could be around twice as accurate as an invasive biopsy at grading the aggressiveness of some sarcomas which develop in bones and soft tissues.

Research also suggests that the technology could recognise subtypes of the disease, speeding up diagnosis as a result and can rapidly learn which specific tumour types respond best to certain drugs which will stop the delay and trauma of trial-and-error failures. TRACERx is a major £14m research programme into lung cancer, led by Cancer Research UK, which will use AI to help identify patients who could benefit from trials of new targeted treatments.

Radiotherapy is an important curative treatment for cancer, but treatments can cause permanent damage to healthy cells. New types of radiotherapy could be far quicker, more targeted and safer.

One type, stereotactic body radiotherapy, could cut treatment time for prostate cancer patients by up to 75 per cent, reducing it from a month to just a week. Another treatment in development, FLASH radiotherapy, is delivered a thousand times faster than conventional radiotherapy. This intensity damages the DNA in cancer cells but is up to 50 per cent less harmful to normal cells.

With FLASH, patients could tolerate much higher doses of radiotherapy and it could be used to treat cancers in sensitive organs such as the brain, lungs or gastrointestinal area and reduce side effects. FLASH is currently in trials but “could be routine within a decade”, says Dr Claire Bromley of Cancer Research UK.

Many cancers are driven by abnormal proteins in the body – mutated proteins that hijack the machinery of normal cells and cause them to proliferate out of control, create tumours and potentially spread through the body.

Scientists have created many protein-inhibiting drugs which effectively block the action of these deadly proteins. However, over time cancers often find ways around them. So, scientists came up with a better idea. Why not, instead of merely blocking the proteins, destroy them permanently?

Protein degraders do clever things like dissolving the biological “glue” that holds proteins together, so they can be disposed of by the body’s own natural rubbish disposal systems. A new potent protein degrader has been created at the ICR which can destroy a protein involved in B-cell lymphoma. It is now in trials and could form the basis of a revolutionary new cancer drug.

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Researchers at the University of Cambridge have discovered the immune cells in breast tissue of healthy women carrying BRCA1 or BRCA2 gene mutations show early signs of malfunction known as “exhaustion”.

Their studies suggest that the immune cells can’t clear out damaged breast cells, which can eventually develop into breast cancer and raise the possibility of using existing immunotherapy drugs as early intervention to prevent breast cancer from developing, in carriers of BRCA1 and BRCA2 gene mutations.

Studies are underway with mice, which, if effective, will be moved to a clinical trial in women carrying the “Angelina Jolie” mutations. If successful, drugs may be an alternative to the life-changing mastectomies currently offered to women to cut their risk of developing breast cancer.

This table-turning possibility is now becoming a reality. Scientists are working on a new breed of engineered viruses which can be injected into the heart of tumours and infect cancer cells causing them to explode and die, without infecting healthy tissues.

In a pleasing double whammy, infected cancer cells also become more “visible” to our immune system which then attacks them. Cancer viruses are being trialled on a number of different cancers including skin, eye, oesophageal and head and neck cancers with promising results. They could become available on the NHS within the next three to five years.