The concept of cancer vaccines has developed over the last century with initial promise from a young doctor, William Coley. In the late 19th to early 20th century Dr. Coley developed a treatment that elicited strong immune response. This elixir was referred to as Coley’s toxin, which comprised of bacteria that generated an inflammatory response in patients. As a result, the generated response recognized and targeted the patient’s tumor. However, his treatment did not yield consistent clinical benefit. He also had his critics among physicians. At the time, the scientific community debated how safe the toxin was and whether it really worked. Colleagues at Memorial Sloan Kettering and other top institutions questioned Coley’s motive for the toxin, since there was little empirical data or scientific basis for its use. Although Coley’s toxin proved to be an inconsistent treatment, it laid the foundation for future immunotherapies as preventative and therapeutic cancer vaccines were developed.
Cancer vaccines were limited in their ability to effectively treat patients with cancer. Preventative cancer vaccines are difficult to developed because of the uncertainty to predict the onset of mutations in patients. Currently, the only U.S. Food and Drug Administration (FDA) approved preventative cancer vaccine is for the Human Papillomavirus (HPV) vaccine. While it directly protects against HPV, the vaccine indirectly prevents a multitude of cancers, including cervical, anal, and genital. Additionally, researchers have previously struggled to generate a therapeutic vaccine that elicits a strong immune response with limited adverse effects. However, a reinvigorated interest has emerged in therapeutic vaccines due to improved delivery platforms and better biomarkers to target on cancer.
Recently, an article in Cell Reports Medicine, by Dr. Nina Bhardwaj and others, examined the evolution of cancer vaccines. Specifically, the paper focused on tumor biomarker-based vaccines, which are highly personalized and designed to target genetic mutations specific to a patient’s tumor. Bhardwaj is a physician scientist, the Ward-Coleman Chair in Cancer Research, and Director of Vaccine and Cell Therapy Laboratory at the Icahn School of Medicine at Mount Sinai. Her work focuses on improving vaccine strategies to provide strong single agent affect against tumors. Bhardwaj’s group studies different cellular pathways to understand how to therapeutically target cancer.
Previously, vaccines struggled to provide durable immunity in cancer patients. However, the advent of sequencing and computational analysis has allowed for advanced immune profiling to improve vaccine platforms and generate more effective immune responses. Bhardwaj and her team highlight the progression of treatment and cite clinical trial data demonstrating tumor biomarkers or neoantigen vaccines are safe and robust. Additionally, effective vaccine therapeutics have been applied to a wide range of cancers including melanoma, pancreatic cancer, glioblastoma, lung cancer, and bladder cancer. Cancer vaccines can also enhance other immunotherapies, which overcome treatment resistance and prolonged patient survival.
The article synthesizes decades of cancer vaccine research and identifies where vaccine develop can improve in the future. Bhardwaj and others draw insights from past and current clinical work to highlight emerging vaccination strategies. They also outline where cancer vaccines fit in standard-of-care therapy. Overall, scientists are optimistic that the medical field is making strides in cancer vaccine development and how current clinical trial research has the potential to improve patient survival and quality of life.
Article, Cell Reports Medicine, Nina Bhardwaj, Icahn School of Medicine, Mount Sinai