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Vaccine against cancer

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The Corona pandemic has helped the development of mRNA vaccines make a breakthrough. But this technology was originally developed to treat cancer. In an interview, Dirk Jäger explains when we can expect an mRNA vaccine against cancer.

Dirk Jäger is Head of the Department of Medical Oncology at Heidelberg University Hospital and a researcher at the German Cancer Research Center (DKFZ). (Credit: DKFZ)

The mRNA technology is world-famous thanks to Covid-19. However, it was originally researched in oncology. What is the state of play in the development of mRNA vaccines against cancer?

Cancer is a much more complex issue than a viral infection, because in cancer you have many millions of non-identical cells against you. Each cell looks a little different from the neighboring cell. To try to trigger an immune response there that attacks all the tumor cells is much more difficult. But still, there is quite promising data from mRNA vaccines in cancer. BioNTech will soon start a large trial in high-risk patients after colon cancer surgery. The trial will test an individualized RNA vaccine, i.e., one that is customized and made specifically for each patient, in combination with concomitant chemotherapy. If it turns out that the additional vaccination in combination with adjuvant chemotherapy is beneficial for high-risk patients, then such a trial could be the first step towards approval.

So we are talking about individualized vaccines against the return of a tumor?

Exactly, and a very large effort is being made for this. After the tumor biopsy, the patient's genome is sequenced and all genetic changes in the tumor cells are determined. This makes it possible to calculate which genetic changes lead to defective proteins that could be good targets for the immune system. And so, for each patient, a completely different composition of blueprints is produced as coding RNA. The vaccination looks formally similar, but with completely different content. Different blueprints are presented to each immune system.

When can we expect that such a vaccine could be approved?

It will take a few years, because such a study is designed for a longer period of time and it has to be observed whether a disease reoccurs or not.

This trial, you said, is aimed at colorectal cancer patients. Will there be other cancers for which mRNA vaccines are being developed?

Basically, the technology is universal. We read the genetic alteration of a tumor disease and try to build the right vaccine for that constellation. This is a process that is completely independent of the tumor entity. If this study is successful, there will soon be similar developments for breast cancer, pancreatic cancer and melanoma.

Has the development of an mRNA vaccine against covid-19 influenced the development of a vaccine against cancer?

That has been a big tailwind. We see the RNA vaccine is safe and well tolerated. The fear that's been floating around is that this is gene therapy. With vaccination, it means that instead of protein, you inject the coding RNA, and the muscle builds the protein, to which you develop an immune response. The principle is simple. And it is now accepted as a safe technology. Oncology research is doing very well.

Is it conceivable that mRNA technology could be used for other disease areas, and is there already research into this?

I see a very great potential. It is foreseeable that we will be able to produce other drugs in RNA form, with which the patient produces his own drug based on the blueprints. The whole field of highly individualized treatment will be served much more quickly with RNA technology. We plan to use tailored treatments based on a deep understanding of a disease. Research is already underway to partially reprogram certain immune cell populations in patients themselves using RNA and turn them into killer cells. The technology brings with it a huge field of options.

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