Top 6
6 Best Cancer Vaccines
Daria Polyakova,
Despite the fact that the results in the development of therapeutic vaccines are still very modest, the developers do not give up and continue research. So, at the World Vaccine Congress (World Vaccine Congress Washington), held in In Washington in April 2019, the "Best Therapeutic Vaccine" award was awarded to 6 projects from different companies:
- anti-cancer SNS-301 from Sensei Bio;
- CV8102 from CureVac for the treatment of melanoma and skin cancer;
- for use in pathology caused by human papillomavirus (HPV), from Advaxis;
- for use in pathology caused by HPV VGX-3100 from Inovio;
- mRNA-anticancer (mRNA) from Merck/Moderna for the treatment of pancreatic, lung, colon cancer;
- MVA-VLP-MUC1 for use in metastatic cancer from GeoVax.
Therapeutic vaccines, mainly antitumor, are designed to form a specific response to antigens specific to a particular type of tumor. The creation of anti-cancer vaccines is complicated by the fact that, unlike viruses, tumor cells are not always recognized by the body's immune system as foreign. More promising, from this point of view, are vaccines for use in malignant neoplasms pathogenetically associated with viruses (HPV, HIV), and those that cause an effective spontaneous immune response (kidney cancer, melanoma).
In this sense, the first and so far the only therapeutic vaccine approved by the US Food and Drug Administration (FDA), Provenge, intended for use in prostate cancer, stands out from the general series. Unlike the above, this malignant neoplasm practically does not regress spontaneously. Having received marketing authorization in the USA back in 2010, and in Europe in 2013, since 2015, however, it has already been withdrawn from the European market by the manufacturer Dendreon UK Ltd. The improvement in overall survival achieved by participants in clinical trials of the vaccine (with metastatic cancer, hormone-resistant type), compared with the control group, was only about 6 months, and 60 months (5 years) after randomization, less than 5% of patients from both groups remained alive. Provenge is obtained from autologous peripheral blood monocytes by activating them with antigens specific to this type of tumor.
Other therapeutic vaccines are still in development. So which of them are awarded the Best Therapeutic Vaccine? This is the SNS-301 from Sensei Bio, a private American biotech company. SNS-301 is the first in its class immunotherapy drug using viral vectors–bacteriophages targeted against cells expressing a specific tumor antigen called human aspartate β-hydroxylase (human aspartate β-hydroxylase - ASPH). Overexpression of this antigen is observed in more than 20 different malignant neoplasms. This gene drug, administered subcutaneously, has passed a phase I clinical trial only.
Also, only at the initial stages of development is the product of the German company CureVac – CV8102, which is based on a modified RNA designed to modulate the tumor microenvironment. Intended for intramuscular administration, the drug may be useful for patients with melanoma, cutaneous squamous cell carcinoma, squamous cell carcinoma of the head and neck and adenoid cystic carcinoma.
More research material has been accumulated regarding the immunotherapeutic vaccine ADXS-11, developed for the treatment of HPV-related pathology. Administered intravenously, it is the 16th type of virus included in inactivated non-pathogenic bacteria – listeria. This combination is able to trigger a T-cell immune response against HPV-loaded tumor cells. ADXS-11 is undergoing Phase II studies. According to the results of one of them, the 12-month survival rate of vaccinated patients was 38% (an improvement of 52% compared to the control literature data), which is a significant improvement compared to the results achieved in such patients with chemotherapy.
The VGX-3100 vaccine from the American company Inovio, which is already undergoing Phase III research, has advanced even further along the development path. Intended also for intramuscular administration, accompanied by electroporation technique, the vaccine may become the first of the clinically approved means for the treatment of cervical intraepithelial neoplasia associated with HPV types 16 and 18, without surgical interventions.
Moderna Therapeutics and Merck (MSD) started their mRNA vaccine research program only in 2017, but aimed at an oncogene very often involved in the process of oncogenesis in humans - KRAS. Thus, its increased expression is detected in 90% of patients with pancreatic oncopathology and 30% with non–small cell lung cancer. The mRNA-5671 vaccine targets the four most common types of KRAS mutations.
MVA-VLP-MUC1 is a vaccine based on viral vector technology aimed at the Mucin 1 (MUC1) antigen overexpressed in metastatic malignant neoplasms (breast, pancreatic, lung and ovarian cancers), has not even entered the phase of clinical trials yet.
Immuno–oncology is an extremely promising field in which a variety of types of vaccines are being studied: from autologous immune cells of the patient expressing tumor antigens, recombinant viral vaccines, peptide, DNA vaccines and heterologous whole-cell vaccines obtained from established human tumor cell lines. Within the framework of these approaches, various immunostimulating and adjuvant approaches are also being studied. They are also considering ways to purposefully overcome the immune barriers created by the tumor with the help of new immunosuppressants, for example, the recently approved ipilimumab (anti-CTLA-4) (Thomas S., Prendergast G.C., 2016). This opens up new prospects for vaccinologists seeking to control and prevent malignant neoplasms.
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