Dr Shivan Sivakumar explains how mRNA vaccines help us treat cancer, as we open Europe’s first site for pancreatic cancer vaccine trial.
The idea of creating vaccines containing mRNA is not a new one. Researchers have been working on their development for decades, but it was the advent of the Covid-19 pandemic that finally led to a breakthrough making mRNA vaccines a reality.
The majority of vaccines contain a dead or weakened form of the pathogen the vaccine aims to protect against, in order to trigger the body’s immune response. However, mRNA vaccines contain instructions for building a protein found on a virus or bacterium. When a patient receives the vaccine, their bodies decode the instructions and make one of these proteins, which is then recognised by the immune system as a foreign body. This kick starts the production of antibodies to destroy the protein. If the body later encounters the real form of a virus or bacteria, the immune system can reproduce these antibodies more rapidly, mounting an immune response before infection takes hold.
Before the pandemic there were numerous labs researching the potential of mRNA vaccines for cancer. Progress was steady, but slow. Thanks to the global doubling down of research efforts to address the urgent need created by Covid-19, the optimisation of mRNA vaccine structure, stability, and delivery methods were realised. Together with reduced manufacturing costs and more scalable production opportunities, the stage is now set to fully explore the potential for mRNA vaccines to treat the leading cause of death worldwide – cancer.
Cancer vaccines have the potential to make conventional immunotherapy, where we use the body’s own immune system to find and destroy cancer cells, more effective. This can be done in one of two ways.
The first way is through ‘off the peg’ immunotherapies such as mRNA-4359 which are mass produced vaccinations given to patients. Batches of the vaccine are made with specific cancers in mind.
Another approach being investigated is creating personalised mRNA vaccines, targeting the unique profile of cancer in each individual patient.
With personalised vaccines, a biopsy from a tumour is taken when the patient is undergoing their initial treatment. This tissue sample is sent away to a lab, where researchers will extract genetic information and build a personalised mRNA vaccine that, when administered, will teach the recipient’s body how to launch an immune response against the tumour if it returns.
Whilst regulatory bodies have not yet approved mRNA vaccines for use in any cancer; there are many clinical trials underway that have yielded promising results. For example, in April 2024 University College London Hospital launched a Phase 3 global trial of personalised mRNA immunotherapy for melanoma, following a Phase 2 study that found a 49% reduction in the risk of recurrence or death three years on from treatment.
This week we announce the opening of first-in-Europe trial of mRNA vaccines in pancreatic cancer.
As an honorary consultant in medical oncology focused on pancreatic, liver and biliary tract cancers, I am perhaps more familiar than most with the devastating nature of this disease. According to the charity Pancreatic Cancer UK, it is the 5th biggest cancer killer in the UK, with 9,000 deaths every year. Pancreatic cancer also has the lowest survival rates of all common cancers, with a five-year survival rate of less than 7%. Sadly, pancreatic cancer is typically diagnosed at a late stage, when curative surgery is no longer an option. The problem is exacerbated by the fact that for the ‘lucky’ 1 in 10 who are eligible for surgery, the recurrence rate of pancreatic cancer after surgical treatment is over 80%.
That’s why any potential breakthroughs in pancreatic cancer treatment are so crucial. With over 150 pancreatic cancer operations happening each year here in Birmingham, it’s a fantastic place to do translational research that will ultimately impact on patient care and outcomes.
If personalised mRNA vaccines are found to be successful at preventing pancreatic cancer reoccurrence, this could be life-changing for the 10,000+ pancreatic cancer patients diagnosed in the UK each year, their loved ones and many thousands more families affected around the world.
Dr Shivan Sivakumar
Associate Professor in Oncology at the University of Birmingham
Associate Professor in Oncology
Staff profile for Dr Shivan Sivakumar, Associate Professor in Oncology based in the Institute of Immunology and Immunotherapy, University of Birmingham.
