I was honored to be able to attend the San Antonio Breast Cancer Symposium in December and learn about so many things! As part of attending the Symposium as an Alamo Advocate Scholar, I was required to write a paper on a specific topic of interest to me or for Check for a Lump based on what I learned during the Symposium.
At Check for a Lump, we strive to have the most up-to-date information about breast cancer prevention as possible. I am constantly being asked about what the latest recommendations are, is there new technology available, what do I know about vaccines, and what else people can do to help them with prevention. While at the San Antonio Breast Cancer Symposium, I was able to attend sessions on several of these topics. For the purposes of this paper, I will be focusing on breast cancer vaccines. During the Symposium I was able to attend a session on Risk Reduction & Early Detection: New Directions in Breast Cancer Prevention, as well as view posters on vaccines. After the Symposium I read Dr. Olivera Finn’s article “Cancer vaccines: between the idea and reality” she wrote in 2003.
Dr. Olivera Finn, started her presentation by showing where we have been and where we are now in regard to cancer vaccine trials. Dr. Finn said at the beginning of her presentation “Our goal is to get you all excited about prevention and also to have sessions like this in future meetings in San Antonio and to fill up the ballroom. So, Let’s see if we’re going to be successful.”
I found it fascinating how the approaches to cancer vaccines have changed since 1980. From 1980-2010, the approach was to treat the patient with therapy and administer the vaccine after treatment, or “adjuvant therapy”. It was shown that giving the vaccines after therapy was not really working so the physicians and researchers needed to go back and rework the trials and studies to see when best to administer the vaccines for them to work the best. Starting in 2010 through the present time, vaccines are being used as prevention and interception of cancer, also known as the “Immunoprevention approach”. These trials have the vaccine being administered prior to a cancer diagnosis for high-risk patients and in DCIS (ductal carcinoma in situ) breast cancer patients.
Since 2010, vaccine trials focus on studying two things: interception and prevention of breast cancer. By vaccinating in the precancerous setting, this allows cancer development to be intercepted and to stop progression to invasive cancer. By vaccinating people at high risk for developing cancer, including but not limited to people with cancer causing gene mutations, it will prevent the cancer from developing. A new trial opened in February 2024 for MUC1 in DCIS breast cancers. For more information on this trial, or to join it, speak to your doctor and ask them to reach out to Dr. Finn at the University of Pittsburgh.
While there are many trials on breast cancer vaccines, the majority, 60%, have only made it into Phase I with only 4% making it to Phase III. In addition, the majority of the trials have been for metastatic cancer as well as for the MUC1 antigen. MUC1 is a protein found on the surface of many cells lining the organs. It acts as a protective barrier against infections in health cells. However, in cancer cells it often behaves abnormally; by overproducing causing cancers cells to grow and spread or by having structural changes in the cancer cell which allows the tumor to evade the immune system. According to one study, MUC1 has also been found in about 94.2% of cancer tissues in patients with triple-negative breast cancer (TNBC), therefore helping the TNBC cells evade the immune system and grow more aggressively.
Several vaccine trials in early breast cancer have shown promise for the clinical setting. According to one study out of the Medical University of Vienna and ABCSG, vaccines might not show they are working initially, they do show better overall disease-free survival rates at a seven year follow up when given alongside the routine standard of care treatment. This study is also the first one to show statistically significant promise with the therapeutic cancer vaccine for women with early breast cancer.
Dr. Finn finished her presentation with the statement “Testing vaccines in the pre-malignant setting and in high-risk settings is feasible. I just showed you the trials that are going on. There’s some others that are going on that I haven’t had a chance to mention, but it’s definitely feasible, and we would encourage retesting all these vaccines that have failed in the therapeutic settings, in a new setting, a setting of prevention and interception, because we can actually induce very high frequency and high levels of immune responses, and we can actually study what it takes to generate an immune response that will be protected in the future against cancer.”
So, what does all this mean?
Are cancer vaccines likely to be available to the general public soon?
Did Dr. Finn get us excited about the future of cancer vaccines?
All three are very good questions. Based on what I heard at the Symposium and read online since then, it is clear that the field is making progress. While many cancer vaccine trials are still in the early stages, their potential to transform breast cancer prevention and treatment is hopeful. The advances in the MUC1 vaccine trials and the long-term benefits of combining vaccines with standard of care treatments, suggests that cancer vaccines could become a baseline part of prevention and treatment for high-risk patients. I feel hopeful that we are getting closer to a future where cancer vaccines will be a key role in saving lives and improving overall survival for breast cancer patients and I do think that Dr. Finn was able to get us excited about the future of cancer vaccines.
References:
Risk Reduction and Early Detection: New Directions in Breast Cancer Prevention
Fri 13 Dec, 2024 - 12:30 PM-01:45 PM
Moderator by Gretchen GierachTopic 1: Prevention Vaccines: Where Are We Now and Where Are We Going by Olivera FinnTopic 2: Can We Use Biomarkers to Implement Prevention? by Seema KhanTopic 3: From Bench to Clinical Trial: A New Target for Breast Cancer Prevention by Geoffrey LindemanPanel Q&A by Olivera Finn, Seema Khan, Geoffrey Lindeman
Poster Spotlight 3: Highlights on Novel Therapeutics
PS3-03: Vaccination with MUC-1-Targeting Tecemotide Improves Survival of Patients Receiving Neo-Adjuvant Chemotherapy for Early Breast Cancer: Results from the Prospective Randomized ABCSG 34 Trial by Christian F. Singer
Poster Spotlight 12: Immunobiology Impact on Therapeutic Efficacy
PS12-06: An In Situ Tumor Vaccine Against Triple Negative Breast Cancer by Nicole McCuen
Cancer vaccines: between the idea and the reality
Olivera J Finn, PH.D.
Published: August 2003
Expression of MUC1 in different tumours and its clinical significance (Review)
Yue Lan, Weihua Ni, Guixiang Tai
November, 2022
