These Next-Generation Vaccines Could Upend Cancer Treatment As We Know It

Ever since the first successful cowpox vaccine arrived in 1796, vaccination has become one of our most powerful tools against a barrage of dangerous infections from the invisible bacteria and viruses that lurk all around us.

In the past few centuries since the cowpox vaccine, society has shifted toward healthier lifestyles, better hygiene, and increasingly robust health care — steadily increasing our average life expectancy.

Despite this, instances of fatal illnesses, such as cancer and heart disease, have also risen dramatically. And as the United States population both swells and grows older, these conditions may become even more prevalent.

In fact, the annual number of cancer cases in the U.S. could increase by nearly 50 percent between 2015 and 2050, according to a 2021 study from the Centers for Disease Control and Prevention, with the greatest impact on people 75 and older.

Conditions that contribute to heart disease risks, like diabetes and hypertension, could also soar among the U.S. population in coming decades, a study published last year in the Journal of the American College of Cardiology found.

But we may have hope for these common ailments. Now, researchers are pouring their resources into creating vaccines for heart disease and cancer — Moderna, the massive biotech company behind one of the leading Covid-19 vaccines, claims it could even have these ready by 2030.

These tools could help stem the tide against the social and physical destruction these diseases reap and, in the process, aid researchers’ understanding of the body’s inner workings. But while they’ve sparked plenty of buzz, these groundbreaking vaccines may not be the magic cure-all many expect them to be.

Harnessing the immune system

Cancers can form for a number of reasons: genetic mutations, environmental factors, or even by chance. That’s partly what makes them so hard to study.

“Cancer is unique to the person who has it, and so technically, every cancer is different,” Lee Wilke, senior medical director of clinical oncology services at UW Health, tells Inverse.

And since tumors arise from abnormal cell growth, our immune systems often won’t recognize them as a threat and fail to defend the body against them. In recent years, though, researchers have made strides in developing innovative new treatments, with these high-tech shots among them.

Vaccines typically work by inoculating people against infectious diseases as a preventative measure. But a cancer vaccine would work much differently — likely as part of someone’s broader treatment. Some would offer a new, potentially more effective form of immunotherapy, which trains the immune system to combat these diseases.

Doctors could give patients these vaccines in combination with existing cancer therapies, like radiation or chemotherapy, to enhance chances of survival, Ravi Majeti, director of the Stanford Institute of Cell Biology and Regenerative Medicine at the Stanford School of Medicine, tells Inverse.

“Cancer vaccination, generally speaking, is not about preventing disease,” Majeti says. “It's about vaccinating individuals who already have the disease in a hope to try to get their immune systems to develop stronger reactions against the cancer.”

Moderna’s shots will work by harnessing a type of genetic material called mRNA to teach the body to make molecules called antigens that rev up one’s immune response. This process would likely begin by taking a biopsy of a patient’s cancer cells and sequencing the genes in a lab to pinpoint those mutations.

Then, immune cells turn the vaccine-introduced mRNA into protein pieces identical to the ones found in the tumor, and they instruct other immune cells to destroy cancer cells that carry the same proteins.

Besides these details, Moderna hasn’t revealed much other information yet — and the company didn’t respond to Inverse’s request for comment.

Other pharmaceutical companies known for their Covid-19 shots are also getting in on the action. BioNTech recently created a vaccine for pancreatic cancer that also relies on mRNA. Scientists just reported that the new shot prompted an immune response in half the patients who received it, and these individuals didn’t show any signs of relapse over about 18 months. While this was a tiny study — it included just 16 patients — the research community found the results promising.

Labs are also looking into vaccines to combat another common cause of death: Heart disease. Nearly a decade ago, a team at Harvard University announced they were working on a one-injection genome editing technique that could help lower cholesterol in mice by about 35 to 40 percent. In humans, it could potentially lower the risk of a heart attack by as high as 90 percent.

Since then, scientists from around the world have also jumped on the bandwagon with designs for a heart disease shot, with many targeting a gene in the liver called PCSK9. This gene tells the body how to make a protein that regulates the amount of cholesterol in the bloodstream, and some people have mutations in this gene that put them at higher risk for heart disease.

At the moment, patients can even receive an injection called Leqvio, which comes in two annual doses. It works by wielding small interfering RNA (siRNA), another type of genetic material, to reduce low-density lipoprotein cholesterol (also known as “bad” cholesterol) — a major risk factor in heart disease. It does this by blocking the PCSK9 protein, helping the body remove LDL cholesterol from the blood.

But Leqvio can’t do it all: Doctors recommend that people take it to supplement statin therapy and a healthy diet.

Shots of the future

Despite their promise, these shots are still decades (and a few billion more dollars) away. The researchers working on these vaccines will have to jump through a number of hoops before the Food and Drug Administration deems them safe and effective. But promising cancer vaccine trials have already kicked off.

Wilke, for instance, is the principal investigator for a breast cancer vaccine trial she’s running with colleagues from the University of Wisconsin School of Medicine and Public Health in Madison. The team is testing whether people who have received treatment for triple-negative breast cancer — a particularly aggressive form of the disease — respond to a DNA-based vaccine that could boost their immune systems and prevent reoccurrence.

While phase I and II of the trial are currently underway, Phase III, which will look at a much bigger patient population, may not arrive for about five years, Wilke says.

Heart disease vaccine research has also seen some recent progress. For example, a U.S. company called Vaxxinity announced in March that it had begun a Phase I trial with a vaccine that generates antibodies against PCSK9.

Ultimately, scientists can’t yet predict when these novel technologies might be widely available — but many researchers are excited about what new discoveries may yet hold for the future of medicine.

“The chronically, never-moving survival curves for Americans with cancer are starting to show real improvements in long-term survival,” Majeti says. “It's a real time to be hopeful, but there's a lot of work to do.”

The Cusp is a weekly Inverse series that offers a sneak peek at the science and technology that could power our future.