Millions of lives could be saved by a groundbreaking set of new vaccines for a range of conditions including cancer, experts have said. A leading pharmaceutical firm said it is confident that jabs for cancer, cardiovascular and autoimmune diseases, and other conditions will be ready by 2030.
Studies into these vaccinations are also showing “tremendous promise”, with some researchers saying 15 years’ worth of progress has been “unspooled” in 12 to 18 months thanks to the success of the Covid jab.
Dr Paul Burton, the chief medical officer of pharmaceutical company Moderna, said he believes the firm will be able to offer such treatments for “all sorts of disease areas” in as little as five years.
The firm, which created a leading coronavirus vaccine, is developing cancer vaccines that target different tumour types.
Burton said: “We will have that vaccine and it will be highly effective, and it will save many hundreds of thousands, if not millions of lives. I think we will be able to offer personalised cancer vaccines against multiple different tumour types to people around the world.”
He also said that multiple respiratory infections could be covered by a single injection – allowing vulnerable people to be protected against Covid, flu and respiratory syncytial virus (RSV) – while mRNA therapies could be available for rare diseases for which there are currently no drugs. Therapies based on mRNA work by teaching cells how to make a protein that triggers the body’s immune response against disease.
Burton said :“I think we will have mRNA-based therapies for rare diseases that were previously undruggable, and I think that 10 years from now, we will be approaching a world where you truly can identify the genetic cause of a disease and, with relative simplicity, go and edit that out and repair it using mRNA-based technology.”
But scientists warn that the accelerated progress, which has surged “by an order of magnitude” in the past three years, will be wasted if a high level of investment is not maintained.
The mRNA molecule instructs cells to make proteins. By injecting a synthetic form, cells can pump out proteins we want our immune system to strike. An mRNA-based cancer vaccine would alert the immune system to a cancer that is already growing in a patient’s body, so it can attack and destroy it, without destroying healthy cells.
This involves identifying protein fragments on the surface of cancer cells that are not present on healthy cells – and which are most likely to trigger an immune response – and then creating pieces of mRNA that will instruct the body on how to manufacture them.
First, doctors take a biopsy of a patient’s tumour and send it to a lab, where its genetic material is sequenced to identify mutations that aren’t present in healthy cells.
A machine learning algorithm then identifies which of these mutations are responsible for driving the cancer’s growth. Over time, it also learns which parts of the abnormal proteins these mutations encode are most likely to trigger an immune response. Then, mRNAs for the most promising antigens are manufactured and packaged into a personalised vaccine.
Burton said: “I think what we have learned in recent months is that if you ever thought that mRNA was just for infectious diseases, or just for Covid, the evidence now is that that’s absolutely not the case.
“It can be applied to all sorts of disease areas; we are in cancer, infectious disease, cardiovascular disease, autoimmune diseases, rare disease. We have studies in all of those areas and they have all shown tremendous promise.”
In January, Moderna announced results from a late-stage trial of its experimental mRNA vaccine for RSV, suggesting it was 83.7% effective at preventing at least two symptoms, such as cough and fever, in adults aged 60 and older. Based on this data, the US Food and Drug Administration (FDA) granted the vaccine breakthrough therapy designation, meaning its regulatory review will be expedited.
In February, the FDA granted the same designation to Moderna’s personalised cancer vaccine, based on recent results in patients with the skin cancer melanoma.
Burton said: “I think it was an order of magnitude, that the pandemic sped [this technology] up by. It has also allowed us to scale up manufacturing, so we’ve got extremely good at making large amounts of vaccine very quickly.”
Pfizer has also begun recruitment for a late-stage clinical trial of an mRNA-based influenza vaccine, and has its sights set on other infectious diseases, including shingles, in collaboration with BioNTech. A spokesperson for Pfizer said: “The learnings from the Covid-19 vaccine development process have informed our overall approach to mRNA research and development, and how Pfizer conducts R&D (research and development) more broadly. We gained a decade’s worth of scientific knowledge in just one year.”
Other vaccine technologies have also benefited from the pandemic, including next-generation protein-based vaccines, such as the Covid jab made by US-based biotechnology company Novavax. The jab helps the immune system thinking it is encountering a virus, so it mounts a stronger response.
Dr Filip Dubovsky, president of research and development at Novavax, said: “There has been a massive acceleration, not just of traditional vaccine technologies, but also novel ones that hadn’t previously been taken through licensure. Certainly, mRNA falls into that category, as does our vaccine.”
Dr Richard Hackett, CEO of the Coalition for Epidemic Preparedness and Innovations (Cepi) said the biggest impact of the pandemic had been the shortening of development timelines for many previously unvalidated vaccine platforms. He explained: “It meant that things that might have unspooled over the next decade or even 15 years, were compressed down into a year or a year and a half …”
Prof Andrew Pollard, director of the Oxford Vaccine Group and chair of the UK’s Joint Committee on Vaccination and Immunisation (JCVI), said: “There’s no doubt there’s a lot more interest in vaccines. The really big question is, what happens from here?”
With the looming threat of wider conflict in Europe, there is a risk that this focus on vaccines is lost, without capitalising on the momentum and technological insights that have been gained during the pandemic. Pollard, for one, believes this would be a mistake.
He said: “If you take a step back to think about what we are prepared to invest in during peacetime, like having a substantial military for most countries … Pandemics are as much a threat, if not more, than a military threat because we know they are going to happen as a certainty from where we are today. But we’re not investing even the amount that it would cost to build one nuclear submarine.”
