The vaccines that are currently in clinical trials for cancer, have passed safety standards and are being tested in real patients in phase 3, are all therapeutic vaccines. They are performed on diagnosed cancer patients and indeed with difficult cancers, such as aggressive stage 4 melanoma with metastasis, for which the most clinically advanced vaccine is being tested. I think the vaccines for the next few years will be very specific to very specific cancers, mostly solid, maybe hematologic, and they will definitely be curative.

The very interesting points he makes in an interview with Fm Agency, o director of Biochemistry at the Netherlands Cancer Institute, researcher at the Oncode Institute and professor at the University of Utrecht, Anastasis Perrakis, which even leaves open the possibility of future preventive vaccines. “Having preventive vaccines for patients with a very high probability of developing cancer for genetic reasons is not something we can rule out in the future. It is a possibility that is being discussed in the scientific community, however, these are not currently in the stage of clinical trials.” When asked whether the therapeutic vaccines that will be released in the first phase will be personalized, or will be addressed to larger groups of patients, the expert in structural biology and macromolecule structures for designing new anticancer drug leads, answers: “I believe both. At the moment, the vaccine that has been the most successful in aggressive melanoma, and for which clinical trials are also being conducted in Greece in four centers, as you have already written, is personalized. That is, it is based on biopsy of the tumor of specific patients. But many other vaccines, which are also in fairly advanced stages of testing, target groups of patients who have some specific subgroups of cancers, with specific characteristics, in specific organs.” Only the melanoma vaccine is in the final stage of clinical trials, in phase 3 at the moment, the professor says, then points out that there are studies on breast cancer, as well as many ideas on the pancreas, and the liver .

Hopes from immunotherapy for difficult tumors -2000 clinical trials underway

And the question that reasonably arises is whether the scientific community for these difficult cancers, in the pancreas, liver or brain, can hope for a vaccine, for better than the existing results. “Right now in all cancers and in those three that you say, along with lung of course, which have the most unfavorable outcomes in general, immunotherapy makes the big difference. That is, we use some component of our immune system, with various approaches that exist and this treatment has created a lot of hope. In fact, there are currently 2,000 immunotherapy clinical trials for different cancers. Vaccines are also a form of immunotherapy. We know this well from the coronavirus, where we make the vaccine so that our immune system is ready to fight the virus. In cancer it is a little different. We make the vaccine so that we somehow ‘command’ our immune system to immediately deal with the malignancy.” In the broader sense of immunotherapy, Mr. Perrakis emphasizes, there are huge developments for many cancers. “Many of these efforts are already in the clinic. They have changed the outcome of melanoma, many forms of cancer in the lung, even in the liver there is a big difference, but also in the brain we are starting to get results.”

By 2026 at the latest, the melanoma vaccine will be available if good phase 2 results are confirmed

As for the melanoma vaccine that is in the final phase of clinical trials, the professor is asked when it is expected to be released, if all goes well until the end. “Clinical trials last two to three years. In this case, they have already started six to nine months ago. Behind this vaccine is a behemoth pharmaceutical company that has access to decision centers, and if the results from a clinical perspective are as encouraging as we expect with phase 2 data, the regulatory part, which also takes time, should move forward. quickly. An optimistic prediction I would make is the summer of 2025. I would be very impressed if this vaccine is not widely available in 2026. Is there a chance that due to good results, trials can be stopped earlier than planned and a drug can be released more quickly? This happens; Mr. Perrakis is then asked: “It happens in very rare cases, when the clinical advantage of a treatment is clear, beyond doubt. We are not waiting for all the patients to finish. If, for example, the first hundred patients have a clearly better outcome than those who do not receive the vaccine, it is of course unethical to continue not giving the vaccine. And there are provisions within a very strict regulatory framework, to stop the tests even earlier.” Will vaccines be monotherapy? Or will they be used adjunctively with other cancer treatments, Mr. Perrakis was asked. “It is certain that these vaccines will be adjuvant. For example, the mrna vaccine for melanoma is given after the surgical removal of the tumor together with immunotherapy and acts adjuvantly, in the best response of the immune system. We expect the same in hematological cancers, where T lymphocyte therapy has great potential. There is also a great prospect for combining vaccines with cell therapy, mainly for hematological cancers, but not only”. On the role that artificial intelligence will play in the development of these vaccines, Anastasis Perrakis explains that there are some machine learning algorithms, which allow scientists more easily than before to analyze big data quickly.