First coronavirus, now cancer: The technology used for new cancer vaccines

What normally takes 10 years was accomplished in 10 months. The urgent need for a vaccine during the coronavirus pandemic prompted hundreds of scientists around the world to search for a solution in record time. In addition to the millions invested and the unprecedented global collaboration, another factor was key: messenger RNA (mRNA) technology.

This molecule carries the instructions for creating a specific protein or a piece of virus, and once it enters the cell, the cellular machinery reads it and begins producing the desired protein or piece of virus. With COVID-19, the instructions allow the virus’s spike protein to be manufactured, which will be located and attacked by the immune system. Given the enormous potential of this technology, BioNTech and Moderna agreed to collaborate with the U.K. National Health Service (NHS) to develop a cancer vaccine using this method. Thousands of people are already participating in clinical trials around the world, and the tests are expected to be accepted by early 2026.

“Rather than giving you a piece of the virus directly, this technology gives you a model — a blueprint — in the form of RNA with instructions on what the abnormality looks like. It’s like a sniffer dog at an airport: you give it a sample so it knows what to look for,” explains the oncologist Lennard Lee, who is leading the project for the NHS and directs Oxford’s Ellison Institute of Technology.

Lee protected thousands of cancer patients by demonstrating that they could continue receiving chemotherapy during the pandemic. In 2020, the potential of the mRNA method was discovered: “It allowed the vaccine to be modified quickly to protect against different variants of the coronavirus, such as Alpha, Beta, or Omicron. Most of the vaccine remained the same; you just changed the instructions on how it looked.”

At the end of the pandemic, companies developing immunity treatments began to consider alternatives to redirect their investment. They focused on cancer, which is expected to increase by 47% over the next two decades, according to the Pan American Health Organization. The same institution recorded 10 million deaths from this disease worldwide in 2022.

The United Kingdom emerged as a good option to establish the project due to the rapid clinical trials it conducted during the pandemic, thanks to its cold storage and large-scale manufacturing facilities. Thus, it has signed an agreement with BioNTech to provide 10,000 patients with access to personalized cancer treatments by 2030. And with Moderna, it has agreed to a 10-year investment to build an innovation and technology center with the capacity to produce up to 250 million vaccines.

Genetics, AI and mRNA

To develop a new cancer vaccine, advances in three areas are coming together: vaccine technology, genetic sequencing, and artificial intelligence. Thanks to the latter, each base pair—the “rungs” that make up the characteristic ladder of DNA—of cancer can be analyzed, abnormalities identified, and these incorporated into the dose. And artificial intelligence, for example, makes it possible to rapidly analyze which of the 1,000 to 10,000 mutations or abnormalities that each cancer can have can be recognized by the immune system.

“The first step is to extract the patient’s tumor and perform genetic sequencing. That information is then fed into an artificial intelligence computer algorithm, which analyzes which cancer mutations the immune system can recognize. The third step is to manufacture a personalized vaccine for that individual and, finally, administer it,” Lee explains. Each dose is individually tailored to each patient’s body. A biopsy is taken, the tissue is sequenced, and then sent to pharmaceutical companies to design a dose tailored to their cancer. That preparation is of no use to anyone else.

Individualized immunity is making it possible to fight any type of cancer: lung, pancreatic, melanoma, kidney, brain tumors, colorectal, or bladder. “Vaccines are designed for people whose cancer has been detected early and removed. The problem is often that, from then on, they live with the constant worry of whether the cancer will return. What these vaccines do now is enter the immune system so it learns to recognize that specific cancer cell. This way, the body itself can monitor and control it, and the hope is that this will help prevent a relapse,” the oncologist points out.

Clinical trials

Because these are personalized doses, clinical trials can take longer than usual. Therefore, Lee launched the Cancer Vaccine Launch Platform at the end of 2022 to accelerate testing. And in January of this year, along with several other British oncologists, he released the first strategic report on progress in cancer vaccines, published by the Cambridge journal Prisms: Precision Medicine, from the University of Cambridge. Among other points, the document recommends that nations develop a modern trial infrastructure and involve the public in this development.

The result of these efforts has been thousands of volunteers undergoing Phase III clinical trials in hospitals in 25 countries on four continents. Among them is Spain, with six vaccination centers spread across Barcelona, Madrid, Málaga and Valencia. Leading the way is the United States with 34 hospitals, far ahead of the second-largest, Germany (12). “Trust has a lot to do with it. In 2020, the world was able to develop a vaccine in a single year. That changes mindsets. Now the question is: why can’t we also accelerate cancer vaccines? Progress is being made at great speed because people saw that the vaccine worked during the pandemic. It’s a very exciting time for science.”

After the results of the trials are released, the next step will be securing approval from regulatory agencies like the Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Lee forecasts that the trials will be approved and that, throughout next year, the vaccines will already be in use as “a more agile alternative to prolonged chemotherapy.” However, he notes that the vaccines should not be seen as a substitute for traditional treatments, but rather as an essential addition to the arsenal of immunotherapy options.

How accessible and popular will the cancer vaccine be? “For now, no one knows for sure how much they will cost. On the one hand, vaccines are generally cheap to produce. But it’s also true that a national infrastructure capable of performing genomic sequencing of tumors is required, which represents an additional cost,” the British oncologist responds. The final price will be determined by pharmaceutical companies once the vaccines are approved.

Sign up for our weekly newsletter to get more English-language news coverage from EL PAÍS USA Edition