This dialogue on personalised cancer vaccine on the horizon has been designed from the work of Ugur Sahin and Özlem Türeci from University of Marburg Germany to elucidate how interception of mRNA and AI could eradicate cancer like polio.
Prof. H.R. Ahmed
How does a turning point come into being?
It occurs dialectically at the crossing of a certain threshold of critical moments to move ahead.
How AI could be linked to unfold cancer vaccine?
It can hunt genetic mutation as a stimulus to transform a normal into a mutated cell.
What were treatment options decades ago?
Chemotherapy and irradiation were the options but with a degree of probability of improvement.
How is the landscape of cancer treatment now?
New medicines can target non-metastatic cancer cells with a high precision.
How is the treatment with metastatic cancer cells?
It remains out of reach of an effective therapy.
What makes metastatic cancer difficult to treat?
It lies in cancer itself. It originates from random mutations within healthy cells acquired over time.
What are triggers for mutations?
Lifestyle, familial predisposition, chronic disease, and environmental chemicals transform mutated cells into cancer ones.
What are implications from randomness?
First, every cancer is as unique as the individual it inflicts. It means the same type of cancer has only a fraction of shared mutations. Second, it is constantly learning to adapt, to evade the immune system and to resist therapeutic strategies.
How the tactic and strategies of cancer cells could be outmaneuvered?
Harnessing constantly learning force: the immune system consisting of billions of cells.
Is there a specificity of the system?
T cells stand out as nature’s vigilant sentinels patrolling our body.
Is the immune system evolutionary programmed?
Yes, it tackles external threats such as viruses and bacteria.
Are they programmed for the mutated normal cells before entering cancer regimen?
Only a tiny fraction of mutations garners the attention of the immune defense.
How the mutated normal cells could be programmed by the immune system?
Personalized cancer vaccines can be tailored instructing immune cells to launch multifaceted attack on the tumor. It is now the focus of extensive clinical trials.
Kulsoom Ghias
What are the steps in development of cancer vaccines?
Deciphering the genetic makeup of each patient’s cancer from a tiny biopsy by reading the DNA using NGST. Advance computing and AI algorithms would fish out the relevant mutations. The “Wanted” poster will be sent to the cells via the messenger RNA in the vaccine.
What is the significance of mRNA in this cancer vaccine?
It is nature’s primordial messenger. It can be designed within weeks to match the essence of time for cancer patients.
What is the evidence of success?
Personalized Cancer Vaccine PCP Trials have shown the feasibility in a smaller number of patients by activating and expanding T cells being capable of recognizing tumor cells based on select mutations. It is an essential prerequisite for the immune system to fight cancer. Recent clinical trials in melanoma and pancreatic cancer have shown the potential utility of personalized mRNA vaccines in reducing the risk of metastatic relapse after surgery.
Is there a comparative trial showing the difference in treatment with PCP to the current therapeutic standard of care?
Good question! The data on the horizon would inform us on the safety and effectiveness of PCV under development.
Advancement in science and technology often occurs in parallel silos. When they merge, what will happen?
The results can be groundbreaking. The merging of mRNA and AI exemplifies such an interception. It lays the foundation of transformative patient centric treatment of cancer.
How is AI functioning in this PCP model?
Its algorithms can quickly analyse massive genome data sets to identify patterns and correlations that are not picked by the traditional methods.
How can this method pick relevant cancer mutations among genetic variations?
This personalized mRNA vaccine is rapid and precise to pinpoint the relevant cancer mutations. As the global cancer data base grow, the predictions for the selection of mutations and the vaccine design for each patient are anticipated to continuously improve.
With all this in grip, how far are we from the medical future of PCV?
PCV must pass the stages of development and clinical trials to ensure a superior efficacy over existing therapies. It is anticipated that PCV to be in clinical practice by 2030. Since cancer is uniquely personal, it is high time its treatment became personal, too!
Referenced from work of Ungur Sahin and Özlem Türeci, who are pioneers as physician scientists in the field of mRNA vaccines and personalized cancer immunotherapies at the University of Mainz Germany.
Dedicated to Ruth Pfau for showing us how to treat leprosy with a legacy of establishing 150 centres across four provinces including rural and urban care.
- Authors are faculty professors at Aga Khan University Karachi and can be reached at kulsoom.ghias@aku.edu and hrahmad.alrazi@aku.edu
