ideasIdea
Cancer interception vaccines for high-risk carriers
Vaccinate people with BRCA or Lynch mutations against the antigens their future cancers will express, before any cancer exists.
Lynch syndrome tumours share frameshift neoantigens; BRCA1 tumours are basal-like with predictable antigens. Nous-209 (Lynch) and alpha-lactalbumin vaccine (TNBC, Cleveland Clinic) are in early trials.
Confidence
15%–35%likelyOnCo editors (initial estimate), 2026-09-07 · Long trials with incidence endpoints; biologically attractive.
Hypothesis
Vaccination of Lynch carriers against recurrent frameshift peptides reduces adenoma and cancer incidence over 5 years.
Rationale
Immune system is intact, tumour burden zero, antigens predictable; prevention needs only modest efficacy to be cost-effective.
What would test it
Randomised placebo-controlled trial in Lynch carriers with colonoscopic adenoma incidence endpoint.
Maturity
early clinical