{"format":{"id":"vaccine","name":"Cancer vaccines","blurb":"An antigen to teach the immune system and a platform to deliver the lesson: mRNA in lipid nanoparticles, peptides, DNA plasmids, viral vectors, dendritic cells, whole cells or virus-like particles.","route":"/modalities/vaccine/","engine":"/pipeline/engine/vaccine/"},"counts":{"drugs":25,"approved":5,"phase3":9,"trials":14,"companies":23,"papers":11,"ideas":24,"eras":11},"how":{"paragraphs":["A vaccine made for one patient, encoding the unique mutations in their own tumour, to train the immune system to hunt it.","Tumour and normal DNA are sequenced, neoantigens are predicted computationally (up to 34 epitopes), and a patient-specific mRNA is made in lipid nanoparticles for dendritic cell presentation and T-cell priming, usually with PD-1 blockade."],"from":[{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/"}],"technologies":[{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/","status":"phase-3","tldr":"A vaccine made for one patient, encoding the unique mutations in their own tumour, to train the immune system to hunt it."},{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/","status":"phase-3","tldr":"Off-the-shelf cancer vaccines target antigens shared across patients, such as mutant KRAS or HER2 peptides, so they are made in advance rather than per person. Sipuleucel-T is still the only approved therapeutic cancer vaccine in the US; tolerance to self-antigens and weak past results hold them back."},{"id":"dendritic-cell-vaccines","kind":"technology","name":"Dendritic cell vaccines","route":"/technologies/dendritic-cell-vaccines/","status":"approved","tldr":"Vaccines made from a patient's own antigen-presenting cells loaded with tumour proteins; sipuleucel-T for prostate cancer was the first approved, and newer versions are tested in brain and other cancers."},{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/","status":"standard-of-care","tldr":"Vaccines that prevent the viral infections behind cervical, throat, anal, and liver cancers. The most effective anti-cancer intervention ever created."},{"id":"interception-vaccination","kind":"technology","name":"Cancer interception vaccines","route":"/technologies/interception-vaccination/","status":"phase-2","tldr":"Cancer interception vaccines immunise people who do not yet have cancer but carry a high inherited risk, such as Lynch syndrome carriers, against the antigens their future tumour is predicted to express, so memory T cells remove transformed cells early. Because healthy people accept risk for a probabilistic benefit, the safety bar is far higher and trials take years."},{"id":"bacterial-vector-vaccines","kind":"technology","name":"Bacterial vector cancer vaccines","route":"/technologies/bacterial-vector-vaccines/","status":"phase-2","tldr":"Weakened bacteria such as Listeria engineered to carry tumour antigens, using the body's strong response to infection to train T cells against cancer."},{"id":"mrna-lnp-manufacturing","kind":"technology","name":"mRNA and lipid nanoparticle manufacturing","route":"/technologies/mrna-lnp-manufacturing/","status":"phase-3","tldr":"An mRNA cancer vaccine is made without cells: a DNA template is copied into RNA by an enzyme in a tank, cleaned up, and wrapped in tiny fat bubbles. For personalised vaccines the whole run is done once for each patient, against that patient's own tumour mutations, in a few weeks."},{"id":"plasmid-dna-manufacturing","kind":"technology","name":"Plasmid DNA and mRNA raw-material manufacturing","route":"/technologies/plasmid-dna-manufacturing/","status":"established","tldr":"Plasmid DNA and mRNA raw materials are the DNA templates and enzymes behind viral vectors and mRNA vaccines. They are invisible to patients but decisive for supply."}]},"terms":[{"id":"neoantigen","kind":"term","name":"Neoantigen","route":"/terms/neoantigen/","tldr":"A protein fragment created by a tumour mutation that the immune system has never seen before, so it can attack it without harming normal cells.","category":"Immunology"}],"engine":{"route":"/pipeline/engine/vaccine/","axes":["Antigen","Platform"],"rows":12,"cols":9,"counts":{"approved":2,"development":11,"stopped":2,"unclear":0,"untried":94},"placed":21,"total":25,"pct":84},"approved":[{"drug":{"id":"hpv-quadrivalent-vaccine","kind":"drug","name":"HPV quadrivalent vaccine (types 6, 11, 16 and 18)","route":"/drugs/hpv-quadrivalent-vaccine/"},"brand":"Gardasil","status":"approved","modality":"Recombinant virus-like particle vaccine","cancers":[{"id":"cervical","kind":"cancer","name":"Cervical cancer","route":"/cancers/cervical/"},{"id":"vulvar","kind":"cancer","name":"Vulvar cancer","route":"/cancers/vulvar/"},{"id":"anal","kind":"cancer","name":"Anal cancer (squamous cell carcinoma)","route":"/cancers/anal/"}],"indications":["Prevention of cervical, vulvar and vaginal cancers and precancers and genital warts caused by HPV 6, 11, 16 and 18 in females 9 to 26 (males 2009; anal cancer 2010); superseded by Gardasil 9","Prevention of premalignant genital lesions, cervical cancer and genital warts from age 9 (Gardasil); anal lesions and cancer added later"],"years":[2006],"firstYear":2006,"regions":["US","EU"],"target":{"key":"antigen","id":"hpv","name":"HPV antigens (L1, E6, E7)","href":"/technologies/hpv-vaccine/"},"companies":[{"id":"merck","kind":"company","name":"Merck & Co. (MSD)","route":"/companies/merck/"},{"id":"shanghai-bovax-biotechnology","kind":"company","name":"Shanghai Bovax Biotechnology","route":"/companies/shanghai-bovax-biotechnology/"}]},{"drug":{"id":"hpv-bivalent-vaccine","kind":"drug","name":"HPV bivalent vaccine (types 16 and 18)","route":"/drugs/hpv-bivalent-vaccine/"},"brand":"Cervarix","status":"approved","modality":"Recombinant virus-like particle vaccine (adjuvanted)","cancers":[{"id":"cervical","kind":"cancer","name":"Cervical cancer","route":"/cancers/cervical/"}],"indications":["Prevention of premalignant cervical lesions and cervical cancer caused by HPV 16 and 18 from age 9 (Cervarix); anal lesions added later","Prevention of cervical cancer and precursor lesions caused by HPV 16 and 18 in females 10 to 25 (discontinued in the US 2016)"],"years":[2007,2009],"firstYear":2007,"regions":["EU","US"],"target":{"key":"antigen","id":"hpv","name":"HPV antigens (L1, E6, E7)","href":"/technologies/hpv-vaccine/"},"companies":[{"id":"gsk","kind":"company","name":"GSK","route":"/companies/gsk/"}]},{"drug":{"id":"sipuleucel-t","kind":"drug","name":"Sipuleucel-T","route":"/drugs/sipuleucel-t/"},"brand":"Provenge","status":"approved","modality":"Autologous cellular immunotherapy (antigen-presenting cell vaccine)","cancers":[{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"},{"id":"prostate-mcrpc","kind":"cancer","name":"Metastatic castration-resistant prostate cancer","route":"/cancers/prostate-mcrpc/"}],"indications":["Asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer","Same (withdrawn 2015 for commercial reasons)"],"years":[2010,2013],"firstYear":2010,"regions":["US","EU"],"target":{"key":"antigen","id":"pap","name":"Prostatic acid phosphatase (ACP3, PAP)","href":"/targets/pap/"},"companies":[{"id":"dendreon","kind":"company","name":"Dendreon","route":"/companies/dendreon/"}]},{"drug":{"id":"gardasil-9","kind":"drug","name":"Nonavalent HPV vaccine","route":"/drugs/gardasil-9/"},"brand":"Gardasil 9","status":"approved","modality":"Prophylactic vaccine (virus-like particles)","cancers":[{"id":"cervical","kind":"cancer","name":"Cervical cancer","route":"/cancers/cervical/"},{"id":"head-and-neck","kind":"cancer","name":"Head and neck squamous cell carcinoma","route":"/cancers/head-and-neck/"},{"id":"anal-hsil-precursor","kind":"cancer","name":"Anal high-grade squamous intraepithelial lesions (precursor)","route":"/cancers/anal-hsil-precursor/"},{"id":"vaginal-squamous-cell-carcinoma","kind":"cancer","name":"Vaginal squamous cell carcinoma (HPV-associated)","route":"/cancers/vaginal-squamous-cell-carcinoma/"}],"indications":["Prevention of HPV-related cancers and precancers, ages 9-26; extended to 45 in 2018","Single-dose schedule recommended for girls 9-20"],"years":[2014,2022],"firstYear":2014,"regions":["US","WHO"],"target":{"key":"antigen","id":"hpv","name":"HPV antigens (L1, E6, E7)","href":"/technologies/hpv-vaccine/"},"companies":[{"id":"merck","kind":"company","name":"Merck & Co. 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97%.","via":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"paper-basu-single-dose-hpv-lancet-oncol-2021","kind":"paper","name":"Vaccine efficacy against persistent HPV 16/18 infection at 10 years after one, two and three doses of quadrivalent HPV vaccine in girls in India","route":"/key-papers/paper-basu-single-dose-hpv-lancet-oncol-2021/","year":2021,"journal":"Lancet Oncology","paperType":"observational","tldr":"Ten years after vaccination, Indian girls who had received a single dose of HPV vaccine were as well protected against the cancer-causing HPV types as those who had two or three doses, which let the world switch to one-dose programmes.","via":[{"id":"cervavac","kind":"drug","name":"CERVAVAC (quadrivalent HPV vaccine, India)","route":"/drugs/cervavac/"},{"id":"gardasil-9","kind":"drug","name":"Nonavalent HPV vaccine","route":"/drugs/gardasil-9/"},{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV 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vaccination almost eliminates cervical cancer when given before 17","route":"/key-papers/paper-hpv-vaccine-sweden-nejm-2020/","year":2020,"journal":"New England Journal of Medicine","paperType":"observational","tldr":"Among 1.7 million Swedish girls and women, quadrivalent HPV vaccination cut invasive cervical cancer by 88% when given before age 17 and by about half when given at 17-30.","via":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"paper-hpv-self-sampling-bmj-2018","kind":"paper","name":"Self-collected HPV samples are as accurate as clinician samples and reach women who never attend screening","route":"/key-papers/paper-hpv-self-sampling-bmj-2018/","year":2018,"journal":"BMJ","paperType":"meta-analysis","tldr":"A meta-analysis of 56 accuracy studies and 25 randomised trials found that self-sampled swabs tested with PCR detect precancer as well as clinician-taken samples, and mailing kits to under-screened women roughly doubles participation.","via":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"paper-kantoff-n-engl-j-med","kind":"paper","name":"Sipuleucel-T immunotherapy for castration-resistant prostate cancer","route":"/key-papers/paper-kantoff-n-engl-j-med/","year":2010,"journal":"New England Journal of Medicine","paperType":"rct","tldr":"Paper cited by one treatment page, indexed on Europe PMC as PubMed record 20818862 and published in New England Journal of Medicine; the citing page links this DOI, which is how the record was matched.","via":[{"id":"sipuleucel-t","kind":"drug","name":"Sipuleucel-T","route":"/drugs/sipuleucel-t/"}]},{"id":"paper-patricia-paavonen-lancet-2009","kind":"paper","name":"Efficacy of HPV-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis","route":"/key-papers/paper-patricia-paavonen-lancet-2009/","year":2009,"journal":"The Lancet","paperType":"rct","tldr":"In young women free of the two target virus types at vaccination, the bivalent vaccine prevented 93 percent of high-grade cervical precancers caused by those types, and it also protected against some related virus types it was not designed for.","via":[{"id":"hpv-bivalent-vaccine","kind":"drug","name":"HPV bivalent vaccine (types 16 and 18)","route":"/drugs/hpv-bivalent-vaccine/"},{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]}],"eras":[{"roadmap":{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-roadmap/"},"era":"1950-2000","title":"Tobacco, hepatitis B and the first chemoprevention","status":"historic","step":1,"route":"/roadmaps/prevention-roadmap/#story-step-0","refs":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"roadmap":{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-roadmap/"},"era":"2006-2020","title":"HPV vaccines, hereditary testing and the elimination goal","status":"historic","step":2,"route":"/roadmaps/prevention-roadmap/#story-step-1","refs":[{"id":"gardasil-9","kind":"drug","name":"Nonavalent HPV vaccine","route":"/drugs/gardasil-9/"}]},{"roadmap":{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-roadmap/"},"era":"2021-2026","title":"One dose, self-sampling and vaccines made where they are needed","status":"current","step":3,"route":"/roadmaps/prevention-roadmap/#story-step-2","refs":[{"id":"cervavac","kind":"drug","name":"CERVAVAC (quadrivalent HPV vaccine, India)","route":"/drugs/cervavac/"}]},{"roadmap":{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-roadmap/"},"era":"2030+","title":"Interception: vaccinating people who do not yet have cancer","status":"speculative","step":7,"route":"/roadmaps/prevention-roadmap/#story-step-6","refs":[{"id":"interception-vaccination","kind":"technology","name":"Cancer interception vaccines","route":"/technologies/interception-vaccination/"},{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/"}]},{"roadmap":{"id":"global-access-roadmap","kind":"roadmap","name":"Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation","route":"/roadmaps/global-access-roadmap/"},"era":"2018-2026","title":"Homegrown innovation in India and China","status":"current","step":4,"route":"/roadmaps/global-access-roadmap/#story-step-3","refs":[{"id":"cervavac","kind":"drug","name":"CERVAVAC (quadrivalent HPV vaccine, India)","route":"/drugs/cervavac/"}]},{"roadmap":{"id":"immunotherapy-roadmap","kind":"roadmap","name":"Immunotherapy roadmap: Coley's toxins → checkpoint inhibitors → engineered immunity","route":"/roadmaps/immunotherapy-roadmap/"},"era":"2028+","title":"Speculative","status":"speculative","step":5,"route":"/roadmaps/immunotherapy-roadmap/#story-step-4","refs":[{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/"}]},{"roadmap":{"id":"kras-roadmap","kind":"roadmap","name":"KRAS roadmap: undruggable → G12C → pan-RAS","route":"/roadmaps/kras-roadmap/"},"era":"2026-2029","title":"Approval and combinations","status":"emerging","step":4,"route":"/roadmaps/kras-roadmap/#story-step-3","refs":[{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/"}]},{"roadmap":{"id":"cure-paths","kind":"roadmap","name":"Paths to cures: interception, eradication, control","route":"/roadmaps/cure-paths/"},"era":"Interception: established","title":"What already prevents cancer","status":"historic","step":1,"route":"/roadmaps/cure-paths/#story-step-0","refs":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"roadmap":{"id":"cure-paths","kind":"roadmap","name":"Paths to cures: interception, eradication, control","route":"/roadmaps/cure-paths/"},"era":"Interception: next","title":"Vaccinating and monitoring people who do not yet have cancer","status":"emerging","step":2,"route":"/roadmaps/cure-paths/#story-step-1","refs":[{"id":"interception-vaccination","kind":"technology","name":"Cancer interception vaccines","route":"/technologies/interception-vaccination/"},{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/"}]},{"roadmap":{"id":"targeted-therapy-roadmap","kind":"roadmap","name":"Targeted therapy roadmap: imatinib → designed for resistance → the undruggable drivers fall","route":"/roadmaps/targeted-therapy-roadmap/"},"era":"2030+","title":"Forecasting resistance instead of waiting for it","status":"speculative","step":7,"route":"/roadmaps/targeted-therapy-roadmap/#story-step-6","refs":[{"id":"eli-002-7p","kind":"drug","name":"ELI-002 7P","route":"/drugs/eli-002-7p/"}]},{"roadmap":{"id":"tnbc-history","kind":"roadmap","name":"TNBC roadmap: from 'nothing to target' to ADC + immunotherapy first line","route":"/roadmaps/tnbc-history/"},"era":"2029+","title":"Speculative: cure for most, control for the rest","status":"speculative","step":6,"route":"/roadmaps/tnbc-history/#story-step-5","refs":[{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/"}]}],"ideas":[{"id":"idea-moon-hpv-vaccine-confidence","kind":"idea","name":"Community-tailored HPV vaccine confidence campaigns with school-based delivery","route":"/ideas/idea-moon-hpv-vaccine-confidence/","maturity":"being-tested-at-scale","tldr":"The HPV vaccine prevents most cervical cancer, but false safety claims have cut uptake in several countries. Rebuild confidence locally and deliver the vaccine in schools.","via":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"idea-moon-eliminate-infection-cancers","kind":"idea","name":"Eliminate infection-caused cancers: HPV, hepatitis B and C, H. pylori and EBV","route":"/ideas/idea-moon-eliminate-infection-cancers/","maturity":"being-tested-at-scale","tldr":"About one in eight cancers is caused by an infection we can vaccinate against, cure or eradicate. A concerted global programme could make those cancers rare within a generation.","via":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"idea-acc-hpv-self-sample-same-day-ablation","kind":"idea","name":"HPV self-testing with same-day treatment as the national cervical programme","route":"/ideas/idea-acc-hpv-self-sample-same-day-ablation/","maturity":"being-tested-at-scale","tldr":"Women can collect their own sample for the virus that causes cervical cancer; those who test positive can be treated the same day with a simple heat device. Done nationally, this could eliminate a disease that still kills hundreds of thousands of women a year.","via":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"idea-single-dose-hpv-self-sampling-elimination","kind":"idea","name":"Single-dose HPV vaccination plus HPV self-sampling to reach WHO elimination in low-income countries","route":"/ideas/idea-single-dose-hpv-self-sampling-elimination/","maturity":"being-tested-at-scale","tldr":"One shot for girls and a mail-in swab for women could hit the WHO 90-70-90 targets at a fraction of the cost of the traditional three-dose, clinic-based model.","via":[{"id":"gardasil-9","kind":"drug","name":"Nonavalent HPV vaccine","route":"/drugs/gardasil-9/"},{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"idea-prev-hpv-single-dose-switch-catchup","kind":"idea","name":"Switch every country to single-dose HPV vaccination and add catch-up to age 26","route":"/ideas/idea-prev-hpv-single-dose-switch-catchup/","maturity":"being-tested-at-scale","tldr":"One dose of HPV vaccine protects as well as two or three. Halving the doses frees supply to vaccinate far more girls, boys and young adults.","via":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"idea-moon-lynch-vaccine-phase3","kind":"idea","name":"A frameshift neoantigen vaccine for Lynch syndrome carriers as the first preventive cancer vaccine approval","route":"/ideas/idea-moon-lynch-vaccine-phase3/","maturity":"early-clinical","tldr":"People with Lynch syndrome have a very high lifetime cancer risk from a predictable set of mutations. Vaccinate them against those shared mutations before cancer appears.","via":[{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/"},{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/"}]},{"id":"idea-prev-lynch-frameshift-vaccine-rct","kind":"idea","name":"A randomised trial of a shared-antigen vaccine to prevent Lynch syndrome cancers","route":"/ideas/idea-prev-lynch-frameshift-vaccine-rct/","maturity":"early-clinical","tldr":"Lynch syndrome tumours share predictable mutations the immune system can target. A vaccine in early trials could be tested to see if it prevents polyps and cancers in carriers.","via":[{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/"}]},{"id":"idea-prev-therapeutic-hpv-vaccine-cin","kind":"idea","name":"A therapeutic vaccine to clear cervical precancer without surgery","route":"/ideas/idea-prev-therapeutic-hpv-vaccine-cin/","maturity":"early-clinical","tldr":"Precancer is treated by cutting away part of the cervix, which raises pregnancy risks. A vaccine that makes the immune system clear the infected cells would avoid surgery.","via":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"idea-interception-vaccines","kind":"idea","name":"Cancer interception vaccines for high-risk carriers","route":"/ideas/idea-interception-vaccines/","maturity":"early-clinical","tldr":"Vaccinate people with BRCA or Lynch mutations against the antigens their future cancers will express, before any cancer exists.","via":[{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/"}]},{"id":"idea-shared-kras-vaccine-adjuvant","kind":"idea","name":"Off-the-shelf KRAS vaccines after pancreatic cancer surgery","route":"/ideas/idea-shared-kras-vaccine-adjuvant/","maturity":"early-clinical","tldr":"Almost every pancreatic cancer shares one of a handful of KRAS mutations. A pre-made vaccine against them could be given to every patient after surgery.","via":[{"id":"autogene-cevumeran","kind":"drug","name":"Autogene cevumeran","route":"/drugs/autogene-cevumeran/"},{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/"}]},{"id":"idea-prev-hpv-vaccinate-at-screening","kind":"idea","name":"Offer HPV vaccination to women when they come for cervical screening or treatment","route":"/ideas/idea-prev-hpv-vaccinate-at-screening/","maturity":"early-clinical","tldr":"Adult women who missed the vaccine could get it at their screening visit. Vaccination around treatment for precancer also seems to cut recurrence.","via":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"idea-moon-neoantigen-vaccines-at-scale","kind":"idea","name":"Personalised cancer vaccines at commodity cost through fully automated manufacturing","route":"/ideas/idea-moon-neoantigen-vaccines-at-scale/","maturity":"early-clinical","tldr":"Vaccines tailored to each patient's tumour mutations are showing real benefit but cost a fortune to make. Automate the whole process so a personalised vaccine costs about as much as a course of chemotherapy.","via":[{"id":"autogene-cevumeran","kind":"drug","name":"Autogene cevumeran","route":"/drugs/autogene-cevumeran/"},{"id":"intismeran-autogene","kind":"drug","name":"Intismeran autogene","route":"/drugs/intismeran-autogene/"},{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/"}]},{"id":"idea-bio2-mrd-triggered-neoantigen-vaccine","kind":"idea","name":"Personalised vaccines given only when the blood test turns positive","route":"/ideas/idea-bio2-mrd-triggered-neoantigen-vaccine/","maturity":"early-clinical","tldr":"Individualised mRNA cancer vaccines take weeks to manufacture and work best against minimal residual disease. Making the vaccine at surgery and giving it only when a blood tumour DNA test turns positive matches both facts and concentrates the cost on the minority who will relapse.","via":[{"id":"autogene-cevumeran","kind":"drug","name":"Autogene cevumeran","route":"/drugs/autogene-cevumeran/"},{"id":"intismeran-autogene","kind":"drug","name":"Intismeran autogene","route":"/drugs/intismeran-autogene/"},{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/"}]},{"id":"idea-fund-shared-personalised-therapy-gmp","kind":"idea","name":"Shared modular GMP facilities for academic personalised vaccines and cell products","route":"/ideas/idea-fund-shared-personalised-therapy-gmp/","maturity":"early-clinical","tldr":"Personalised cancer vaccines and cell therapies need a manufacturing run for each patient, and universities cannot afford their own plants. Regional closed, automated, modular GMP facilities offering slots to academic trials at cost, with common release testing and a shared quality system, modelled on the UK Cell and Gene Therapy Catapult centre, would let academic groups run these trials.","via":[{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/"}]},{"id":"idea-bio1-clonal-neoantigen-vaccines","kind":"idea","name":"Vaccines aimed only at mutations shared by every tumour cell","route":"/ideas/idea-bio1-clonal-neoantigen-vaccines/","maturity":"early-clinical","tldr":"Personal cancer vaccines target a list of mutations, some present in only part of the tumour, so the tumour can escape by losing them. Restricting vaccines and T-cell products to clonal mutations shared by every tumour cell, identified by multi-region sequencing, should close that escape route.","via":[{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/"}]},{"id":"idea-bio1-omomyc-mrna","kind":"idea","name":"mRNA-delivered MYC decoy proteins instead of MYC inhibitors","route":"/ideas/idea-bio1-omomyc-mrna/","maturity":"preclinical-evidence","tldr":"A decoy protein can bind MYC's partner and block it. Delivering the instructions for that decoy as mRNA in a fat nanoparticle avoids having to inject the protein itself.","via":[{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/"}]},{"id":"idea-neoantigen-immunogenicity-rules","kind":"idea","name":"What makes a neoantigen actually immunogenic?","route":"/ideas/idea-neoantigen-immunogenicity-rules/","maturity":"preclinical-evidence","tldr":"Vaccines can now encode dozens of a tumour's mutations, but only a minority provoke useful T cells. Learning the rules would make vaccines smaller, cheaper, and stronger.","via":[{"id":"autogene-cevumeran","kind":"drug","name":"Autogene cevumeran","route":"/drugs/autogene-cevumeran/"},{"id":"intismeran-autogene","kind":"drug","name":"Intismeran autogene","route":"/drugs/intismeran-autogene/"},{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/"}]},{"id":"idea-fund-prevention-moonshot","kind":"idea","name":"A delivery-science moonshot for prevention we already own","route":"/ideas/idea-fund-prevention-moonshot/","maturity":"speculative","tldr":"Around four in ten cancers are preventable with tools that exist now. This would fund the hard, unglamorous work of getting vaccines, screening and tobacco control to everyone, paid on results.","via":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"idea-bio2-n-of-1-framework","kind":"idea","name":"A standing rulebook for one-patient treatments","route":"/ideas/idea-bio2-n-of-1-framework/","maturity":"speculative","tldr":"Sometimes a treatment must be designed for a single patient. Agreeing in advance what evidence and safety checks are needed would make that fast, fair and learnable.","via":[{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/"}]},{"id":"idea-prev-hpv-male-catchup-oropharynx","kind":"idea","name":"Catch-up HPV vaccination for men to prevent throat cancer","route":"/ideas/idea-prev-hpv-male-catchup-oropharynx/","maturity":"speculative","tldr":"HPV throat cancer now exceeds cervical cancer in some countries and mostly affects men, who were not vaccinated. Vaccinating men up to 45 could reduce it.","via":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"idea-bio1-mrna-intrabodies","kind":"idea","name":"Instruct tumour cells to make antibodies against their own oncoprotein","route":"/ideas/idea-bio1-mrna-intrabodies/","maturity":"speculative","tldr":"Deliver genetic instructions so the cancer cell itself manufactures a molecule that traps its driver protein inside the cell.","via":[{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/"}]},{"id":"idea-splice-neoantigens","kind":"idea","name":"Shared splice-derived neoantigens as off-the-shelf vaccine targets","route":"/ideas/idea-splice-neoantigens/","maturity":"speculative","tldr":"Mutations in the RNA splicing genes SF3B1, SRSF2 and U2AF1 produce the same mis-spliced proteins in patient after patient with MDS, CLL or uveal melanoma. If fragments of those proteins are displayed on common HLA molecules and seen by T cells, one off-the-shelf vaccine or TCR-T therapy could serve every SF3B1-mutant patient instead of being built per person.","via":[{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/"}]},{"id":"idea-fund-social-impact-bonds-prevention","kind":"idea","name":"Social impact bonds for cancer prevention, repaid from avoided treatment costs","route":"/ideas/idea-fund-social-impact-bonds-prevention/","maturity":"speculative","tldr":"Investors would fund vaccination and screening campaigns up front and be repaid by health systems only if the campaigns hit verified targets, turning future savings into money for prevention now.","via":[{"id":"hpv-vaccine","kind":"technology","name":"HPV & HBV vaccination","route":"/technologies/hpv-vaccine/"}]},{"id":"idea-bio1-resistance-mutation-vaccine","kind":"idea","name":"Vaccinate against the resistance mutation before it takes over","route":"/ideas/idea-bio1-resistance-mutation-vaccine/","maturity":"speculative","tldr":"Resistance often arrives as the same few mutations. Teaching the immune system to recognise them in advance could remove the escaping cells while they are still rare.","via":[{"id":"neoantigen-mrna-vaccine","kind":"technology","name":"Personalised neoantigen (mRNA) vaccines","route":"/technologies/neoantigen-mrna-vaccine/"},{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/"}]}],"manufacturing":{"sites":[{"id":"aldevron-fargo","name":"Aldevron Fargo","operator":"Aldevron (Danaher)","operatorRoute":"/companies/aldevron/","ownership":"cdmo","city":"Fargo, North Dakota","country":"US","capabilities":["plasmid-mrna"],"capabilityLabels":["Plasmid DNA and mRNA"],"drugs":[],"source":{"label":"Aldevron","url":"https://www.aldevron.com/"}}],"capabilities":["Plasmid DNA and mRNA"],"chain":{"id":"mrna","name":"mRNA and plasmid","summary":"Plasmid templates, enzymes and cap analogues, in vitro transcription, lipid nanoparticles, and a one-patient batch for each personalised vaccine.","route":"/manufacturing/#chain-mrna","technologies":[{"id":"plasmid-dna-manufacturing","kind":"technology","name":"Plasmid DNA and mRNA raw-material manufacturing","route":"/technologies/plasmid-dna-manufacturing/"},{"id":"mrna-lnp-manufacturing","kind":"technology","name":"mRNA and lipid nanoparticle manufacturing","route":"/technologies/mrna-lnp-manufacturing/"},{"id":"single-use-bioprocessing","kind":"technology","name":"Single-use bioprocessing systems","route":"/technologies/single-use-bioprocessing/"},{"id":"sterile-fill-finish","kind":"technology","name":"Sterile fill-finish and lyophilisation","route":"/technologies/sterile-fill-finish/"}],"companies":[{"id":"moderna","kind":"company","name":"Moderna","route":"/companies/moderna/"},{"id":"biontech","kind":"company","name":"BioNTech","route":"/companies/biontech/"},{"id":"merck","kind":"company","name":"Merck & Co. (MSD)","route":"/companies/merck/"},{"id":"aldevron","kind":"company","name":"Aldevron (Danaher)","route":"/companies/aldevron/"},{"id":"touchlight","kind":"company","name":"Touchlight","route":"/companies/touchlight/"},{"id":"thermo-fisher","kind":"company","name":"Thermo Fisher Scientific","route":"/companies/thermo-fisher/"},{"id":"lonza","kind":"company","name":"Lonza","route":"/companies/lonza/"}],"products":[{"id":"intismeran-autogene","kind":"drug","name":"Intismeran autogene","route":"/drugs/intismeran-autogene/"},{"id":"autogene-cevumeran","kind":"drug","name":"Autogene cevumeran","route":"/drugs/autogene-cevumeran/"}]},"technologies":[{"id":"mrna-lnp-manufacturing","kind":"technology","name":"mRNA and lipid nanoparticle manufacturing","route":"/technologies/mrna-lnp-manufacturing/","tldr":"An mRNA cancer vaccine is made without cells: a DNA template is copied into RNA by an enzyme in a tank, cleaned up, and wrapped in tiny fat bubbles. For personalised vaccines the whole run is done once for each patient, against that patient's own tumour mutations, in a few weeks."},{"id":"plasmid-dna-manufacturing","kind":"technology","name":"Plasmid DNA and mRNA raw-material manufacturing","route":"/technologies/plasmid-dna-manufacturing/","tldr":"Plasmid DNA and mRNA raw materials are the DNA templates and enzymes behind viral vectors and mRNA vaccines. They are invisible to patients but decisive for supply."}]},"drugs":[{"id":"adagloxad-simolenin","kind":"drug","name":"Adagloxad simolenin","route":"/drugs/adagloxad-simolenin/"},{"id":"algenpantucel-l","kind":"drug","name":"Algenpantucel-L","route":"/drugs/algenpantucel-l/"},{"id":"autogene-cevumeran","kind":"drug","name":"Autogene cevumeran","route":"/drugs/autogene-cevumeran/"},{"id":"bnt113","kind":"drug","name":"BNT113","route":"/drugs/bnt113/"},{"id":"cervavac","kind":"drug","name":"CERVAVAC (quadrivalent HPV vaccine, India)","route":"/drugs/cervavac/"},{"id":"dcvax-l","kind":"drug","name":"DCVax-L","route":"/drugs/dcvax-l/"},{"id":"doc1021","kind":"drug","name":"DOC1021","route":"/drugs/doc1021/"},{"id":"eli-002-7p","kind":"drug","name":"ELI-002 7P","route":"/drugs/eli-002-7p/"},{"id":"evm14","kind":"drug","name":"EVM14","route":"/drugs/evm14/"},{"id":"gi-6301","kind":"drug","name":"GI-6301","route":"/drugs/gi-6301/"},{"id":"glsi-100","kind":"drug","name":"GLSI-100","route":"/drugs/glsi-100/"},{"id":"grt-c901","kind":"drug","name":"GRT-C901","route":"/drugs/grt-c901/"},{"id":"grt-r902","kind":"drug","name":"GRT-R902","route":"/drugs/grt-r902/"},{"id":"hb-200","kind":"drug","name":"HB-200","route":"/drugs/hb-200/"},{"id":"hpv-bivalent-vaccine","kind":"drug","name":"HPV bivalent vaccine (types 16 and 18)","route":"/drugs/hpv-bivalent-vaccine/"},{"id":"hpv-quadrivalent-vaccine","kind":"drug","name":"HPV quadrivalent vaccine (types 6, 11, 16 and 18)","route":"/drugs/hpv-quadrivalent-vaccine/"},{"id":"ino-5401","kind":"drug","name":"INO-5401","route":"/drugs/ino-5401/"},{"id":"intismeran-autogene","kind":"drug","name":"Intismeran autogene","route":"/drugs/intismeran-autogene/"},{"id":"io102-io103","kind":"drug","name":"IO102-IO103","route":"/drugs/io102-io103/"},{"id":"neovax","kind":"drug","name":"NeoVax","route":"/drugs/neovax/"},{"id":"gardasil-9","kind":"drug","name":"Nonavalent HPV vaccine","route":"/drugs/gardasil-9/"},{"id":"ose2101","kind":"drug","name":"OSE2101","route":"/drugs/ose2101/"},{"id":"rindopepimut","kind":"drug","name":"Rindopepimut","route":"/drugs/rindopepimut/"},{"id":"rv001v","kind":"drug","name":"RV001V","route":"/drugs/rv001v/"},{"id":"sipuleucel-t","kind":"drug","name":"Sipuleucel-T","route":"/drugs/sipuleucel-t/"}],"note":"Every section is read from existing corpus records and names them (from, via, exemplars, refs); a section with nothing behind it is empty. Medicines of a format are the open drug engine's (/pipeline/engine/); technologies are listed in src/lib/modular-formats.ts. CC BY-NC 4.0, attribute Data from OnCo (onco.cc). Not medical advice."}