You can’t treat a heterogeneous disease with a homogeneous treatment. That was the takeaway message from Vaccinogen’s founder at the World Vaccines Congress Europe
Vaccine Nation caught up with Michael Hanna, the founder of Vaccinogen and creator of autologous patient-specific tumour cell vaccine OncoVAX, to discuss why there have been so many high-profile cancer vaccine failures and how this has affected the development and funding of OncoVAX.
You laid into early attempts at therapeutic cancer vaccines in your presentation earlier, what was wrong with them:
Well, they were designed by oncologists for the most part, there was very little immunology put into them. They tried to make a vaccine that would fit the paradigm of one size fits all. So you take something of the shelf and you treat all patients with the same thing. That system works well for Big Pharma. They were trying to treat a heterogeneous disease with a homogeneous treatment. That just doesn’t work.
Second of all, for some reason the oncologists decided that they should treat advanced disease patients. Now I know where some of this came from, some of it came from the National Cancer Institute. When I was there, we used to bring in a large number of what we called ‘three year wonders’, Medical graduates who had just finished their residency and are ready to go out into the world, but want to do research in an academic setting. So they came to the NCI for three years trying to hit a home-run.
Now in advanced disease you can get an answer within three years, assuming you ask the right question. I remember distinctively after I had started and I had designed my autologous tumor cell vaccine study in stage 2 colon cancer, one of the top people in the NCI took me aside and said “big mistake, you should do it in advanced disease”. Of course as an immunologist I knew better, it would be analogous to treating a polio patient with the polio vaccine. But I didn’t say anything, I just did what I knew made sense from an immunological point of view. In fact today we know that contact inhibitors exist in established tumors which prevent anti tumor immunity. So whilst my study took 5 years, those other guys had negative studies in 3. It’s just a matter of transitioning. The oncologist wanted to treat the way they treated with chemotherapeutic drugs, dose until you cure the disease. In my case I showed that more is not better, in fact more is often worse.
The other way was that a lot of the companies had to go out and raise money, and investors don’t like more than three years return on their investment.
So that’s why I criticize the past cancer vaccine attempts. The trouble is there are companies out there still doing the same thing in spite of the greater than 75% failures.
Is there a medium between the two?
So we know that based on the intertumoral genomic heterogeneity, 1,2,or 3 common antigens won’t work. In colon cancer there are about 80 antigens on average. 80 mutations. So the medium would be at least half of them but today we cannot predict which half will woe, so we use autologous tumor cell vaccines to cover all the possible diversity and thus all the tumor antigens. So we get a robust and clinically effective immune response by covering all the bases.