“After 13 years since I began to dream of the use of therapeutic vaccines against cancer, I can say that I feel close to the realization of this extraordinary advance”. Close to the point that, “within the year, the one against melanoma could already be produced, which will then enter the experimental phase”.
The biologist Maria Rescigno, one of the leading scientists in the country engaged in the fight against cancer, holds the chair of General Pathology at the Humanitas University of Rozzano, near Milan, where he is vice rector with responsibility for research. He considers the program on melanoma – whose preclinical studies have given excellent results – as the forerunner of curative vaccines against cancer, which will be followed by that on sarcomas, which is already well advanced. Unlike preventive vaccines, which are used when the disease has not yet presented itself – such as those for viruses associated with tumors – therapeutics are used when the patient has already been diagnosed with cancer. Indeed, in this case when the disease is already metastatic.
Come does the vaccine work?
Its task is to reactivate the patient’s immune system so that it can recognize the tumor and attack it. There are two types of therapeutic vaccines: personalized ones, which identify the characteristics of the individual patient’s tumor and which are prepared ad hoc but with times often not compatible with the disease; and then the more “universal” ones, aimed not at the individual but at a specific pathology, and this is what we pursue. In this case we would have a remedy available to use immediately, already at the time of diagnosis.
It would be a novelty capable of changing the fight against cancer…
It’s a completely new approach. When the cell becomes cancerous, it is enriched with mutations and undergoes stress: in practice, it struggles to live with these mutations. And then it implements survival mechanisms linked to cellular stress. Here, just as she is stressed, she shows signs, “spies” on the surface; they are like “flags” that vary for each pathology: melanoma has some, sarcoma has others. Our job consists in identifying these flags, giving them “a name and a surname”, in order to create a vaccine that targets the cells that express them.
Who will benefit from it?
Our approach is universal. In research we have analyzed the cells of people with melanoma by identifying the “flags” common to several patients, in order to be able to prepare a vaccine for large groups of people.
Why did you focus on melanoma and sarcoma?
We chose melanoma because immunotherapy already works in 40% of cases in this tumour. In other words, it manages to activate those immune cells in our body that the tumor has somehow shut down. In the rest of the patients the therapy doesn’t work in part because the immune response was never turned on. Our research is aimed at them. We want to start the immune response using our vaccine in combination: that is, we want to allow the vaccine to trigger the response and the immune system to keep it active. The choice of sarcoma, on the other hand, is dictated by the fact that it is one of those tumors at the moment with scarce therapeutic options, and therefore has an enormous need for new therapies.
Why are you optimistic?
We have conducted both preclinical studies, which have given us very positive indications, and clinical studies on animal patients, i.e. on dogs that have spontaneously fallen ill with cancer. We are working with Professor Laura Marconato, of the veterinary clinic of the University of Bologna, studying two types of sarcomas: osteosarcoma and hemangiosarcoma, and now also melanoma. The results were also confirmed on animals.
What time do you expect to arrive at the man?
The melanoma vaccine, as far as we are concerned, will be ready by 2023. Phase 1 trials (the first of three that lead to the approval of the drug) should begin in mid-2024, we have already started the process with the institutions regulators. For sarcoma it will take a little more time because we have not completed the work of identifying the “flags”.
How long have you been working on it?
The idea dates back to 2010 but we have been working on it operationally since 2019, thanks to a substantial funding from the Airc, deriving from the funds of 5 per 1000. As many as 9 operating units belonging to Humanitas, the Milan Bicocca University, the University of Eastern Piedmont, and at the National Cancer Institute “Pascale” of Naples. Immunologists, molecular biologists, cell biologists, biochemists and oncologists are involved in the project.
Will it be possible to extend the use of your vaccine to other types of cancer as well?
Yes, because we have developed a platform for identifying these flags. In this sense, my experience of interaction with bacteria and work on the microbiota have been fundamental in “educating” and almost “deceiving” the immune system to convince it to take the malignant cells by surprise, finally made visible. Next year we will try the fruits of our human research.