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Breast Cancer Vaccine

Breast Cancer Vaccine

Breast cancer vaccines are an active immunotherapy strategy designed to stimulate the patient’s immune system and help recognize and destroy tumor cells by presenting tumor-associated antigens (TAAs) and tumor-specific antigens (TSAs). The examination of pre-existing immune responses directed against tumours in cancer patients can yield valuable insights to inform the choice of targets for cancer vaccines and identify dependable responders.

Pink Eraser Project

The Pink Eraser Project is a nonprofit organization launched by breast cancer survivors Michele Young and Kristen Dahlgren, aiming to accelerate the development of a breast cancer vaccine. The project aims to bring together leading minds in breast cancer research, including doctors from prominent cancer centers, to create a vaccine that can prevent or slow the progression of breast cancer. The organization is led by Dr. Nora Disis, the director of the University of Washington’s Cancer Vaccine Institute, who has a breast cancer vaccine in early-stage trials with promising results.

Therapeutic mRNA Cancer Vaccines

Microenvironment Targeting Vaccine

A novel approach to breast cancer vaccination involves utilizing TME antigens over tumor cell antigens. These antigens are more stable and less susceptible to immune escape caused by antigen mutations, making immunotherapy more effective. Several prospective targets have been identified in pre-clinical models, such as whole-cell endothelial-based, EGFR-, CD105-, PDGFR-β-, and VEGF-targeting BC vaccines, as well as DNA-based fibroblast activation protein-alpha (FAP-α)-targeting vaccines.

Clinical Trials

  • Phase I Trial

A phase I trial evaluated the safety of a vaccine targeting the protein human epidermal growth factor receptor 2 (HER2), which is overexpressed in about 30% of breast cancers. The vaccine used a DNA-based approach, where the DNA instructions for a part of the HER2 protein are injected into the patient. It is well known that this intracellular portion elicits more potent cytotoxic immune responses.

The trial involved 66 women with metastatic breast cancer who had completed standard therapy and achieved complete remission or had slow-growing tumors. The participants were divided into three groups, each receiving three injections of the vaccine at different doses. The results showed that the vaccine was safe and generated a strong immune response to the HER2 protein, suggesting its potential for treating different types of breast cancer.

Future Directions

The findings from this trial are promising and will be evaluated in a larger, randomized clinical trial. The development of breast cancer vaccines is an active area of research, with ongoing investigations into various vaccine types, such as peptide vaccines, cell-based vaccines, bacterial or viral vector vaccines, and dendritic cell-based vaccinations. These studies aim to improve the selection of vaccine targets and delivery methods to enhance the effectiveness of breast cancer vaccines.

Immunotherapy for Breast Cancer

Immunotherapy has emerged as a critical component in the treatment of breast cancer, offering significant improvements in prognosis and survival rates. The mainstay of passive immunotherapy includes trastuzumab, pertuzumab, and trastuzumab emtansine (T-DM1), which have been shown to be effective in both metastatic and adjuvant settings. Active specific immunotherapy, such as cancer vaccines, also holds promise, particularly in the adjuvant setting, where they can potentially elicit long-term immune responses and prevent disease recurrence.

Hormone therapy for Breast Cancer

Hormone therapy is a common treatment for hormone receptor-positive (HR+) breast cancer, which accounts for about two-thirds of all breast cancer cases. It functions by preventing progesterone and oestrogen from promoting the growth and metastasis of cancer cells.

There are several types of hormone therapy drugs used to treat breast cancer:

  • Selective estrogen receptor modulators (SERMs) like tamoxifen block estrogen from attaching to cancer cells. Tamoxifen is often used for 5-10 years after surgery to reduce the risk of recurrence.
  • Aromatase inhibitors (AIs) like anastrozole, letrozole and exemestane lower estrogen levels in postmenopausal women by blocking the aromatase enzyme that converts other hormones into estrogen. AIs are often used for 5 years after surgery or after 2-3 years of tamoxifen.
  • Estrogen receptor down-regulators (SERDs) like fulvestrant block and degrade estrogen receptors, preventing estrogen from stimulating cancer cell growth.

Hormone therapy is commonly used after surgery (adjuvant therapy) to reduce recurrence risk. It may also be used before surgery (neoadjuvant therapy) to shrink tumors and allow less extensive surgery. For metastatic disease, hormone therapy can help control cancer growth and progression.

Side effects vary by medication but may include hot flashes, night sweats, joint pain, fatigue, and increased risk of blood clots or uterine cancer with tamoxifen. Hormone therapy is an effective treatment that can significantly improve outcomes for hormone receptor-positive breast cancer patients.

FAQ’s

1: What percentage of breast biopsies are cancer?

The percentage of breast biopsies that are cancerous varies but generally ranges from 20% to 40%. For women aged 40 to 49 years, 20% of breast biopsies show breast cancer. For women aged 50 to 59 years, 32% of biopsies are positive for cancer. For women 60 years and older, 42% of biopsies are cancerous.

2: What type of breast cancer has the highest reoccurrence rate?

The types of breast cancer with the highest recurrence rates are inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC). IBC has a recurrence rate as high as 50%, while TNBC has a nearly three-fold higher risk of recurrence within five years compared to other cancer types.

3: Why is left breast cancer more common?

Left breast cancer is more common than right breast cancer, although the exact reasons behind this phenomenon are not fully understood. This discrepancy has been explained by a number of theories, including:

  • Breast Size: The left breast tends to be slightly larger than the right breast, which could lead to a higher chance of cell division and mutations that result in cancer.
  • Self-Examination Habits: Right-handed individuals may be better able to detect lumps in their left breast due to their dominant hand, leading to earlier detection and diagnosis of left-sided breast cancer.
  • Breastfeeding: Some studies suggest that breastfeeding from the right breast more often than the left breast could contribute to the higher incidence of left-sided breast cancer. This could be due to hormonal imbalances and tissue damage from incomplete emptying of the left breast.
  • Random Chance: It is also possible that the difference in breast cancer prevalence between the left and right breasts is simply due to random chance and does not have an underlying biological explanation.

These theories are speculative and require further research to fully understand the underlying causes.

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