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Can you vaccinate yourself against cancer?

Published on 22 February 2018 back to previous

Over several decades, cancer vaccines have emerged as a form of immunotherapy, a treatment approach that stimulates or restores the body's own immune system to either help prevent cancer from developing or help treat an existing cancer.
The HPV vaccine is among the best-known cancer preventive vaccines. It helps prevent human papillomavirus infections. Certain HPV infections are associated with cervix, vagina, vulva, penis, anus, rectum, and head and neck cancers.
As for cancer treatment vaccines, the first to be approved by the Food and Drug Administration in the United States is Provenge or sipuleucel-T, which harnesses a patient's own immune system to attack cancer cells. The vaccine is approved for use in some men with prostate cancer.
"Whether used for prevention of infectious diseases or for prevention and treatment of cancer, vaccines work by similar mechanisms: They teach the immune system how to recognize the infectious pathogen or the cancer cell as something foreign that needs to be eliminated," said Dr. Dmitriy Zamarin, a cancer immunologist at Memorial Sloan Kettering Cancer Center in New York who researches vaccines.
"In the case of cancer, various vaccine strategies teach the immune system to recognize a protein, also known as antigen, or a part of a protein that is present on the surface of cancer cells but not normal cells," he said. "By targeting these proteins, the immune system can specifically eliminate cancer cells while leaving normal cells intact."
Here's a look at the past successes and failures of cancer vaccine research, and where the future of research is heading.

19th century: The 'father of immunotherapy'

In the 1890s, the man who is considered "the father of cancer immunotherapy" noticed something in his cancer patients that would forever impact the course of cancer research.
Dr. William Coley observed that feverish infections in some of his cancer patients, such as bacterial skin infections, were sometimes associated with the cancer regressing.
To test this, Coley concocted a mixture of bacteria. He used a cocktail called Coley's toxins to create infections in his cancer patients in an effort to trigger their immune systems to attack not only those bacterial infections but other parts of the body that appeared foreign, such as a malignant tumor.
Coley described these cases in a study published in the American Journal of the Medical Sciences in May 1893. One was a 35-year-old Italian man diagnosed with sarcoma of the neck and tonsil.

In the study, Coley detailed how the man's tumor was injected with streptococcal bacteria that caused a skin infection called erysipelas.
The patient's temperature rose to 105 degrees Fahrenheit as the skin infection appeared on his neck and gradually extended over his face and head, Coley wrote.
Then, "the tumor of the neck began to break down on the second day, and discharged until the end of the attack. The discharge was not pus, but resembled the caseous material of the tubercular gland," he wrote. "At the end of two weeks the tumor of the neck had disappeared."
Meanwhile, the patient's tonsil tumor appeared smaller, but the reduction in size was not as significant, Coley noted.
Despite that case and others, Coley's toxins were not widely accepted as a possible cancer treatment option for years to come.

1920s-'30s: A turn of opinions

"Basically, no one understood the mechanism," said Jill O'Donnell-Tormey, chief executive officer and director of scientific affairs of the Cancer Research Institute in New York.
In other words, no one knew exactly how Coley's toxins were related to a reduction in tumor growth. Making matters worse, the toxins were a "crude" mixture of bacteria, O'Donnell-Tormey said.
"There was no standardization, so every batch was somewhat different, and some were more potent than others, so you got a variability of response," she said.
"Some patients responded, and some didn't, and no one understood why ... and then radiation was discovered," she said. "So radiation became kind of the new treatment du jour as a way to treat cancer. It produced more reliable results than Coley's toxins could, and that contributed to it being more widely adopted as a cancer treatment."

By 1920, Coley's research received serious resistance from the Bone Sarcoma Registry, whose role was to standardize the diagnosis and treatment of bone cancers. Members of the registry believed that Coley's toxins were ineffective, dismissing his ideas, according to a paper published in The Iowa Orthopaedic Journal in 2006.
Then, the Journal of the American Medical Association, which had criticized Coley's work, published an editorial in 1934 suggesting that his immunotherapy approach might warrant further research.
"Although Coley first employed a vaccine of Streptococcus [erysipelas] in inoperable malignant conditions as early as 1893, a satisfactory explanation of the therapeutic mechanism has not yet been advanced," the editorial began.
It ended with, "Further studies on the effect of powerfully antigenic substances in inoperable malignant conditions or as a postoperative measure in attempting to combat recurrence seem to be indicated in the light of the accumulated evidence."

Click here to keep reading this article sourced by CNN Health.
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