National Breast Cancer Coalition

Call to Action Online - November 8, 2019

Beyond the Headlines.
We often hear about breakthroughs in breast cancer that in reality are just more of the same. Sometimes the media reports on research that is too early in the process to know if it really will make a difference in people’s lives. Promising maybe, but way too soon to declare victory. Often times news reports are unintentionally misleading, such as when a new drug is shown to improve progression free survival (PFS - lengthening the time before tumors get bigger) and it is described as a breakthrough. And yet we know that PFS has no real impact on helping women feel better or live longer. Maybe promising, but way too soon to warrant celebration and all too often setting up unrealistic expectations for the public.

Why Does this Happen?
Many of the sensational reports we read in the news citing “breakthroughs” and “game-changers” are based on press releases from the marketing and public relations offices of academic institutions–NOT published, peer-reviewed research. But the media react to those press releases and the public responds to the eye catching headlines. This is especially true during Breast Cancer Awareness month when the players take advantage of the quest for “news.”  As advocates, our role is to explain the reality of the science.

So let’s talk about vaccines and the recent media blitz. First though, we need to understand that we are discussing two different types of vaccines. One is therapeutic—aimed at treating breast cancer that has already been diagnosed. The other is preventative and will be given to healthy women and men to prevent them from being diagnosed with breast cancer.

The study of immune interventions in cancer, including vaccines, seems new, but actually has a lengthy history. The mainstream research community dismissed this approach when the first attempts were not effective. But new technology and knowledge led to immunology again being investigated as a way to treat cancer, with some recent positive, but limited, results. And there is much hope that this approach will ultimately save lives.

The Role of NBCC Advocates.
The Department of Defense Breast Cancer Research Program (DOD BCRP), a program brought about by NBCC’s advocacy, has played a major role for some time in supporting research into immune approaches for breast cancer. Separate and apart from this work, NBCC’s Artemis Project®—an advocate-led, mission-driven research collaboration with leading scientists and other stakeholders—has also focused on the role the immune system may play in preventing breast cancer, and in preventing metastasis. Indeed, for the last 10 years, NBCC’s Artemis Project has been leading the development of a preventive, not a therapeutic, vaccine.

Now to the News.
With that background, we can review the recent news about the therapeutic vaccine currently in Phase I clinical trials at Mayo Clinic.  Phase I trials are designed to test safety. In this instance, as in most vaccine research, the investigators also want to see if the candidate vaccine can generate an immune response. The news reports stated that a woman who was part of the trial had no more cancer cells as a result of getting the vaccine. Is that right? Does this mean the vaccine cured her? We really do not know, and cannot know from this study. It was not designed to answer that question. And there are too many other issues to be analyzed, including the rest of her treatment approaches. But do not lose sight of the fact that the vaccine appears safe and there was an immune response. That is important and exciting. Wouldn’t those of us who have breast cancer want a vaccine, and not toxic therapy, and one that works? This may be the first, early step to tell us if it may work.

But the reports tell us what happened to one person in the trial so far. This result in one person is intriguing, but at most it is a signal that more women should enroll in the trial so we can get robust, and not just tantalizing, answers. Frankly, it is amazing that we have vaccines in clinical trials in the first place! This work was funded through a DOD BCRP grant. That means the underlying science was evaluated through a rigorous peer review process and gives us some comfort that the science is good.  It remains to be seen if it works.

While this therapeutic vaccine trial came out of a funding program NBCC helped create, and is being run by a scientist who is a participant in NBCC’s Artemis Project, it is NOT under the umbrella of Artemis.  The Artemis vaccine work involves a preventive vaccine, to stop healthy women and men from getting breast cancer in the first place. That vaccine will be in clinical trials in 2020, again to test safety and immune response.  This is also extremely exciting. Do we know if it will work? Not yet. But these are the first steps that must be taken to answer that question.

Stay tuned. We may be close to getting important answers. Be they yes or no.