Cancer vaccines – what are they and how do they work?

Mr Rob Jones is a consultant surgeon based in Liverpool and the UK research lead for advanced and metastatic colorectal cancer. He's funded by Bowel Cancer UK, the Royal College of Surgeons of England and the Association of Upper Gastrointestinal Surgeons.

He’s the lead investigator for a trial looking at giving personalised cancer vaccines to people with bowel cancer. The study recently marked a milestone with the first trial patient receiving a vaccine. We caught up with Mr Jones to find out more about this exciting new treatment.

What is a cancer vaccine?

Vaccines work by harnessing the body’s ability to fight infections and disease. When people are given a vaccine against an infection, their immune system is exposed to something that looks like the infection. This teaches the immune system how to handle that type of infection. Then, when the person is exposed to the real infection their immune system is ready to go and starts to work against the infection. 

It's the same idea with cancer vaccines. By doing this, we can help the patient’s immune system recognise cancer cells and be able to destroy them. This means their own immune system treats the cancer, rather than drugs or other treatments. 

How does the trial work? 

One of the problems with cancer vaccines is that everybody’s cancer looks different and has its own unique genetic makeup. The other problem is that cancer forms from normal body cells. 

We need to find a way of making vaccines that are:

• different enough from normal cells, so that the immune system can recognise them as needing to be removed
• specific enough to tackle the cancer cells with their specific genetic makeup

BioNTech and Genentech, the companies behind the vaccine, have a platform where we can take samples of a tumour after surgery and look at them in the laboratory. We can look at the unique genetic mutations of the tumour and use that to make a vaccine specific for that individual’s cancer. 

Once we’ve checked the vaccine is of high enough quality, we send it back to the treatment team for the patient. After the sample from surgery is taken, it takes about eight weeks to make the specific vaccine. So by the time people have recovered from surgery the vaccine’s ready to go and we can give it to them. 

This particular trial is for a vaccine against bowel cancer, after people have had surgery and chemotherapy. We’re going to randomly put the people taking part into two groups. One group will have the standard current treatment, which is to have follow-up scans to see if the cancer comes back. The other group will have the scans but they’ll also have the individual vaccine for their cancer. We’ll then look to see if having the vaccine means the cancer is less likely to come back. 

The UK is front and centre of this research and is the lead recruiter of patients into the trial. Just a few weeks ago we gave the first ever personalised cancer vaccine for colorectal cancer and that was to a UK patient. Some of the early data is really positive and we think this could be a big change in the way we manage patients like this. 

We’re aiming to trial this with 164 patients in total and recruitment should finish towards the end of this year. We hope that if the results from this trial are as positive as we expect, we’ll be able to move into a bigger trial. This will work to prove that this is effective in all patients. If that larger trial is successful, we’ll could start to be able to use cancer vaccines in normal clinical practice. 

Who can take part in this trial? 

Anyone who has colorectal cancer limited to their bowel, which has been removed by surgery and is going to have chemotherapy to reduce the risk of the cancer coming back. To take part we need to get in touch with you before you start your chemotherapy, so we can do some tests and check you’re fully eligible. 

The trial’s open in 14 sites in the UK, but with the UK approach to cancer vaccines you don’t necessarily need to be being treated at one of those hospitals to take part. It’s possible for you to be referred by your oncologist or your surgeon to one of the trial sites. Then we can do the testing to check if you can take part wherever you’re based. 

If you speak to your oncologist or your surgeon, they’ll be aware of the trial. They can tell you if you’re potentially eligible and put you in touch with the screening team to start the process.

We’re currently working up a study looking at the same process in patients who’ve got liver metastases from colorectal cancer and are having surgery to remove those. The technology is also being used across other disease types. BioNTech has over 20 trials in set-up using the same technology for different cancer types. They’re building on the framework that we’ve built for the colorectal cancer trial to make sure that as many patients as possible can take part in this research. 

What difference could this make to people with cancer? 

At the moment we’re doing this in a trial and it’s still in the research stage. So we have to be very strict and very controlled about how we give the vaccine and how we monitor it afterwards.  

But what we’re seeing at this early stage is that the vaccine is very well tolerated, the side effects are low and the risk is very low. If you compare that with something like chemotherapy which can have very unpleasant side effects it looks very positive. 

The other really important thing is that most people will have had other vaccines, like their covid vaccine, in a church hall or a scout hut and there’s no reason why cancer vaccines can’t be delivered in the same way. This means we could bring cancer treatment to people, rather than expect them to go to large hospitals for long chemotherapy treatment courses. That would be a complete change in how this kind of treatment is given.

• Find out more about the cancer vaccine trial via the trial website
• Read the NHS article on this vaccine trial
• Read more about Mr Jones' research
• Learn about our current research projects