Q&A with a Montreal researcher who's working on a cancer treatment vaccine

Cancer researchers at the Université de Montréal Research Centre (CRCHUM) have teamed up with Quebec City-based biotechnology company Angany to try to develop cancer treatment vaccines.

The goal is to identify genetic targets in each patient after a cancer diagnosis and then produce a custom-made vaccine in anywhere from four to eight weeks potentially, to trigger a personalized immune response.

Dr. Rejean Lapointe, principal scientist and the head of cancer research at the CRCHUM, said that he believes this type of research will eventually have an impact on how cancer is treated.

The cancer vaccines will first be tested in the laboratory before researchers move onto clinical trials with patients, likely in about two years, said Lapointe, whose area of expertise is cancer immunotherapy.

The Q & A with CTV News below has been edited for clarity and concision.

CTV: Let's start with what you're describing as not a regular vaccine, but a treatment vaccine. What is a treatment vaccine?

Lapointe: Actually, it is a vaccine and I will explain. We know what vaccines are, especially in the last few years. We've heard a lot about it. A vaccine is probably the most significant discovery in the history of medicine, when you think about it, hundreds of millions of people have been saved from diseases like tetanus, smallpox and many others. Those are preventive vaccines, so you give the vaccine to prevent the infection from a deadly pathogen.

Now, what we're talking about here is a cancer vaccine. So it's a vaccine designed to trigger almost the same kind of immune reaction you would see with a preventive vaccine. But instead of targeting a pathogen or bacteria or virus, we target cancer. In this situation, the patient already has cancer, so now this vaccine is therapeutic. We want to trigger very active, very strong immune reactions against cancer.

So that's the difference.

CTV: So that's the key thing, that it's given to someone after they're diagnosed. It's in that category of very personalized treatments, personalized medicine because we know there are so many kinds of cancers. How would this theoretically work?

Lapointe: Remember like 100 years ago, cancer was one disease? Everyone has cancer and it's the same thing and we would give the one thing that will cure everyone. We know it's not like that. We know now that different cancers will react differently to therapies and even inside one cancer type like breast cancer there are different levels and different categories of breast cancer.

Now we know about personalized medicine, about the big book, the genetic book of cells that says how you are made, and the famous DNA that we are in our cells. In cancer cells, this book is completely messed up. So you have words that are removed, you have chapters that are inverted, multiplied and it's a big mess. So every person will have different mutations, alterations and modifications in their book of cancer. So what we do now … is focus on taking advantage of those mutations that are specific in the cancer cells. And each patient has different mutations.

So we have to work individually and make tailored approaches to treat the patient and now in designing a cancer vaccine, that's the goal, is to take those mutations, those alterations put them in a vaccine to really trigger immune reactions against those mutations that are specific to each patient.

CTV: What would happen, ideally, to an individual patient who comes to see their oncologist?

Lapointe: The patient in this program with this Precision Oncology Program, the patient we recruit, will sign a consent [form], will be informed and during the surgery or biopsy, we would get access to the tumour to have access to the genetic material from the [genetic] book I was referring to earlier.

We will have the capacity to sequence, and decode all the books from one page to the last page. And we're talking about billions and billions of letters in sequence and this is very high-level biology and medicine. So now we can do it. It's not easy. If it would be easy, we'd have it already. After a week or two or three, we hope it's not going to be too long to have this decoding.

Now we could make different decisions. Depending on the mutational profile, the different mutations could be like a reassignment, medicine or different types of treatment. With this collaboration with a company from Quebec City, Angany that has an amazing vaccination platform, we think they could make a vaccine that will specifically target the mutations specific to each patient. so they will make this vaccine and after four to eight weeks. We still need to see, but the technologies are so good that they can move very fast. We'll be able to vaccinate the patient against the same cancer.

In addition, we're very lucky we've been supported by the Fondation Guy Lafleur. When he was sick unfortunately, he was treated at the CHUM, and he said I want to do something. I want to help 

CTV: Would the vaccination still be used in conjunction with chemotherapy and other treatments?

Lapointe: It's combination, combination, combination. I mean, the genetics of cancer is so unstable, it changes so much. It's like evolution. So we need to target [cancer] from multiple angles. So yes, the vaccine would be extremely useful and with other treatments for sure, other immunotherapies or other ways to stimulate the immune system.

But for a vaccine in the first, I would say five to 10 years, it's still going to be in the context of research. It's not going to be standard of care. We need to learn how to really make it work great.

CTV: This is an exciting avenue for you. But it could take many years to bear fruit. Is that accurate?

Lapointe: I would say yes and no. Yes, in the sense that the innovation, the novelty of this will take maybe a few years. But still, even with the first patient we'll recruit, maybe for 15 to 20 per cent of those patients we'll be able to find a mutation for which there is a medicine that we could give. So this is a reality even in the [early stages]. After a few patients, if we find a mutation for which there's a medicine, I mean we'll do everything we can to get this medicine to the patient. This can save the life of the patient. And we didn't know that [in the past] because we didn't have this genetic information. And so early on, I think we could have an impact.

What makes a difference today is the fact that now we have the capacity to find those mutations and target those mutations in a vaccine and now we start to see data and results coming from different groups in the world.

We were very fortunate and have to thank Leon Gosselin with his foundation, Fondation Gosselin, who invested in this collaboration.

Biomedical research is a long, long endeavour. We still need a year or two of hard work in the lab before we can move to patients. If I put on my rosy glasses I will tell you maybe in two years we'll be ready but it's going to be a very precisely targeted, selected patient cohort. That's our goal, for sure.