SABCS 2024: Unlocking the Potential of Breast Cancer Prevention Vaccines

In an interview with Pharmacy Times®, Olivera Finn, PhD, distinguished professor at the University of Pittsburgh School of Medicine, shared that developing effective breast cancer prevention vaccines is hindered by limited funding and lack of public awareness, compared to the focus on cancer treatments. Screening methods could help identify high-risk populations that would benefit most from prevention vaccines, which need to be rigorously tested for safety. Finn noted that increased advocacy from those affected by breast cancer could help drive more support for this preventative approach and realize its potential to reduce cancer diagnoses.

Pharmacy Times

What are the current challenges and limitations in developing effective breast cancer prevention vaccines, and how are researchers addressing these obstacles?

Olivera Finn, PhD

There are actually many challenges — a lot of them are financial. Unlike therapy and investment in therapy, there is actually very little investment in prevention currently. Immunotherapy has had some really great successes, and therefore it has attracted a lot of funding. But immunoprevention, which is what cancer vaccines, would be — to prevent cancer, is still a field that is very highly underfunded. Because of that, there are many fewer people working in cancer immunoprevention, and many fewer people have been trained to work in cancer immunoprevention. So, those are really the main challenges. The challenges are never good ideas, the ideas are always there. It is if you can support the work that can test those ideas, that really creates a big issue. I think things are getting better, and part of it is that the field of cancer vaccines is a very old field. It isn't something that's a very new idea. However, it has been implemented primarily in people who already have cancer. We have learned that in that setting, when the tumor has had an opportunity to suppress the immune system, to evade the immune system, to escape the immune system, it's very difficult to use a vaccine to reset the stage so that we can be effective in preventing recurrence, etc. Because we have failed in the therapeutic setting, it is only reasonable to move everything to the prevention setting. It's a better place to put an effort in, because not only would you reduce cancer risk, but you would also really save a lot of people from the agony of cancer diagnosis to begin with.

Pharmacy Times

How could a breast cancer vaccine be used with other prevention methods like screenings?

Finn

Screening is very good, because screening can identify candidates for vaccines. When we're thinking about prevention vaccines for cancer, specifically, we're not thinking the same way as people trying to prevent infectious diseases. We're not thinking about starting with vaccinating school children. You know that the HPV vaccine is incredibly effective implementing HPV infection and reducing the risk for cervical cancer and head and neck cancer and prostate cancer, etc. But in the case of breast cancer, we need to focus on the population most at risk so that we can help in the best way possible. Screening is really the only way — and that can be imaging, that can be genetic screening, that can be familial history that we become very aware of, that points to population at risk, and that's the population that would most likely benefit from the vaccine. We could focus on developing vaccines for that population.

Pharmacy Times

What are the ethical issues and societal impacts of a breast cancer vaccine?

Finn

They all are positive. As far as I can tell, and I've been in the field a long, a long time, there are really no negatives to developing a prevention vaccine. As scientists, we are very aware of the fact that that we can develop a vaccine that, for example, may not be safe. So, we spend a lot of time choosing very carefully the target that we would like to vaccinate and induce an immune response to on future breast cancer. We are very careful with the composition of the vaccine. Everything we put into the vaccine has to be incredibly safe. The standards for safety for prevention vaccine are much higher than for therapeutic vaccine where a person is already really ill, and we're trying to help any which way we can. In prevention, you don't want to do any harm — so the ethical issue is do no harm, and we are very much aware of that.

Finn

The vaccine that are now being tested have been shown to be safe in the therapeutic setting. They've been shown to be safe in animal models. They have been studied to the great extent and shown to be safe. In terms of the safety issue, I think we are aware of it, and we are dealing with it. The interesting thing is the risk benefit ratio. Since we're dealing with a person who is only at high risk but doesn't have cancer, you want to make sure that there's no risk and there's a lot of benefit of administering that vaccine. But considering that cancer is on the rise and in younger people, this risk benefit ratio really has to be reconsidered. For example, what is the risk of giving a relatively safe vaccine and developed with the best possible science, versus the risk of not giving it and allowing the cancer just to continue to rise in incidents? We are really very much trying to push that concept that it's time to take this risk, because it's not so great, and the greater risk is not developing prevention.

Pharmacy Times

Is there anything you would like to add?

Finn

I think that prevention vaccine is not going to be developed by companies very readily, because it takes some time to prove efficacy, so to develop a product. A lot of companies don't wait long enough and don't want to wait long enough. Investors don't want to wait long enough. This is something that really has to be taken up by public policy and government. The other thing is that, in order to do that, because we're investing taxpayers’ money in developing these things, we need more advocacy. We have now a lot of people advocating for cancer therapy and cancer cure— every cancer has its own advocacy group. We don't really have good advocacy for prevention. I would really like people, especially people who have cancer in the family, who know what it's like to receive the diagnosis — to have a daughter, a mother that received that diagnosis to speak loud and clear that we need to prevent that cancer.