Can Personalised Vaccines Help Cure Cancer?

What cancer treatment can do today — and how medicine is trying to make treatment personal

Cancer is one of those words that can change the atmosphere in a room. When someone says, “I have cancer,” the first question for the person, the family and often the doctor is simple: Can it be cured?

There is no single answer. Cancer is not one disease. There are hundreds of different cancers, and even two people with what is called the same cancer can have very different diseases. Their cancers may have different genetic characteristics, respond differently to treatment and behave differently over time.

That is one of the reasons cancer remains such a difficult disease to treat. It is also why one of the most interesting developments in modern cancer research is based on a simple idea: what if we could make the treatment as individual as the cancer itself?

Cancer in India: the numbers are people

Cancer is already a major health challenge in India. According to the International Agency for Research on Cancer’s GLOBOCAN 2022 estimates, India had 1.41 million new cancer cases and 916,827 cancer deaths in 2022. More than 3.25 million people were living with cancer diagnosed during the previous five years.

But statistics can make cancer feel like a number. For a family, it is usually a person: a parent, a spouse, a brother or sister, or a friend.

That is why the search for better cancer treatments matters. It is not simply a scientific race to develop another drug. It is an attempt to change what happens after a diagnosis that can alter the course of an entire family’s life.

There is no single cure for cancer

When we talk about curing cancer, we need to be careful about what we mean. Some cancers can be cured, particularly when they are detected early and treated effectively. Some can be controlled for many years, while others may go into remission but require continued monitoring. Advanced cancers can remain extremely difficult to eliminate completely.

Depending on the cancer, its stage and its biology, treatment today may involve surgery, radiation, chemotherapy, targeted medicines, hormone therapy, immunotherapy, stem-cell transplantation or combinations of these approaches.

The important change is that cancer treatment is increasingly being guided not only by where a cancer started, but by what that particular cancer is doing at a biological level.

And that brings us to an important idea: cancer is personal.

Why two people with the same cancer may respond differently

Imagine two people who both have colon cancer. On paper, they have the same type of cancer. Look more closely, however, and their tumours may contain different genetic mutations, produce different proteins and interact differently with the body’s immune system.

Cancer cells can also change as the disease progresses. A treatment that works extremely well against one patient’s tumour may therefore work less well against another patient’s tumour, even when both patients have been given the same diagnosis.

For decades, cancer research has been moving towards a more personalised approach. Advances in DNA sequencing, RNA analysis, computing and immunology have made it possible to study tumours in far greater detail than before.

The ambition is straightforward, even if achieving it is not: understand the cancer in front of you, rather than treating every cancer as though it were the same.

What if we could teach the immune system to recognise your cancer?

Our immune system is remarkably good at recognising things that do not belong in our bodies. Viruses, bacteria and other foreign threats can trigger an immune response that helps the body identify and destroy them.

Cancer creates a much harder problem because cancer cells originate from our own cells. They can therefore look sufficiently like normal cells that the immune system may not recognise them as a threat, or may not attack them strongly enough.

But cancer cells can also acquire changes that distinguish them from healthy cells. Some of these changes can produce proteins or fragments of proteins that the immune system can potentially recognise. These are sometimes called neoantigens.

This is where the idea of a personalised cancer vaccine comes in. Researchers can analyse a patient’s tumour, identify potential targets that are distinctive to that cancer. Sequencing only gives candidate targets. Each one still has to be expressed by the RNA into protein, then the protein has to be processed and presented on the patient’s own HLA molecules and able to trigger a real T-cell response and then design an immune-based treatment intended to help the body’s T-cells recognise and attack cells carrying those targets.

This is different from the familiar vaccines we receive to prevent infectious diseases. A therapeutic cancer vaccine is designed for someone who already has cancer and is intended to help the immune system fight it. Personalised cancer vaccines remain an active area of clinical research, with ongoing trials testing different approaches and combinations with other immunotherapies.

An idea I was exploring in 2019

Seven years ago, I wrote about this possibility.

My thinking then was that two developments were changing what might be possible: much more powerful DNA sequencing and enormous increases in computing power. If we could compare the DNA of a person’s cancer cells with that person’s normal cells, identify important differences and then use algorithms to determine which differences the immune system might recognise, perhaps we could design a treatment specifically for that patient’s cancer.

At the time, this was an emerging area of research. I was not simply asking whether vaccines could treat cancer. I was asking whether a vaccine could be designed around the individual biology of one person’s cancer.

That distinction remains at the heart of personalised cancer immunotherapy.

From one-size-fits-all to one-person-at-a-time

Making this possible requires an enormous amount of information. A tumour can be analysed through DNA sequencing, while RNA and other technologies can provide additional information about what the cancer cells are actually producing. Mass spectrometry can help researchers look at proteins and potential targets presented by cancer cells.

The challenge is then to determine which of the many possible targets are most likely to produce a useful immune response.

This is where computing and artificial intelligence become important. There can be thousands of potential differences to analyse, and not all of them will be useful targets. Algorithms can help researchers rank and prioritise them.

The objective is not simply to find a target. It is to find the targets that may matter most for this patient’s cancer.

The science has moved forward

The idea of personalised cancer vaccines is no longer confined to theoretical discussion. Clinical research is actively testing personalised vaccines in different cancers and treatment settings.

The National Cancer Institute currently lists active trials involving personalised neoantigen vaccines, including studies in advanced solid tumours and trials combining personalised vaccines with other immunotherapies. There are also active studies in cancers including melanoma, breast cancer, lung cancer, liver cancer and others.

But promising research is not the same thing as a proven cure.

Cancer medicine moves through stages of discovery, laboratory research, early clinical trials and larger trials before we know whether a treatment actually helps patients live longer or better. The fact that a personalised vaccine can generate an immune response is important; the bigger question is whether that response translates into meaningful and durable benefits for patients.

That is what the research now has to establish.

What we are trying to do at BreakBio

This is where my work today connects directly with the idea I was exploring in 2019.

At BreakBio, we are trying to develop personalised cancer immunotherapy by combining information from an individual patient’s tumour with computational analysis. Our platform uses DNA and RNA sequencing together with proteomic information to identify potential targets in the patient’s cancer.

The aim is to select targets that are specific or relevant to that individual’s tumour and use them to create a customised peptide immunotherapy designed to stimulate T-cells against those targets. Our initial clinical programme is focused on triple-negative breast cancer, while the underlying platform is being developed with the intention of applying the approach across solid cancers.

This is still clinical research. We are testing whether the approach is safe, feasible and, ultimately, whether it can help patients. The important distinction is between trying to develop a personalised treatment and having a proven treatment that cures cancer.

The latter can only be established through rigorous clinical trials.

Why making cancer treatment personal is so difficult

The logic sounds straightforward: understand the patient’s tumour, identify its targets, design a treatment and try to teach the immune system to attack it. The biology is much harder.

Cancer cells within the same tumour are not all identical. Tumours evolve and change. Also, some cancers contain relatively few mutations that can be turned into obvious targets, and others have many mutations. Researchers have to determine whether a candidate target identified through sequencing and other analyses is actually presented and can produce a meaningful immune response in a patient.

There is another challenge: manufacturing.

A treatment designed for one patient cannot simply be taken from a shelf. The patient’s tumour has to be analysed, targets selected, the treatment manufactured and then delivered within a clinically useful timeframe.

For personalised cancer treatment to become widely useful, it therefore has to become not only scientifically accurate, but also sufficiently fast, reliable, safe and scalable.

Seven years later, the question is different

When I wrote my original article in 2019, the question was essentially:

Could personalised cancer vaccines become possible?

Today, the question is more demanding:

Can personalised cancer treatments work reliably, improve outcomes for patients and eventually be made at a scale that makes them accessible?

That is a much harder question.

The field has active clinical trials and increasingly sophisticated ways of analysing individual tumours. Researchers are learning more about how personalised vaccines can generate targeted immune responses and how they might work alongside existing treatments.

But the finish line is still ahead.

So, can personalised vaccines cure cancer?

Not “cancer” as a whole.

There is no single cancer and therefore no single cure. Some cancers are already curable in many patients, some can be controlled for long periods and others remain extremely difficult to treat.

Personalised cancer vaccines represent one of the ways researchers are trying to make treatment more precise: by looking closely at an individual’s tumour, identifying targets and attempting to direct the immune system towards them.

That makes the idea worth watching. But it is equally important not to confuse hope with proof.

A promising early trial does not establish a cure. A technology platform does not establish clinical effectiveness. Those answers can only come through rigorous research involving patients.

The human question behind the science

Cancer research can easily become a discussion about sequencing, algorithms, proteins, T-cells and clinical trials. But behind every tumour is a person, and behind that person is usually a family.

My own interest in personalised cancer treatment became deeply personal when my wife was diagnosed with metastatic colon cancer in 2017. I began looking more deeply into cancer research and the possibility that the emerging tools of sequencing, computation and immunology might eventually allow us to design treatments around the individual patient.

That experience eventually led to the work we are doing today.

The ambition is not to assume that every promising technology will succeed. It is to keep asking whether we can do better.

Seven years after I first wrote about personalised cancer vaccines, the tools have become more sophisticated and the research has moved forward. The challenges remain enormous.

But perhaps the most important change is this: the question is no longer simply whether we can imagine a treatment designed for one person’s cancer.

We are now beginning to test whether we can actually build one.

Sources & References

• International Agency for Research on Cancer (IARC), GLOBOCAN 2022 — India cancer estimates.
• National Cancer Institute — Cancer treatment vaccine research and clinical trials.
• National Cancer Institute — Active personalised neoantigen vaccine trials.
• BreakBio — Personalised cancer immunotherapy platform and clinical development.