Researchers have found that mRNA COVID-19 vaccines prime certain cancers to a cancer treatment known as immune checkpoint inhibitor (ICI) immunotherapy!
Within 100 days of starting immunotherapy, people with advanced cancer who received mRNA COVID-19 vaccines survived nearly twice as long as those who did not receive the shot (approximately 37 months versus 21 months). Could mRNA vaccines act as an unexpected sidekick to existing cancer treatments?
š§ š Why this matters: This finding has opened the door for more research using mRNA technology specifically designed to fight tumors, and might change how we time vaccines for people with cancer undergoing immunotherapy.
š¤ What is immunotherapy?
š¬ Immunotherapy is a type of cancer therapy that helps T-cells in our own immune system respond better to destroy cancer cells. A common form of cancer immunotherapy is called immune checkpoint inhibitor (ICI) immunotherapy. Researchers have found that cancer cells can ātrickā our immune system. They do this by putting special proteins on their surface that act like an āoff switch.ā
š¤Nerd Alert! The āoff switchā proteins are known as checkpoint ligands. When these proteins connect with immune cells (called T-cells), they signal them to hold back instead of launching an attack. As a result, the immune system doesnāt destroy the cancer the way it normally would. This is where ICI immunotherapy enters the chat!
In theory, ICIs can remove the ābrakesā (inhibitory checkpoint interactions) that stop T-cells from recognizing and attacking the cancer cells. However, there are some shortcomings to immunotherapy, as it can work very well for some people but not for others. If only there was a way to help T-cells recognize the cancer cells more easily!
Image created by J. Fornsaglio using DeeVidAI
š Enter mRNA vaccines. We know that these vaccines, such as the COVID-19 mRNA vaccines, train our immune system by instructing certain immune cells to produce a specific protein, which is then broken into fragments that T-cells can recognize.
āWhat if mRNA vaccines are providing our immune cells the extra nudge they need to help them identify and attack cancer cells? Actually, current research suggests these vaccines may be doing just that!
š Researchers studied health records of patients with certain types of lung and skin cancer. Those who received a COVID-19 mRNA vaccine within 100 days of starting ICI immunotherapy had better survival. In fact, they survived nearly twice as long when compared to those who did not get a COVID-19 vaccine. They even found these patients (vaccinated before ICI therapy) were more likely to be alive three years after their treatment (55.7% 3-year survival versus 30.8% 3-year survival in those who did not receive the mRNA vaccine). Notably, patients whose tumors donāt respond well to immunotherapy (less immune-active tumors) seemed to benefit the most.
š In line with good science and to avoid jumping to conclusions, scientists demonstrated that the effect didnāt happen with just any vaccine because receiving a standard flu vaccine within 100 days of starting immunotherapy was not associated with improved survival.
Likewise, chemotherapy given within 100 days of starting ICI immunotherapy did not lead to improved survival.
šµļø We have seen such plot twists before! Recently, Those Nerdy Girls wrote about a cancer treatment that reduced symptoms in those with certain autoimmune conditions.
š«¶ What does this mean for you or your loved ones starting ICI immunotherapy?
ā” We know that vaccines are already recommended for most cancer patients ššļø.
ā” For those diagnosed with cancer who are planning on undergoing ICI immunotherapy, it may be worthwhile to discuss the timing of your COVID-19 mRNA vaccine with your oncology team.
ā” While this is good news, we need further confirmation with controlled clinical trials to determine if mRNA vaccination actively improves ICI outcomes in cancer patients. A multi-center, randomized Phase III trial [archived link] with larger sample sizes is in the works to validate these findings and to identify whether COVID-19 mRNA vaccines should be added to the care regimen for those initiating ICI immunotherapy. Also, scientists are working on mRNA vaccines specifically designed to enhance cancer treatment, not just to fight COVID-19. Stay tuned!
ā” Itās important to note that none of this science would have been possible without decades ā of basic research! Breakthroughs such as mRNA vaccines and immunotherapy (and possibly them working together) do not happen if the basic science didnāt already pave the way beforehand š„. Scientists studied ideas such as basic RNA chemistry or basic T-cell immunology without an obvious payoff at the time. Without these fundamental studies, more specific research into how mRNA vaccines impact cancer outcomes would not be possible.
I have heard people discussing āsilver liningsā of the COVID-19 pandemic. At first, I thought this was insensitive considering all of the suffering that occurred and continues as a result of COVID-19. However, with the passage of time and further reflection, we have found some positives. For example, we canāt deny that the pandemic came with some improvements in community kindness and cleaner air (if only briefly for both). Also, I would like to think that discussions of mental health (depression, anxiety, and loneliness, for example) became more widespread (check out the hundreds of Nerdy Girl posts on mental health), as phrases such as āIām not okayā and the like, seemingly became more acceptable. And with the global and around-the-clock work of scientists, the speed at which sound and effective research brought mRNA vaccines to the public inevitably saved more lives than we may ever know. Scientists estimate that COVID-19 vaccinations prevented around 2.5 million deaths from 2020-2024, with one death prevented for every ~5,400 vaccine doses administered š. Recent research leads to a happy surprise that mRNA vaccines may have contributed to global health. Are mRNA vaccines lending the immune system a helping hand š«“ in the fight against cancer in patients receiving immunotherapy? Possibly!
In closing: Science rarely moves in straight lines āÆ ā°. If you believe in the evolution of science as a foundation for future advances, then spread the word that basic science research funding matters!
Nerdy Takeaway š¤: Has the pandemic given us an unexpected weapon in the fight against cancer through mRNA vaccines? Could mRNA vaccines āredirectā patientsā immune systems to improve their response to immunotherapy? Only time will tell exactly what this science will bring, but the hope it offers is already worth celebrating!
Stay well,
Those Nerdy Girls
