Could scientists create a world where no one dies from breast cancer?
That's the goal of a new five-year partnership between scientists at Victoria University's Ferrier Research Institute and the Breast Cancer Foundation New Zealand (BCFNZ), which aims to transform a major breakthrough into a life-saving vaccine.
The bold project, supported with an initial $500,000 boost from the foundation, will focus on bringing new drugs, starting with a therapeutic vaccine, to the clinical trial stage.
Ferrier Research Institute chemists are making gains in the area of cancer immunotherapy, described by leading journal Science as the "breakthrough of the year" in 2013.
The institute is developing a synthetic cancer vaccine that can activate tumour-specific T cells, producing a targeted immune response.
This synthetic cancer vaccine causes rejection of cancer in several types of animal models.
Cancer immunotherapy has caused a paradigm shift in cancer treatment, with a focus on targeting the body's own immune system to fight cancer cells rather than introducing toxic agents to attack tumours directly.
This line of research has led to the production of cancer vaccines that are showing promising results in certain situations. They are well tolerated by the body, have fewer side effects than current chemotherapy treatments and may be more effective in the long-term.
Excitingly, the first use of such a vaccine is likely to be in patients with incurable cancer that has spread beyond the breast, or in those whose tumours are resistant to current treatments and likely to spread.
Almost all breast cancer deaths are the result of the cancer spreading; whereas cancer that's confined to the breast can be treated successfully.
Ferrier Institute director Professor Richard Furneaux said the technology was "almost there".
"We just need to get it to the next level of testing: human clinical trials."
Ferrier's successful immunotherapy treatment platform has already led to the establishment of biotechnology company Avalia Immunotherapies, which aims to commercialise vaccine technology to help Kiwis.
Avalia's chief executive is Dr Shivali Gulab, a former NZBIO Young Bioscientist of the Year who is based in New York and driving the progress of Ferrier's vaccine technology towards human clinical trials.
Ferrier Research Institute has had a 20-year working relationship with the Albert Einstein College of Medicine in New York, which has resulted in successful drug trials, including trials in leukaemia and lymphoma.
But the support of BCFNZ was crucial, said Professor Gavin Painter, who leads Ferrier's chemistry team.
"Getting a new therapy to human clinical trials requires significant investment, and an intensive campaign of chemistry, biology and regulatory compliance.
"Our success to date has been made possible because we work with the exceptional immunology research group led by Professor Ian Hermans at the Malaghan Institute of Medical Research here in Wellington, a relationship built up in a seven-year strategic collaboration."
BCFNZ chief executive Evangelia Henderson said the foundation had been looking for a research partner that could help achieve its vision of zero deaths from breast cancer.
"We were blown away by the calibre of the Ferrier team, the work they'd already done in the exciting field of immunotherapy and vaccines, and the strength of their international partnerships.
"It was a no-brainer for us."
Breast cancer: The battle for a cure
Breast cancer, which kills more than 600 women in New Zealand every year, is a complex disease with many factors affecting individual patients.
The risk of breast cancer increases as women age, and around 75 per cent of all cases occur in women aged over 50.
Maori women have, on average, a 33 per cent higher incidence of breast cancer than non-Maori women.
Researchers do not believe a vaccine to prevent breast cancer developing in the first place is a realistic prospect in the near future.
The kind of therapeutic vaccine that the new research effort will target is different from already-available immunotherapies such as Herceptin and Keytruda.
Immunotherapy generally describes four main types, of which therapeutic vaccines are considered by many researchers to be the most exciting.
The other three are:
• Monoclonal antibodies, including the breast-cancer drugs Herceptin and Perjeta, which typically block the signalling pathways need for tumour growth, triggering an immune response that kills cancer cells or prevents the formation of the new blood vessels needed to feed a tumour.
• Checkpoint inhibitors, such as the melanoma drugs Keytruda and Opdivo recently approved in New Zealand, which disable the "checkpoints" in tumours that help them evade detection by the immune system. When the checkpoint is disabled, the immune system has a better chance of detecting and attacking cancer cells.
• Cytokine therapy, which has been explored with some success in kidney cancers and melanoma. There is evidence that cytokines (proteins that control communication between cells of the immune system) play a role in the development and spread of breast cancer, linked to inflammation.