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Cancer vaccines: the next immunotherapy frontier

Buttons840

A medicine that sometimes stops a bad thing from happening is hard for people to appreciate, because if it works you'll never know it, and it might have some side effects.

We need to improve public education about why we believe these medicines work. I want to see the studies presented on social media: "We gave 30,000 people this drug and you won't believe what happened!" Less censoring people and more presenting the studies in a way people can understand. Less appealing to authority and more appealing to observations; yes, you observed your 2 relatives, and I observed 30,000 people, judge for yourself which is more persuasive.

Most people aren't going to read your 3 paragraph abstract, let alone the the full paper. You have to tell them the observations in a few sentences, preferably with minimal added interpretation.

ajsnigrutin

> I want to see the studies presented on social media: "We gave 30,000 people this drug and you won't believe what happened!"

We've had two years of that... get vaccinated and you won't get it, also get vaccinated and you won't get your grandparents ill!

Somehow all the censoring was done on people who didn't believe these claims.

mig39

I guess we were hearing different messages?

I thought the vaccine message was "get vaccinated so you won't die when you get it."

ajsnigrutin

> DR. ROCHELLE WALENSKY, CDC DIRECTOR

> And we have -- we can kind of almost see the end. We`re vaccinating so very fast, our data from the CDC today suggests, you know, that vaccinated people do not carry the virus, don`t get sick, and that it`s not just in the clinical trials but it`s also in real world data.

https://web.archive.org/web/20210402002315/https://www.msnbc...

vinyl7

It depended on the day of the week. Sometimes it was slow the spread, sometimes it was to prevent getting covid, other times it was to reduce the severity if you got it.

Buttons840

My point was that should not be the message. Promising people the vaccine will save them is a false hope, people look around and find someone who got vaccinated but still died and now the trust is broken.

Instead, tell people about the trial control group vs treatment group, let people see that there is risk on both sides, but that the treatment group was ultimately better off. Use minimal interpretation. I'd like to see so much focus on the trial outcomes that the number of people who died in both groups is a household fact that families talk about.

dimitrios1

That was the updated messaging from DNC HQ because the first one was clearly wrong.

throwaway0x7E6

because there were a lot of different, often contradicting messages

Cloudef

I think the whole ordeal just reminded me how strong grip the mass media has on the general public. Fearmongering is a strong weapon. Peak of covid was some of the most depressing time to me seeing people tear each other apart.

bamboozled

To be fair we also now have stories that some people were injured from the vaccines ?

ajsnigrutin

We had them before too. A girl died in my country due to a J&J shot, autopsy was done by a whole panel of doctors, we officially stopped using J&J vaccine, our minister of health made an apology (while not admitting that she got vaccinated due to his mandates), official reports were published...

...and people here got all snarky when I mentioned her death, and attacked me with stuff like "what are your qualifications to rule her death as caused by vaccines?" and "i'm guessing you did the autopsy yourself?"

cm2187

And also be transparent about the pros and cons. One of the mistakes with covid is having made all sort of false statements about the efficiency of the vaccines (like it stops infections, the virus would be gone if everyone was vaccinated, kids are at risk of covid and must be vaccinated, etc) while the actual merits of the vaccine (dramatically reduces deaths and hospitalisations) should have been enough to convince the population at risk. Once you lied to people once, it takes a lot of time to re-establish trust.

yieldcrv

dont need masks

do need masks we lied because we think you’re stupid and would hoard all the masks

now you don't believe we need masks because we said prevent instead of reduce, and nothing was prevented

now you bolstered your opinion because we said “no evidence” instead of “the study hasn't been completed”

yes we said it affects young people and that caused a panic as if it was 1918 all over again, but you have to understand that 50 year olds are young to us and we are always speaking in a health professional context that nobody else knows even during the one time the public needs clear communication

enraged_camel

>> do need masks we lied because we think you’re stupid and would hoard all the masks

People panicked and hoarded toilet paper, of course they would also have hoarded masks and deprive healthcare workers of them.

jostmey

Cancer vaccines would be given to someone with cancer. These vaccines would not be preventative

bitxbitxbitcoin

That there is confusion just emphasizes that the term therapeutic vaccine needs more education around it.

When I think of vaccines, I think of something that’s preventative - regardless of the mechanism. Even the coming “Lyme Disease” vaccine is still preventative though it’s more of a tick bite vaccine.

Someone please school me.

Why is it a therapeutic vaccine - what’s wrong with calling it a treatment?

svara

It's a vaccine because it doesn't work on the cancer directly but rather teaches your immune system to attack the cancer.

Izkata

Then these shouldn't be called vaccines.

NegativeLatency

What basis is there for saying that?

There are many vaccines that can be given after exposure, for example the rabies vaccine: https://en.wikipedia.org/wiki/Rabies_vaccine

lkrubner

These are vaccines. They train the immune system to respond a particular way to particular proteins: that is a vaccine, full stop.

mig39

Giving HPV vaccines to teens (including boys) seems to be preventative.

bawolff

Which is not the type of vaccine the article is about.

90d

We need to improve public education

>more propaganda

No.. we need to improve transparency and actually do the studies?

the-printer

> "We gave 30,000 people this drug and you won't believe what happened!"

Lab coat Clickbait?

pydry

>Less appealing to authority and more appealing to observations

Antivaxxers aren't exactly scientifically inclined skeptics who will change their minds if fed more objective, impartial evidence.

They probably can be reached but I'm certain this isnt the way.

dmix

Every antivaxxer I know is skeptical because it ties into their existing beliefs of some hidden overarching power-system trying to control them.

Censorship and hiding criticism (informed or not) ‘for the greater good’ is like throwing gasoline on the fire. I have a family member who was merely just a lightweight New Age/holistic type of…skeptic. But the whole COVID response made it way worse. She doesn’t watch videos about why vaccines are bad, 90% of them are how the virus government/billionaires/big tech did x shady thing, so therefore don’t trust the vacinnes.

It’s really easy to spin that sort of thing into “they must have something to hide”.

I highly doubt all of the effort Facebook, Twitter, YouTube etc put into silencing dissent really did anything to promote better science or quell the fringes.

I don’t think anyone even cares if it did or not after-the-fact.

TexanFeller

I'm a relatively well educated and informed person about STEM topics, but I grew up in a family full of modern medicine skeptics, and living in TX am surrounded by many more. You have it exactly right, trying to censor the COVID misinformation(problem: do you trust who defines that) made it these people FAR more paranoid than they were before. I've actually had quite a bit of success listening to these people and addressing their concerns point by point with citations to studies. They may be less educated and informed, but they're not blithering idiots and will come around if you engage in a good faith discussion with them.

The other problem is resorting to force. If you mandate something to a Texan, you better believe they're resist the hell out of it, even if they know it's in their best interest otherwise. I have several friends that knew it was in their best interest to get the vaccine, but their libertarian values/morals drove them to take a stand against their companies who tried to compel them to take it. Medical freedom, which I largely agree with, but I was first in line to get the shot voluntarily.

asadotzler

Every anti-vaxxer I know has a totally different reason for ignoring their own self interest but they all seem to have one thing in common, they are absolutely not thinking for themselves. To the last one, they all regurgitated to me something they heard from one of the various celebrities they worship. They are all sheep following one or more of the dozens of victimization cults that have become so popular over the last two decades. "We're being repressed and misled and we're fed up. We're gonna stick it to the consensus by contracting preventable diseases!"

I'd actually be OK with letting Darwin run his train on those populations, if they weren't also recklessly causing the illness, disability, and death of their innocent neighbors who for age, health, or other legitimate reasons cannot get a particular vaccine. Should a child that's allergic to the MMR vaccine experience encephalitis and face possible lifelong disability or even death because his schoolmate's mom or dad worships a blathering radio host or a washed up model peddling conspiracies for profit?

I suspect most of you grew up in clean western neighborhoods. I grew up with a schoolmate and a member of my household, each severely disabled by polio. They drew a short straw and weren't lucky enough to have well functioning healthcare apparatuses in their birth countries. And for that crime, they were robbed of significant bodily mobility forever. That so many in the US would have us move toward that awful state of affairs instead of away from that is disappointing but I suppose not terribly surprising.

When I was younger, I thought only the simple minded were so easily conned and steered by hacks and hucksters but the last 20 years or so have demonstrated that many intelligent and educated Americans are just acutely gullible.

yonaguska

You're exactly right, and all the propaganda efforts just made it worse. Now I'm even more convinced that it's all about people seeking to exert more control over others.

I do however, consume lot's of media on how the vaccines are bad, and I'm skeptical of media that glosses over the science aspect and focuses on far fetched control conspiracies only. Limited hangouts and poisoning the well are misinformation tactics fwiw.

robocat

> Every antivaxxer I know is skeptical because

I know a bunch of anti-vaxxers in New Zealand, and they notably each had a different stated reason for being antivax. Perhaps because we don’t have the same political partisanship in this country (although partisanship was still a factor: it was interesting hearing right leaning people here reproduce sound-bites that I thought were American Republican political cliches).

heavyset_go

It's been my experience that people do not understand or care about what representative samples are.

amluto

I hope this technology, if successful, doesn’t get stuck in the land of very expensive, exotic cancer therapies. Epstein-Barr virus, for example, is nasty, and if you are over the age of 20 or so you probably have a latent EBV infection. A safe vaccine that could clear an existing EBV infection has the potential to prevent quite a large set of nasty conditions, cancer and otherwise. Think of it as something like the shingles vaccine, but a bigger deal.

It with also be interesting to see if the technologies used could lead to dramatically better vaccines for ordinary acute conditions. There is some evidence that people with pre-existing cellular immunity to intercellular antigens expressed very early in the lifecycle of a Covid-infected cell confers very strong immunity. The current vaccines don’t provide this sort of immunity, but the cancer vaccines are mostly targeting cellular immunity to intracellular antigens.

ackbar03

A very expensive and exotic treatment is still better than no treatment I guess. At least we have a starting point of knowing that something works, other people can hopefully come along and cut the costs down.

That being said, we still have cost problems even for not-so exotic treatments like bio-similars drugs (the generic equivalent for biologic drugs such as insulin). A lot of these drugs are off patent but still highly difficult and expensive to produce. Solving this bottleneck will be hugely beneficial to a lot of people

christkv

These are therapeutic vaccines customised to each case. My father is heavily involved with this working on one targeting brain cancers.

It's not a silver bullet but it will help if the patient responds and the cancer is not aggressive enough to kill the patient before the immune system is reactivated to fight the cancer successfully.

If it does work it looks very likely there will be no relapse.

Gatsky

> For instance, numerous monoclonal antibody trials failed to show reproducible efficacy for nearly 20 years before the eventual success of rituximab in 1997 (ref. 7); anti-programmed cell death protein 1 (PD-1) antibody data lacked clinical efficacy for years before the first nivolumab data were published8; and many years of ineffective chimeric antigen receptor T cell (CAR T cell) clinical data prefaced their eventual success.

This is a bit disingenuous. The mentioned therapies were developed from scratch in those time frames, whereas vaccine technology has been around for over 3 times as long. CART cells are also a much more complex and difficult therapy than vaccines…

lm28469

Cancer is already preventable, the vast majority of them are lifestyle/environment related: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515569/

This is like preventively giving broad spectrum antibiotics to animals raised in super dense cage farms. You wouldn't need most of them if you weren't raising them in hellish conditions, and the long term consequences are dire

khnov

My father has cancer on stage 4, he probably will die soon, do anyone knows if there are treatment he can try ?

JPLeRouzic

I am very sorry for your father.

There are many different kind of cancers, and metastasis' complexity further complicates the treatment. I guess the best hope is to get a bleeding edge medical treatment by joining a clinical trial, (and hoping to not be in the control arm).

Did you hear about CUSP9:

https://en.wikipedia.org/wiki/CUSP9

freddealmeida

We are learning more each day but i would never take anything like this. Preventing cancer without understanding the causal/morphological underpinnings seems like stopping kitchen fires by removing all the air in the room. Side effects would/could be significant.

JumpCrisscross

> Side effects would/could be significant

Got to give it to the internet. Railing against a hypothetical cure for cancer.

lm28469

It wouldn't be the first health scandal

adamredwoods

>> Effective vaccines are likely to be combined with other immunostimulatory approaches including adoptive T cell therapies and to be deployed in postsurgical adjuvant settings to prevent relapses.

Mostly post-surgical, but I wouldn't be surprised if eventually used for metastatic as well. Good luck to all involved.

mcbain

Immunotherapy is also being trialled as a neoadjuvant with promising results.

Vaslo

Armamentarium is a the word of the day for me.

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