Focus on cancer vaccine trials at UCLH

Among the many cancer clinical trials opening each year at UCLH, this year will see a focus on trials of personalised cancer treatments based on precision immunotherapies.

By the end of the year UCLH hopes to open more than 10 such trials, strengthening UCLH’s lead role in trialling new immunotherapies, and building on a body of work which is looking at new ways of treating or preventing cancer.

Colloquially known as cancer vaccines, these immunotherapies stimulate the immune system to recognise and eliminate cancer cells. Research in this area is at an early stage, so at the moment these treatments are mainly only available as part of clinical trials. But the NHS is aiming to provide access to personalised treatments like these for up to 10,000 patients by 2030.

Different treatment vaccines work in different ways. They can keep the cancer from recurring, destroy cancer cells left in the body after the end of conventional treatment, or stop a tumour from growing or spreading. But they all aim to prime the immune system so that a patient can generate a tailored immune response targeting the specific characteristics of their tumour.

Research into these treatments will help show how well they work – and which cancers they could treat.

At UCLH, we are working on several clinical trials of cancer services. For example, medical oncologist Mark Linch is the principal investigator (PI) on a trial which is trying to establish whether a particular type of immunotherapy could treat the cancer and avoid the need for a cystectomy, the removal of the whole bladder. He is testing the immunotherapy on its own and in combination with an experimental drug to find out how well the combination works to treat non muscle invasive bladder cancer, how safe it is and what the side effects are.

Another clinical trial which has just opened is looking at an mRNA-based cancer vaccine for people who had high-risk melanomas removed. Melanoma is a type of skin cancer. The vaccine works by instructing the body to make up to 34 neoantigens. These are proteins found only on the cancer cells, and the vaccine is personalised for each recipient so that it carries instructions for the neoantigens on their cancer cells.

Medical oncologist Heather Shaw, the PI of this new trial, says: “The idea behind the vaccine is that, by prompting the body to make these proteins, it can prepare the immune system to quickly identify and attack any new cancer cells bearing them, preventing recurrence.”

Medical oncologist Martin Forster is examining a vaccine which works to target a protein called Survivin. Survivin is found in many solid tumour cells, and prevents cancer cells from dying off. Survivin can be targeted by part of the immune system called Cytotoxic T Lymphocytes (CTL). The vaccine will stimulate the development of specific CTLs which in turn will target cells expressing Survivin, in the process becoming a therapeutic agent for the treatment of many solid tumours including lung, prostate and ovary.

And consultant interventional radiologist Steve Bandula is looking at whether immunotherapy during ablation can help treat colorectal, lung and sarcoma cancers. Ablation treatment involves destroying tumour tissue with heat or cold using a needle probe inserted through the skin guided by imaging. In this trial, patients undergoing ablation will have a special substance injected into their tumour at the end of the treatment procedure. This substance stimulates specific local immune responses and encourages the body’s immune system to ‘see’ tumour proteins released by the ablation treatment. The aim is to stimulate the immune system to recognise and attack cancer cells both in the treated organ and elsewhere in the body. 

These are just some of the new cancer vaccine clinical trials opening at UCLH this year. Other clinicians working on opening new trials include Kai Keen Shiu, Khurum Khan, Sarah Benafif, Siow Ming Lee and Rowan Miller. These clinical trials are looking at new treatments for solid tumours, and cancers of the pancreas, lung, ovary, head and neck, breast, bone and bone tissue and prostate.

Medical director Geoff Bellingan said: “This is an exciting time for cancer research and treatment at UCLH. We have several highly skilled teams working on the next stage of cancer treatment and prevention and, as a specialist centre for cancer, we are invested in looking for innovative ways to provide cancer care.”

Cancer Services divisional manager Lois Roberts said: “Cancer now affects one in two of us and finding new ways of treating cancer and less harmful forms of treatment is a huge motivation for our staff. These advancements and the continued focus on improving care for our cancer patients at UCLH have contributed to the North Central London Cancer Alliance demonstrating the top one-year and five-year cancer survival figures among Cancer Alliances in England.”

Kylie Gyertson, Head of Cancer Clinical Trials Unit said: “The volume and breath of cancer clinical trials delivered at UCLH really highlights how important our partnership with patients is. Without the trust and generosity of patients, we would not be able to continue to make these advancements in cancer care.”

Dr Nick McNally, Managing Director of Research, UCLH and UCL, said: “Developing new treatments for cancer is a major strategic priority for research at UCLH and UCL There is a lot of excitement around new immune-based therapies.

“The expert clinicians and scientists we have at our institutions, along with our clinical and research infrastructure and facilities, much of which is supported by the National Institute for Health and Care Research, have enabled us to become stand out leaders in this space. It is exciting to witness the delivery of these studies – which will pave the way for big improvements in care for our patients.”

For more information on clinical trials at UCLH, please consult our trials database.