Personalization of vaccines, the future of medicine

New vaccines or therapies against cancer will be obtained from the patient's cells or antigens, which will help treatments to be less aggressive and with fewer adverse events, was made clear during the talk "Vaccines of the future: cancer and HIV", which was part of the activities of the Festival of Sciences and Humanities 2021. Javier Sacristán de Alva, in charge of Continuing Education of the University Program of Studies on Asia and Africa (PUEAA) of the UNAM, considered that these diseases must be solved hand in hand between the social and technical fields.

Meanwhile, Jacobo Silva Parada, a postdoctoral fellow at PUEAA and professor at the Faculty of Political and Social Sciences, referred to the case of India where the health system is inequitable and there are approximately 2.3 million people infected with HIV; it is the third most affected country in the world. Everardo González González, from the Instituto Tecnológico y de Estudios Superiores de Monterrey (ITESM), explained that Molecular Biology has created a revolution.

A project of the pharmaceutical company Moderna is to develop personalized biologics, particularly against cancer. "It is a heterogeneous disease, so this vaccine would have the capacity to select elements characteristic of each patient and try to guarantee a greater effect, protection, and better therapy. This goes hand in hand with sequencing technologies, which determine the genetic code present in the tumor cells and enable the vaccines to go directly, with greater precision, to their target. These projects are under study; they are what is coming, he assured.

The biotechnologist affirmed that with the evolution of techniques, the possibility of generating safer biologicals has increased, although "obviously there will always be risks; the intention is that each time they should be minimal", and with greater efficiency and efficacy for protection against diseases.

By having in vitro cell culture, viruses can also be cultivated for treatment, making them as harmless as possible and providing protection. "With the evolution of technologies such as recombinant or molecular biology, new forms of vaccines have been generated." Another important part is bioinformatics, he noted.

There are more than 80 vaccines approved by the U.S. Food and Drug Administration (FDA); among the important ones against cancer are: Provenge, in 2010, and five years later the second, against prostate cancer and adenomas (a tumor that is not cancerous), one based on the genetically modified herpes virus, "trained" to attack cancerous cells that are administered directly into the tumors; and the other is through the isolation of dendritic cells ("sentinels" of the immune system) from the patient that are "trained" in vitro to attack tumors and then re-implanted as a vaccine.

González González stressed that science and technology must go hand in hand with the social, cultural, and even religious aspects because vaccines and other advances can be available, but there are also impediments for them to reach people.

The importance of vaccination

In the session moderated by Martín Bonfil Olivera, from UNAM's General Directorate for the Dissemination of Science, Itzel Montserrat Lara Mayorga, also from ITESM, explained that there are cancers associated with viruses and others that are produced by various routes. It is complex, which is why no vaccine or definitive cure has been achieved. "It is a disease in which biological, environmental and social factors intervene"; for example, 75 percent of breast cancer cases are associated more with lifestyle (smoking, excessive alcohol consumption, stress), the scientist added. In addition, there are different types of cancer, depending on the organ where it develops; genetics makes it different from one patient to another, and not all the cells that make up a tumor are the same.

In the case of the human immunodeficiency virus, he mentioned that a few years ago a diagnosis of HIV was synonymous with death, but several effective treatments were created, which have made it practically a chronic disease today. Now there is a phase 3 study (i.e. before commercialization) of which Mexico is part. The results of the new drug will be available at the end of 2023 or the beginning of 2024. "We hope to have good news regarding this vaccine".

Meanwhile, the human papillomavirus (HPV) is related to the majority of cases of cervical cancer. Eight out of 10 people will at some point have contact with it; "that is one reason why this disease is one of the leading causes of death and incidence in women. But HPV is associated with six other types of cancer, including throat cancer". Against this, there are several vaccines; 90 percent of the cases could be solved with vaccination.

Javier Sacristán de Alva, in charge of Continuing Education at UNAM's University Program of Studies on Asia and Africa (PUEAA), said that in Africa there are a significant number of countries with a problem of cervical cancer, and "this disease is closely linked to HPV and this, in turn, to the abuse of women and girls". In that continent, the incidence of HIV has been decreasing in recent years, unlike the different types of cancer, which are on the rise.

He explained that in this latitude it is not the same to have cancer and a high income that allows medical attention, even abroad, than to lack resources and live with less than a dollar a day; for the poor sector of the population, this diagnosis is the same as a death sentence because it is impossible to have access to the most modern treatments. "It is necessary to think about how to implement programs for early detection of the disease, accompanied by science and gender programs." The university professor argued that science must be linked to social ones and the programs that can be implemented from them; even those actions cannot be stopped because, for example, there would be no promotion of vaccination.

Meanwhile, Jacobo Silva Parada, a postdoctoral fellow at PUEAA and professor at the Faculty of Political and Social Sciences, explained that primary health care, especially in rural environments, maybe basic, elementary, and incomplete, but it has first-rate research institutions. In addition, the nation has the largest vaccine factory in the world. Since 2000, he recalled, biologicals against HIV have been tested there as part of a global initiative; "they have an institute for research into the virus, but also an organization for its control and a series of international cooperation mechanisms, with the United States and Europe in particular, to try to develop the vaccine".

Silva Parada pointed out that 70 percent of the Indian health system is private and there is no incentive for the public; it spends more on military hardware and defense than on health. Likewise, there have been anti-vaccine movements; there are prejudices and superstitions that assemble like a wall and prevent public policies and technological advances from being available to all, he concluded.

Source: UNAM