{"entity":{"id":"idea-interception-vaccines","kind":"idea","name":"Cancer interception vaccines for high-risk carriers","aka":[],"tldr":"Vaccinate people with BRCA or Lynch mutations against the antigens their future cancers will express, before any cancer exists.","summary":"Vaccinate people with BRCA or Lynch mutations against the antigens their future cancers will express, before any cancer exists. Lynch syndrome tumours share recurrent frameshift neoantigens and BRCA1 tumours are basal-like with predictable antigens, so vaccination could reduce adenoma and cancer incidence in carriers whose immune systems are intact and tumour burden is zero. Nous-209 for Lynch syndrome and the alpha-lactalbumin vaccine for TNBC from Cleveland Clinic are in early trials, and prevention needs only modest efficacy to be cost-effective. The test is a randomised placebo-controlled trial in Lynch carriers with colonoscopic adenoma incidence as the endpoint. At early-clinical maturity it addresses the bottleneck Inherited risk is mostly unidentified.","asOf":"2026-09-04","links":[{"label":"CAPP2: two years of aspirin cuts bowel cancer in Lynch syndrome by more than a third over 10 years (The Lancet 2020)","url":"https://doi.org/10.1016/S0140-6736(20)30366-4"}],"tags":[],"related":[],"cancers":["colorectal","tnbc"],"sections":[],"technologies":["shared-antigen-vaccine","chemoprevention","germline-testing"],"targets":["brca"],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Vaccination of Lynch carriers against recurrent frameshift peptides reduces adenoma and cancer incidence over 5 years.","rationale":"Immune system is intact, tumour burden zero, antigens predictable; prevention needs only modest efficacy to be cost-effective.","test":"Randomised placebo-controlled trial in Lynch carriers with colonoscopic adenoma incidence endpoint.","maturity":"early-clinical"},"route":"/ideas/idea-interception-vaccines/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"chemoprevention","kind":"technology","name":"Chemoprevention & risk-reducing surgery","route":"/technologies/chemoprevention/"},{"id":"germline-testing","kind":"technology","name":"Germline (hereditary) testing","route":"/technologies/germline-testing/"},{"id":"shared-antigen-vaccine","kind":"technology","name":"Off-the-shelf cancer vaccines","route":"/technologies/shared-antigen-vaccine/"}],"target":[{"id":"brca","kind":"target","name":"BRCA1 / BRCA2 (HRD)","route":"/targets/brca/"}],"bottleneck":[{"id":"b-hereditary-risk","kind":"bottleneck","name":"Inherited risk is mostly unidentified","route":"/bottlenecks/b-hereditary-risk/"}],"idea":[{"id":"idea-moon-lynch-vaccine-phase3","kind":"idea","name":"A frameshift neoantigen vaccine for Lynch syndrome carriers as the first preventive cancer vaccine approval","route":"/ideas/idea-moon-lynch-vaccine-phase3/"},{"id":"idea-prev-lynch-frameshift-vaccine-rct","kind":"idea","name":"A randomised trial of a shared-antigen vaccine to prevent Lynch syndrome cancers","route":"/ideas/idea-prev-lynch-frameshift-vaccine-rct/"},{"id":"idea-prev-therapeutic-hpv-vaccine-cin","kind":"idea","name":"A therapeutic vaccine to clear cervical precancer without surgery","route":"/ideas/idea-prev-therapeutic-hpv-vaccine-cin/"}],"paper":[{"id":"paper-lynch-frameshift-vaccine-ccr-2020","kind":"paper","name":"First trial of a vaccine against the shared neoantigens of mismatch-repair-deficient cancers","route":"/key-papers/paper-lynch-frameshift-vaccine-ccr-2020/"}],"roadmap":[{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-roadmap/"}]}}