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Cancer interception vaccines immunise people who do not yet have cancer but carry a high inherited risk, such as Lynch syndrome carriers, against the antigens their future tumour is predicted to express, so memory T cells remove transformed cells early. Because healthy people accept risk for a probabilistic benefit, the safety bar is far higher and trials take years.
Lynch syndrome tumours share recurrent frameshift neoantigens, making a shared off-the-shelf vaccine possible; Nous-209 has been tested in Lynch carriers, and a preventive vaccine against alpha-lactalbumin is in early trials for triple-negative breast cancer at the Cleveland Clinic. The strategy asks a healthy person to accept risk for a probabilistic benefit, so the safety bar is far higher and trials need long follow-up with adenoma or lesion endpoints.
Immunising against antigens a future tumour is predicted to express creates memory T cells that eliminate transformed cells before a clinical cancer forms.
Cervarix is a vaccine against HPV types 16 and 18, the two types that cause most cervical cancers, authorised in the EU in 2007 and the US in 2009 after the 18,000-woman PATRICIA trial showed near-complete protection against type-specific precancer. GSK withdrew it from the US in 2016, but it remains WHO-prequalified and used in national programmes, including single-dose schedules.
Gardasil was the first HPV vaccine, licensed in 2006 to prevent cervical and other genital cancers and genital warts. It has been replaced in most countries by the nine-type version, Gardasil 9.
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