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UK on “cusp of revolution” in cancer care, report finds

The UK is on the cusp of a major advancement in cancer care with its research into life-saving cancer vaccines, according to a new report from Public Policy Projects.

Advances in mRNA immunotherapies and new agreement between UK government and BioNTech could bolster UK’s status as ‘Life Sciences Superpower’, report from Public Policy Projects finds.

The UK is on the cusp of a major advancement in cancer care with its research into life-saving cancer vaccines, according to a new report from Public Policy Projects. Implementing precision medicine in the UK: The case of cancer vaccines finds that soon-to-be trialled personalised neoantigen vaccines potentially represent the next paradigm shift in precision treatment for cancer patients.

The experiences of running some of the fastest recruiting Covid-19 vaccine studies globally, alongside its growing genomic capabilities and research talent present an opportunity for the UK to achieve the government’s ambition of becoming a ‘Life Sciences Superpower’, the report says.

Further, gains in mRNA immunotherapy technology made during the pandemic have bolstered the UK’s attractiveness to outside investment in this area, as typified by the recently announced partnership between the UK government and BioNTech to run ground-breaking research into the development of cancer vaccines.

Cautious optimism

Based on insights generated during a roundtable event chaired by Professor Lennard Lee, National Clinical Advisor on Innovation and Cancer Vaccines, NHSE & Office for Life Sciences, and Dr Joanne Hackett, Head of Genomic and Precision at IQVIA, and attended by senior clinical oncologists. Despite the optimism within the report, it concludes that several key challenges must be overcome in order for initial trials to be a success and subsequent investment to be won.

These include core infrastructural limitations in the NHS, which the report says pose a threat to the success of cancer vaccine trials. High elective care waiting lists and a dissatisfied workforce could also mean that there is not the capacity to run demanding research trials, and therefore capacity issues must be overcome for oncology surgery services in particular, where vaccines are to be administered.

Additionally, it finds that the NHS must ensure equity of access to potentially life-saving trials, to ensure the benefits of trials are felt equally throughout the UK among different social groups and avoid the risk of exacerbating prevailing health inequalities.

The reports also identifies public trust as a potentially limiting factor to the success of vaccine trials, as participation from a diverse cross-section of society will be a crucial factor. In the report, author, Mary Brown, recommends that new incentives should be developed to encourage trial participation from underserved groups with lower socioeconomic status. This, it is argued, would help to overcome historical barriers to trial participation that often limit the diversity of trial participants, as would hospital trusts engaging with trusted community leaders to encourage those who may be vaccine hesitant to engage with clinical trials.

The “silver lining” of the pandemic

Commenting upon the release of the report, report chair, Dr Lennard Lee, said: “We are now all at the cusp of a potential revolution in cancer care, with the development of vaccines for cancer. Vaccines can be rapidly repurposed, switching in new modules that can deliver the blueprint to target cancer. These modules may be individualised to the very genomic changes that caused the cancer in the first place.

“The stimulus for this report is that if we, in 2023, build and address the issues that hold us back, we can deliver the silver lining of the pandemic.”

The report also recommends that:

  • NHS England and DHSC should review the progress of their funded plan to tackle care backlogs and waiting lists for elective care, given that targets for oncology services, and other elective care services, are continually unmet. The success of cancer vaccine trials will be dependent on investment that factors in the costs incurred in the clinical settings in which they are taking place.
  • Multidisciplinary teams should be formed during cancer vaccine trials so that pressures on frontline medical staff and overloaded clinical settings are reduced, lightening the burden of clinical trials overall.
  • As part of the overhaul of regulatory processes, the MHRA should consider ethical fast-tracking as part of their review.
  • Clinical trials should be required by the MHRA to adhere to diversity standards, which are reflective of the UK’s demographic diversity.
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