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Breast cancer

A ray of hope (The Hindu:3 June 2010)

The results of a vaccine trial for preventing breast cancer in mice have raised hopes of finding an effective
vaccine for use in humans. Breast cancer is one of the biggest killers in several countries. With nearly
100,000 new cases reported every year in India, it has overtaken cervical cancer as the number one cancer
afflicting women. The results published online in the journal Nature Medicine (“An autoimmune-
mediated strategy for prophylactic breast cancer vaccination,” by Ritika Jaini et al, of Cleveland Clinic,
Ohio) show that none of the genetically breast cancer-prone mice vaccinated with a single dose of alpha-
lactalbumin protein developed the cancer while those that received a placebo did. Except for a couple of
studies, research has shown the significance of using this protein as a potential antigen for breast cancer.
Alpha-lactalbumin is normally not present in non-breast human tissues. Hence to be chosen as a
preventive vaccine candidate antigen to prime the immune system, the protein should satisfy certain
conditions. It should be expressed by a majority of breast tumours at significant levels that allow its
detection. Secondly, its production by normal breast cells should be restricted to certain easily traceable
situations. In this case, alpha-lactalbumin, a lactation-dependent milk protein, is expressed only by
lactating mothers. Also, there appears to be less likelihood of the prophylactic vaccine causing any harm
to vaccinated women because, the authors note, the availability of the protein is “insufficient in normal
non-lactating tissue.”

Preventive vaccines against cervical cancer and liver cancers have been approved for use in the United
States and in several European countries. But unlike in the case of breast cancer, the approved vaccines
are directed against a virus that causes the cancer and not cancer formation itself. Another challenge is
that while viruses are easily detected by the immune system, breast cancer cells are normal cells that have
turned into rogue cells and hence escape detection and destruction by the immune system. Despite the
study showing that the targeted protein lies dormant in the breast tissue in non-lactating mothers and
therefore poses less risk of destroying normal cells through vaccination, the need to collect more
supporting evidence before undertaking human clinical trials cannot be over-emphasised. However, if
proven safe, a preventive breast cancer vaccine can be administrated to those past child-bearing age. This
study is significant for another reason: it has successfully demonstrated in animal trials the criteria to be
used for choosing the ideal antigen for cancer prevention vaccines.