During the Congress in April we were pleased to meet Dr Pravin Kaumaya for a conversation about the state of play in the cancer vaccine field. Dr Kaumaya joined us to chair the Cancer and Immunotherapy track, present a session and join a panel. Here we learn more about Dr Kaumaya’s approach, how it differs to those of his colleagues, and why he believes that vaccines are the way forward for cancer therapy. We are so grateful to Dr Kaumaya for his time and hope that you enjoy the interview!
Introducing Dr Kaumaya
Dr Kaumaya is a Professor at the Wexner Medical Centre in Columbus Ohio and has been there for 30 years! Originally from Mauritius, Dr Kaumaya was educated in the UK and has now made his home in the US.
“My lab is in involved in vaccine research for the last three decades.”
What does the cancer field look like now?
With Dr Kaumaya’s experience working in the field of cancer we were curious to hear his thoughts on the progress that has been made. He suggests that “a lot of progress has been made” particularly in recent years. He refers to the Nobel Prize winners Professor Honjo and Professor Allison for their work on checkpoint inhibitors, which he believes has “energised the field of cancer vaccines”.
“I think, in a positive way, I think we will have a cure very, very soon, because of all the combination immunotherapy that is going to be done.”
What does Dr Kaumaya’s lab address?
Within this promising field, we asked Dr Kaumaya to explain his work. His cancer vaccines are “based on peptides”. He tells us that there are two response options: the humoral response or the cellular response. Many of Dr Kaumaya’s colleagues, including Dr Disis, who we spoke to at the Congress, target T cell cellular responses.
“We’ve taken a different route for the last 20-25 years, is to look at B cell vaccines, so where you would generate a polyclonal antibody response.”
This is being applied to HER2, which is over-expressed in breast and colon cancer. The team has “translated” their work to the clinic, with a Phase II trial ongoing.
“The nice thing about what we do is we develop those peptide B cell epitope conformational; we engineer it to fall into 3-dimensional structure, and that is very unique to my lab.”
The lab has developed a “whole portfolio” of vaccines. These acknowledge the “mechanism of resistance that’s come in”, which leads to “up-regulation of all the other receptor tyrosine kynases”. When checkpoint inhibitors “came along”, Dr Kaumaya decided to use peptide vaccines. The beauty of “just peptides” in contrast to the toxicity of other approaches, is the long-established safety.
Combination approaches
Some of Dr Kaumaya’s sessions were focused on combination approaches. We asked about the importance or the benefit that this focus provides.
“Of course, single mono-therapy is only valid in about 20% of patients. So, if you have a combination you can elevate the response.”
The combination could be with chemotherapy, radiotherapy, or other checkpoint inhibitors. For Dr Kaumaya’s team, combination is with the HER2 vaccine, currently in trial.
“You can see the synergy, the additivity of multiple targeting agents.”
Getting clinical trials right
Discussions at the Congress addressed the difficulty of clinical trials in this space. When we asked Dr Kaumaya about his, he reminded us that “we are dealing with biologics here”. Although peptides are “100% safe”, the work that he does is governed by the FDA as if it was small molecule work.
“We have to follow that regimen, and that is not very good.”
The example that Dr Kaumaya gives is their clinical trial with the HER2 vaccine, for all comers. These patients have been “subjected to multiple regimens of toxic events”. Consequently, the immune system is “depressed”. Therefore, to be able to use a vaccine approach the team get the patients to “lay low” without treatment for 6 weeks.
“Hopefully the FDA and the EMA will understand as we move forward, that when we do Phase I clinical trial they should allow us to be able to access patients that have not undergone multiple regimen, because it’s not beneficial to a vaccine approach. And hopefully that mentality will change.”
The importance of access
Another hot topic at the Congress was access, and how to develop vaccines with equitable intentions. When we asked whether access was a challenge or a worry for Dr Kaumaya, he replied emphatically: “not at all”. He contrasts current therapies in clinical trial, which don’t provide a cure but cost hundreds of thousands of dollars, with his vaccine. This is a 3-shot programme for $140 a shot.
“I don’t think you can beat vaccination… vaccines are a very good way to go forward.”
Joining us at the Congress
Our final question was on the reasons that Dr Kaumaya was joining us at the Congress. The focus of Dr Kaumaya’s time in Washington was education. He hoped to convince people that B cell vaccination was the way forward.
“I have to educate scientists.”
Taking us back a bit, Dr Kaumaya points out that currently FDA-approved treatments are monoclonal antibodies. Therefore he asks why we can’t “have the immune system make those antibodies”.
“We’ve got the technology to design those vaccines based on protein folding, biochemistry, and so on. And then when we put those in humans or in animals, you get a high-affinity, polyclonal antibody response, which should be as effective as a monoclonal antibody.”
We hope that the opportunity to “educate” his peers was successful for Dr Kaumaya, and look forward to hearing more at future events. To get more like this make sure you subscribe!
