The Artemis Project® and a Preventative Vaccine

On May 20-23, 2017, four New Hampshire Breast Cancer Coalition board members had the opportunity to attend the National Breast Cancer Coalition Advocate Leadership Summit in Washington, D.C. In 2010, the Nation-al Breast Cancer Coalition set a deadline to know how to end breast cancer by 2020. The Artemis Project®, an advocate-led re-search effort, was launched by NBCC as part of Breast Cancer Deadline 2020®. The focus of the Artemis Project® is preventing women and men from getting breast cancer and preventing metastasis. As stated on the NBCC website, there have been annual meetings and interim meetings to develop plans for a preventative vaccine. An international team of scientists together with advocates is developing the experimental protocols to create the preventative vaccine and gather the preclinical safety and efficacy data that will be necessary for FDA approval. Artemis participants are ready to begin the preclinical phase for a preventative vaccine.

The idea of a vaccine for breast cancer may seem like science fiction but it is not without precedent. Just think about how far we’ve come since the first vaccine was developed for small pox in the 1790’s. The childhood mortality rate has decreased sig-nificantly due to vaccines not only for small pox but also for diphtheria, polio, pertussis, and measles. Science breakthroughs contin-ued with the vaccine for hemophilus influen-za type B (HIB), meningococcal disease, herpes zoster, pneumococcal pneumoniae, and most recently, the vaccine to prevent the Human Papillomavirus. HPV is known to cause approximately 70% of cervical can-cers as well as anal cancer and oropharyn-geal cancer.

Increased knowledge about immu-nology, genomics, the molecular basis of tumor genesis and vaccine technology has created an opportunity for development of a preventative vaccine for breast cancer. The goal of the scientists on the Artemis Project® is to make a vaccine that may be adminis-tered to all women without a diagnosis of breast cancer.

Four issues were identified by the Artemis Project® team as objectives for the development of a vaccine.

  1. Search for a virus(es) or antigen target(s) that will be safe, effective, and pro-vide broad coverage for a diverse popu-lation of women.
  2. Determine how the immune system responds to breast cancer with the aim of determining what the vaccine needs to accomplish.
  3. Design appropriate clinical trials taking into account the optimal time for inter-vention and the appropriate population in order to achieve the highest impact and maximum results for those at risk of breast cancer.
  4. Develop a plan to address safety issues across all steps of the project.

The researchers who spoke at the NBCC Advocate Leadership Summit pre-sented the science behind their research, the challenges they face, and the exciting potential of immunotherapy. The selected antigens to be used in a vaccine have been identified and have already been individually tested in humans. In regards to testing the vaccine, it will likely first be given to women previously treated for Ductal Carcinoma In Situ (DCIS) to evaluate safety and immuno-genicity.The challenges will be choosing a vaccine vector (mechanism of transporting the vaccine into the immune system), determining who will make the vaccine, the cost of the vaccine, and transitioning from using the vaccine in a patient with DCIS to a healthy individual.

The science and treatment of breast cancer have made great progress in the past few decades, yet the overall survival rate of breast cancer has not significantly changed. The scientific breakthroughs in immuno-oncology and the development of a preventative vaccine will be the game changer that will lead to our success of meeting Breast Cancer Deadline 2020®.