Sarah Blagden, oncologist: “Eventually we should have a vaccine that you get at 40 that will protect you from cancer” | The science

Every second person will develop cancer during their lifetime, warns English oncologist Sarah Blagden from the University of Oxford. This is the same probability as if you tossed a coin and it came up heads. Blagden, however, argues that cancer is not inevitable. The researcher is leading a revolutionary project that aims to develop the first preventive vaccine against lung cancer.

Every second person will develop cancer during their lifetime, warns English oncologist Sarah Blagden from the University of Oxford. This is the same probability as if you tossed a coin and it came up heads. Blagden, however, argues that cancer is not inevitable. The researcher is leading a groundbreaking project that aims to develop the first preventative vaccine against lung cancer, the world’s most common and deadly cancer, which kills nearly two million people a year. The initial goal is for the injection, called LungVax, to prevent tumors in an upcoming study of 600 high-risk smokers or former smokers.

Blagden compares cancer to a plague that for centuries was considered an unforgiving curse: tuberculosis, which today is largely preventable with childhood vaccines. The oncologist was born 55 years ago in the military hospital in Aldershot, because her father, Brigadier General Paddy Blagden, served there. Progenitor was an international benchmark in the dangerous disposal of landmines after wars in countries infested with hidden explosives such as Rwanda, Iraq and Afghanistan. Now Sarah Blagden is trying to defuse other hidden bombs: the cells that form the so-called pre-cancer.

The oncologist had just visited Madrid to take part in a symposium organized by the CRIS Cancer Foundation, a Spanish organization that co-funded the development of its experimental injection with half a million euros. Blagden’s team is using technology similar to that of the Oxford and pharmaceutical company AstraZeneca’s Covid vaccine. These are harmless chimpanzee cold viruses that have been modified to introduce a piece of DNA that creates protection against certain proteins in precancerous cells. Blagden speaks urgently. In the hour that the interview lasts, 200 people died from lung cancer in the world. “Every minute counts,” he warns.

Ask. You claim that today we have the same thing “culture of resignation” to cancer than a hundred years ago to tuberculosis. Why do you believe this?

Reply. We recognize that cancer has been around for a long time and is already a part of life. This is mistake. We must view this as a preventable disease. Many oncologists work with established cancers, but we know it takes years or even decades to get started. For example, pancreatic cancer takes about 15 years to form in the body, and if you get it, you will die within six months. Why don’t we investigate these 15 years? Why don’t we try to understand the biological changes that cause normal cells to turn into cancer cells? This is an empty area of ​​inquiry, although it seems so obvious that we should try to understand it. When cancer is at this stage of development we call it precancer, it can last for decades and is reversible. You can prevent pancreatic, colon, ovarian, lung or any other cancer from developing.

TO. Can we stop cancer before it starts?

R. Accurate. It seems incredible, but this has already happened with tuberculosis. It was said that this was the price you paid for your poverty: you contracted tuberculosis and died. The mentality is the same now: the price you pay for a bad lifestyle is cancer, and you die from it. It is not true. I suspect that most cancers could be detected in the latent phase if we knew how to look for them.

Precancer can last for decades and is reversible: you can prevent it from becoming cancer.

TO. This precancerous phase is usually not detected by blood tests and scans. In what tumors can it be found?

R. There are two very good examples that can save lives. For cervical cancer, precancerous lesions can be detected using a smear. For colon cancer, polyps can be detected using colonoscopy. However, most of our organs, such as the pancreas and ovaries, are internal and you cannot see them.

TO. And what can we do about those precancerous lesions that cannot be detected?

R. We need to understand what biological events occur to detect biomarkers in the blood. Preliminary work is already underway in many laboratories, including mine.

TO. What stage of development is your LungVax vaccine at?

R. We will begin enrolling patients in January 2026. We develop a vaccine by trying to find the best combination of epitopes (the part of the molecule that antibodies recognize) to trigger the strongest possible immune response. We have already decided which one is best and will produce it in Oxford, at the same site where the AstraZeneca covid vaccine was produced.

TO. If all goes well, when will there be a vaccine to prevent lung cancer?

R. In 10 years at most.

TO. 10 years until you get a shot in the arm?

R. Yes, you don’t have a vaccine in hand yet because we are not in a pandemic situation, so we cannot speed up the processes in the same way.

TO. Why can’t they be sped up? Lung cancer is the leading cause of cancer deaths worldwide.

R. This is a terrible disease. I think that if there is evidence that the vaccine works, it could be accelerated, but it is still difficult to say.

TO. His group received nearly two million euros from two non-profit organizations: Cancer Research UK and the CRIS Cancer Foundation. The US government has invested $1 billion in the development of the Oxford and AstraZeneca Covid vaccine. Why is the difference so big?

R. If the vaccine is proven to work, many countries will want to get it because lung cancer is a terrible killer that costs billions of dollars to treat.

TO. Lung cancer kills 1.8 million people every year. Why isn’t €1 billion on the table yet?

R. Well, I think we don’t need 1 billion yet because we have yet to prove that it works for a small number of people. This is not like the pandemic, where you had to trust that experimental vaccines would work. Now we’re trying something completely different. We apply cancer vaccination methodology. This is the first time it has been tried anywhere in the world. Vaccines work well against infections, but it is not the infection: we are targeting the cancer itself, the first changes that occur in pre-cancer of the lung. There are currently other experimental vaccines to treat cancer, but no one has developed a vaccine to prevent it.

TO. This will be the first.

R. Yeah.

TO. The first against any type of cancer?

R. Vaccines are being developed in the United States to prevent colorectal cancer, especially in people with Lynch syndrome, which is an inherited disease. Our vaccine will be the first vaccine designed to prevent lung cancer.

All the vaccines in the world will do nothing compared to the main thing: quitting smoking.

TO. New cancer treatments cost hundreds of thousands of euros per patient and often have no clinical value. Do you think pharmaceutical companies make too much money?

R. It’s a difficult question. Pricing cancer drugs is really complicated. I love the idea of ​​a vaccine because it completely changes the paradigm.

TO. AstraZeneca CEO Pascal Soriot earned about 20 million euros last year, 10 times the initial cost of the lung cancer vaccine project. Over the past decade, Soriot has earned a total of $140 million. What do you think?

R. I don’t know what to say about this, honestly.

TO. Could this be immoral?

R. I prefer not to comment. Yes, I can assure you that I do not earn 20 million euros (laughs).

TO. What would you say to a friend who smokes?

R. There is overwhelming evidence that smoking causes cancer, but it is also very harmful to cardiovascular health and all types of diseases associated with aging. I would advise my friend to quit smoking. All the vaccines in the world will do nothing compared to the main thing: quitting smoking.

TO. What if your vaccine works?

R. This is just the tip of the iceberg. At Oxford, as in the US, we are developing vaccines against other types of cancer, such as colorectal cancer caused by Lynch syndrome. Ultimately, I would like to see the vaccine given to everyone at a certain age, around 40 or 50, to protect them from the major cancers that come later. We must achieve this goal, but we need to start somewhere.

TO. That would be great.

R. If you think about it, the chance that we will get cancer in our lifetime is 50%. Why don’t we try to prevent this? I insist on the culture of resignation that we have in the face of cancer: “Well, it just happens.” But this will happen to 50% of us! With Covid, we started even though we knew there was a 1 in 70 chance of dying. We were all vaccinated then. And our chance of getting cancer is 1 in 2, it is huge. We have to do something.

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