Aiming for the Bullseye: A Breast Cancer Vaccine

I am on a flight right now headed home from the second annual meeting of NBCC's Artemis Project® to develop a breast cancer preventive vaccine. I find myself extremely excited about the spirit of collaboration and innovation among the participants. I am impressed with the eagerness of all in attendance to think beyond their own work, to figure out the barriers to progress and to design strategies to overcome them.

I am also a bit overwhelmed at the moment as I review the weekend and anticipate the very hard work to come to make real the plans developed over the past few days. I have been thinking about a letter the National Breast Cancer Coalition sent to breast cancer clinicians and researchers last year asking them to imagine, just for a moment, what it would be like if we all collaborated toward the common goal of meeting our deadline to end breast cancer by January 1, 2020. In that letter, we asked what barriers they believed we needed to remove. We asked what they thought we could change and what they saw as the steps we needed to take to achieve our goal.

This weekend, as I sat among advocates from around the country and researchers from institutions including Cold Spring Harbor Laboratory, City of Hope Beckman Research Institute, the Mayo Clinic, University of Pennsylvania, the Whitehead Institute and several others -- all of us immersed in the challenges and opportunities in front of us -- we did exactly what I'd hoped when we set a deadline to end this disease. We worked together toward one common goal -- to end breast cancer by the end of the decade.

With the Artemis Project® preventive vaccine work, we are not simply facilitating work in progress, but actually creating the infrastructure for collaboration around development of the vaccine and moving new research forward. The Artemis Project® is not about developing better tools to identify the disease or creating better ways to manage it. It is not about taking the first possible vaccine target and accelerating it forward. It is about taking an unbiased look at what we do know and what we need to know to create the safest vaccine that actually works to prevent breast cancer in women. It is about harnessing what is already known and building upon that knowledge to develop and implement our strategic plan to achieve Breast Cancer Deadline 2020®. I'd like to remind you of something I said in my blog last week: this vaccine project is just one of the areas of focus for our deadline campaign. We are working on several other overarching issues in both primary prevention and preventing metastasis. But we had to begin with an issue around which we could create, build and test a model for collaboration and progress.

So you may be asking, why a preventive vaccine? For decades, billions of dollars have been invested in breast cancer research. We know more about the biology of the disease and we have many new tools and advanced technologies to apply that knowledge. This fairly recent scientific progress has created an opportunity. Increased knowledge about immunology, genomics, the molecular basis of tumor genesis and vaccine technology -- including design, synthesis and delivery -- have together created an unprecedented opportunity for development of a preventive vaccine. We could not have looked at this issue even five years ago. But now is the time to leverage those prior investments and get an answer.

You may also be asking, "aren't there others doing work on a preventive vaccine?" Yes, there are. And we are working with some of those scientists and researchers through the Artemis Project®. Some of them were at this past meeting; others will be invited in the future. Research in this area has not progressed very far. There are still many, many questions. No one approach so far has proven to be the right one. We need to continue to work with scientists with a mind open to the best path to saving lives -- and not just to their own research. Several of the researchers at the meeting this past weekend spoke to how the Artemis Project® helps them think differently about their work. They have formed new collaborations that will get answers more quickly. They are able to hear from others doing the same type of work and from other disciplines about strategies to get around problems. They recognize that through our deadline work they are able to participate in something that has been missing in breast cancer research: a true collaboration that rises above individual agendas to focus on the big picture of what is happening and with the focus of ending breast cancer. Not a focus on an individual's work, or the next publication or grant, but rather a focus on the real goal of saving lives.

When we began work on the preventive vaccine project, we identified four key issues and established a project team of scientists and advocates to work on each:

  • The search for a virus or antigen target or targets that will be safe, effective, and provide broad coverage for a diverse population of women.
  • Determine how the immune system responds to breast cancer with the aim of determining what the vaccine needs to accomplish.
  • Decide the optimal time for intervention and the appropriate population in order to achieve the highest impact and maximum results for those at risk of breast cancer.
  • Work with the other teams to consider safety issues across all steps of the project.

The Artemis Project® is not just about bringing stakeholders together and developing plans of action. NBCC understands that funding is an important component of catalyzing research. That is why the project includes seed grants to allow scientists to begin the research required in each of the key areas. We are in the process of soliciting and reviewing proposals for the first area, the identification of the antigens -- or targets -- for the vaccine. Grantees will be announced in a couple of months. Shortly thereafter, we will offer a request for inquiries for a second round of seed grants in keeping with the plan that the participants fleshed out this weekend.

None of us involved in this project are falsely comforted by an illusion that this work is easy. We have chosen a very difficult path. Not only are we bringing people together with differing views and different perspectives and challenging them to find the best path forward toward the common goal, we are asking them to do so in an area where there is a lot of uncertainty. There is not one clear and obvious path, but decisions must be made about strategies and priorities, so it is not for those with a weak constitution.

Yet all those who attended were willing and even enthusiastic about giving their best efforts toward this challenging work, willing to work differently and try new ways, in order to accomplish the ultimate goal of preventing breast cancer for women. That is what we are doing that through the Artemis Project®.

Why that name? Well, there are many projects named after Greek and Roman gods: Apollo , Mercury and Morpheus. But we wanted a goddess. Artemis was a Greek goddess who was the twin sister of Apollo and the daughter of Zeus. She was the goddess of the Moon, of the chase and hunt and worshipped mostly by women. She was an expert with a bow and arrow and the story is that she only needed one arrow to decimate an entire town where injustice ruled.

We do not have Artemis herself to take aim and rid the world of this disease, but I do believe that the Artemis Project® holds great promise for protecting future generations from breast cancer.