We Can Now Customize Cancer Cures, Tumor by Tumor
But can any company afford to manufacture one-off medical treatments?
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By Adam Piore
The first time someone pitched Genentech’s senior leadership on a personalized cancer vaccine, it did not go well. “I thought there was going to be a riot,” Ira Mellman, then Genentech’s head of research oncology, recalls.
From across the table, he watched the scientific review committee grimly shaking their heads as his team member and longtime collaborator Lélia Delamarre made her case. Then he overheard the head of clinical development turn to the person sitting next to him and mutter, “Over my dead body. A vaccine will never work.”
That was in 2012. Cancer immunotherapy, which uses a person’s own immune system to attack tumors, is now one of medicine’s most promising fields, and one of the greatest breakthroughs in oncology in decades. But it took a long time to get there. Until the recent advent of a new class of blockbuster immunology drugs, the field was notorious for questionable science, hype, and spectacular disappointments.
And what Mellman and his team were proposing that day went further than turbocharging immune cells to make them better able to attack cancers. They were talking about a vaccine precisely tailored to stimulate the immune system to react to specific tumors. If it worked, the approach could, in some cases, be even more potent than other types of immunotherapy. But it faced a series of daunting hurdles. If Genentech, a San Francisco–based biotech company owned by the Swiss pharma giant Roche, were to attempt to develop a vaccine that could attack individual tumors, it wouldn’t just have to accept new scientific advances; it would also have to embrace an entirely new and untested business model. That’s because the vaccine Mellman and Delamarre envisioned could not be manufactured the traditional way, in large batches that could be packaged in bulk, warehoused, and dispensed off the shelf at your local pharmacy.
When Mellman and Delamarre said “personalized,” they really meant it. The composition of each vaccine would be based on the characteristics of each patient’s tumor DNA. The company would have to, in essence, make a separate treatment for every single…
