Friday, 15 May 2015

Cuba's Lung Cancer Vaccine

The sudden shift in US-Cuba relations presents the world with a tremendous opportunity in the field of medical research, not least in developing a promising vaccine for lung cancer.
CimaVax is a vaccine treatment for non-small cell lung cancer, targeting a particular protein, epidermal growth factor (EGF), that attaches itself to receptor proteins on the surface of cells causing them to grow and divide. Cancers can cause the body to produce excess EGF to enhance the pace of cell growth. CimaVax is designed to stimulate the body’s immune system, prompting it to produce antibodies in response to the increase in EGF, preventing the protein from attaching to cancer cell receptors.
In theory, this will stop the signal that tells cancer cells to grow, slowing the cancer's likely growth. After 25 years of work at the Centre for Molecular Immunology in Havana, the drug was made available in 2011, free of charge, to patients at clinics and hospitals across the island while it underwent a third set of trials. Researchers looked for signs of an immune response among lung cancer patients and have so far found patients who have taken CimaVax do better.
The patients tested lived slightly longer - on average, between 4 to 6 months - while symptoms, like coughing and breathlessness, were reduced. The trial results also suggest younger patients fare better. Twelve people under the age of 60, who had strong immune responses, lived 15 months longer than previously expected. Any conclusions drawn should come with the caveat that only a small sample of patients were tested.

The politics of CimaVax 
CimaVax’s importance to Cuba is underscored by the fact that lung cancer is the fourth leading cause of death in the country. It is also the leading cause of cancer death in the US.
The results of the first trials in Cuba has triggered follow-ups by researchers in Japan and some European countries, but until now it has been politically impossible for the United States to undertake such trials. In December 2014, however, President Obama and Cuban leader Raul Castro announced their move towards normalising relations. Since then, US delegates have visited Cuba for the first time in over 50 years and, last month, Governor of New York Andrew Cuomo visited Havana in a landmark event for the two countries.

At the same time, the Roswell Park Cancer Institute at the State University of New York closed a historic deal with Cuba’s Centre for Molecular Immunology which will allow Roswell Park’s researchers to bring CimaVax to the US, where it can be put before the Food and Drug Administration (FDA). The drug can then be put through trials later this year before potentially entering the US health market. With Roswell Park’s financial resources, collaboration may prove beneficial to cancer sufferers around the world as alternative applications of the vaccine are explored.
“The chance to evaluate a vaccine like this is a very exciting prospect,” Roswell Park CEO Candace Johnson told WIRED. The company’s research team plan to explore the vaccine’s potential as a preventative measure in line with a standard vaccine that focuses on preempting conditions rather than minimising their symptoms. It may even be used to treat prostate, colon, breast, pancreatic and other cancers.
The Obama administration has so far relied on executive power to remove restrictions against the importation of medical and research equipment from Cuba. Congress are yet to decide whether or not the US will ultimately lift the trade embargo. If it is lifted, this could a groundbreaking opportunity for scientific and medical collaboration between the countries.

Doing more with less
Notwithstanding five decades of economic sanctions, Fidel Castro gave priority to medical research and biotechnology. “They’ve had to do more with less,” Dr. Johnson told WIRED. “So they’ve had to be even more innovative with how they approach things. For over 40 years, they have had a preeminent immunology community.”
Following a 1981 dengue fever outbreak which infected 350,000 Cuban citizens, Fidel Castro set up a Biological Front to focus the research efforts of different agencies. Mr. Castro dispatched Cuban scientists to Finland where they learned how to synthesise interferon, a virus-fighting protein, bankrolling their lab. By 1991, Cuba had become a major exporter of pharmaceutical products, at first to the USSR, then across Latin America and the developing world.
Today Cuba exports healthcare globally. Cuban health workers recently flew to West Africa to provide support in the multinational efforts to contain Ebola. The Cuban government also ensures the prices of the drugs the country's doctors offer are far below others on the market, in order to give developing countries a preferential option. As part of “south-to-south technology transfers” Cuba has provided support for China, Malaysia, India and Iran to set up pharmaceutical factories.

NOTE: In 2004, Cuba's biotech capacity was noted by American critics, such as UN ambassador John Bolton, as a potential basis for developing "biological weapons". The Cuban government strongly denied these accusations and invited US scientists to observe the laboratories.

As a result of these efforts, Cuba receives $8 billion a year in foreign exchange and financial support from the World Health Organisation. Export of medical services has not just brought in revenue - it has led the Castro brothers to grant over 100 patents to scientists and, in effect, open up the country to intellectual property rights. The prospect of normalised relations between Cuba and the United States thus holds enormous potential for the scientific community.

This article was originally written for The World Weekly on May 14, 2015.

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