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The PancChat Podcast is a collaborative effort from Let’s Win Pancreatic Cancer and the Pancreatic Cancer Action Network (PanCAN), inspired by the long-running #PancChat Twitter/X chat.
Hosted by award-winning journalist Alisyn Camerota, each episode features conversations with leading researchers, clinicians, patients, and advocates who are shaping the future of pancreatic cancer care and research. Together, we deliver expert insights, personal journeys, and the latest breakthroughs—bridging the gap between science and lived experience.
Whether you’re a patient, caregiver, healthcare professional, or simply want to learn more, join us to connect, be inspired, and learn how you can help to accelerate progress in the fight against pancreatic cancer.
PANCCHAT PODCAST — EPISODE 19
Vaccines for Pancreatic Cancer
CINDY GAVIN: Hi everybody, and welcome to Episode 19 of the PancChat Podcast. I'm Cindy Gavin, CEO and co-founder of Let's Win Pancreatic Cancer. On today's episode, we will meet with Dr. Vinod Balachandran to take a closer look at vaccines being developed to prevent a recurrence of pancreatic cancer. Take it away, Alisyn.
ALISYN CAMEROTA: Hi, everyone. I'm your host, Alisyn Camerota. Welcome to the 19th episode of PancChat. We also want to thank our sponsor, Revolution Medicines. Today's episode focuses on a very hot topic: vaccines for pancreatic cancer.
We're talking to Dr. Vinod Balachandran, who can help us understand three promising vaccines that are on the horizon for pancreatic cancer. Dr. Balachandran is a surgeon scientist at Memorial Sloan Kettering Cancer Center in New York and the founding director of the Oleian Center for Cancer Vaccines. His team is working on an mRNA pancreatic cancer vaccine.
Doctor, thanks so much for being here.
DR. VINOD BALACHANDRAN: Thanks for having me, Alisyn. Great to be here.
ALISYN CAMEROTA: So what does it mean to have a vaccine for pancreatic cancer? Does that mean it prevents someone from getting pancreatic cancer, stops the spread once they have it, or something entirely different?
DR. VINOD BALACHANDRAN: That's an important distinction, Alisyn — one that sets cancer vaccines apart from the vaccines we typically think of for infectious diseases, like flu or COVID. With pathogen vaccines, you're vaccinating healthy people to prevent a future disease. In cancer, most vaccines are used not as prevention, but as therapy. They're given to patients who already have a cancer — in this case, pancreatic cancer. Specifically, most current pancreatic cancer vaccines are focused on preventing the cancer from returning after surgery. Patients have surgery to remove their cancer, and then receive a vaccine afterward to help prevent recurrence.
ALISYN CAMEROTA: Interesting. So it's actually neither of the ways I spelled it out — it's not treating healthy people, as you said. And at the moment, the vaccines only exist for someone who can be treated with surgery, which is not the majority of pancreatic cancer patients.
DR. VINOD BALACHANDRAN: What you're saying is correct, but it is somewhat similar to that first concept you mentioned — stopping spread — because it is designed to stop spread after surgery. So yes, this applies to patients with earlier-stage pancreatic cancer, but the goal is to prevent spread before it occurs.
ALISYN CAMEROTA: In other words, this is a different model than how most of us think about vaccines, like the COVID vaccine or the flu vaccine.
DR. VINOD BALACHANDRAN: That's right. With COVID or flu vaccines, they're given to people who don't yet have the disease, to prevent future illness. With cancer vaccines, most patients already have cancer when they receive their vaccine. The vaccine is used as one component of their overall treatment plan — to prevent cancer from returning. And this is generally how cancer vaccines are currently being tested, not just in pancreatic cancer but across many cancer types, with a similar approach throughout.
ALISYN CAMEROTA: I think all of us learned the term "mRNA vaccine" with COVID. What is that, and how is it different from our old childhood vaccines?
DR. VINOD BALACHANDRAN: That raises a bigger question: why is it so hard to make a cancer vaccine? We've made so many vaccines for pathogens — flu, COVID, others — so why haven't we successfully made a standalone vaccine for cancer?
Part of the answer is that vaccines for pathogens work because our immune systems are already hardwired to recognize bacteria and viruses as foreign. The vaccine is essentially boosting what the immune system already wants to do.
Cancer is different. Unlike pathogens, which are non-self — not part of our bodies — cancer cells are self. They are part of our own bodies, and our immune systems are hardwired not to attack our own tissue. So to make a cancer vaccine, we have to teach the immune system to specifically recognize certain elements within cancer cells that are more foreign and thus recognizable. That has been a fundamental scientific challenge the field has been working on for many decades.
One important discovery is that the immune system can recognize a cancer cell as foreign by identifying something called a mutation. A normal cell becomes cancerous due to breaks in the DNA, which can happen for a variety of reasons — ultraviolet radiation leading to skin cancer, smoking contributing to lung cancer, and so on. As cancer cells divide and spread, they accumulate more genetic errors. Some of those mutations form red flags on the surface of the cancer cell, signaling to the immune system that something is wrong. The immune system can then recognize those mutations and destroy the cancer cells.
Most current cancer vaccine technology focuses on identifying the mutations found in cancer cells but not in normal cells — and then converting that information into an instruction for the immune system via technologies like mRNA, essentially telling it: that's a bad cell.
ALISYN CAMEROTA: And is mRNA doing this differently than older vaccines, like those for rubella or other childhood diseases?
DR. VINOD BALACHANDRAN: One major challenge in making cancer vaccines is that the mutations found in cancer cells — the ones that allow the immune system to recognize cancer as foreign — are largely individual to each person's cancer. That means one patient's immune system recognizes their cancer in a way that's different from another patient who also has pancreatic cancer. So a vaccine would need to be personalized for that person's cancer and immune system.
To make a bespoke vaccine for each individual, you need a technology that can do it very rapidly. That's one reason mRNA has become a game changer. It allows you to make a personalized vaccine quickly, and it also generates a very strong immune response. Both of those characteristics make it well-suited for a cancer vaccine.
ALISYN CAMEROTA: And I assume that's also why molecular profiling of a tumor is so important for this type of vaccine — since each tumor is unique, you need to know exactly what you're working with?
DR. VINOD BALACHANDRAN: Exactly right. Molecular profiling, or genetic analysis of the tumor, allows us to identify the specific red flags present in an individual patient's tumor — the ones that will allow their immune system to recognize their own cancer as foreign. We then take that information and put it into a vaccine made specifically for that person. Because of this, personalized vaccines require individual genetic analysis and individualized manufacturing.
There are other approaches being tested that don't require personalization. One is trying to generate an immune response against mutations found across multiple pancreatic cancers — most commonly, mutations in the driver gene KRAS. A vaccine targeting a shared mutation like that would allow for an off-the-shelf option, without the need to generate a personalized vaccine for each patient.
Which approach is better — or can both work? Those are questions we don't yet have clear answers to. All of them are being tested in clinical trials, which makes this a very exciting moment for the field.
ALISYN CAMEROTA: But doctor, if you're personalizing a vaccine and tailoring it specifically to a patient's own mutation, why can't it be given at a later stage — say, stage four? If it's targeting the mutation, why would it only work after surgery removes the tumor?
DR. VINOD BALACHANDRAN: That's a great question, and the honest answer is that we do not yet fully know why. One observation is that there are lots of similarities in how the immune system recognizes a virus or pathogen and how it recognizes a cancer — using the same cells, molecules, and circuits. And while vaccines for pathogens have been extraordinarily successful — perhaps the most successful medicine in history — we know they don't work as treatment after someone already has the disease. For example, a COVID vaccine doesn't effectively treat someone who already has COVID.
It's plausible that similar rules may limit the current generation of cancer vaccines in patients with metastatic or advanced cancer. But there is significant effort in the field to understand exactly what the roadblocks and barriers are, and to engineer newer approaches to break through them.
ALISYN CAMEROTA: So explain the other two promising vaccine types that are reportedly in the pipeline — GVAX and ELI-2. What are those?
DR. VINOD BALACHANDRAN: Both of those vaccines are variations on the same common theme as the mRNA vaccine — they use different proteins or targets to teach the immune system that a cancer cell is cancerous and needs to be eliminated. In vaccine terminology, what the immune system is taught to recognize is called an antigen. The mRNA strategy uses a personalized antigen, which requires individualized genetic analysis and identification. GVAX uses a shared antigen found across many different pancreatic cancers, which would allow for an off-the-shelf vaccine. And the ELI vaccine also uses a shared antigen, in this case arising from driver mutations in KRAS.
So all three use different antigens to accomplish the same goal: teaching the immune system to recognize a pancreatic cancer cell as foreign. They also differ in their delivery platform. The mRNA vaccine uses mRNA technology, while GVAX and ELI use what's called a peptide vaccine. Same concept, different antigens, different delivery platforms — and all in various stages of clinical development.
ALISYN CAMEROTA: Has there been success so far? I know the idea of a vaccine that could stop the spread is considered the holy grail of pancreatic cancer treatment.
DR. VINOD BALACHANDRAN: How to make an immune response against cancer has been a fundamental challenge for the entire field of oncology — something the whole field has been working on for many decades. I think we're at a moment right now where advances across many different areas have put us closer than we've ever been before to answering this: how can you make an immune response against cancer with a vaccine? We've had evidence suggesting what antigen to use, what delivery platform, and what clinical setting. And we've now seen this validated in multiple applications using mRNA and other technologies.
What's particularly exciting is that many of these advances are happening in pancreatic cancer, which has historically been thought to be among the least likely cancers to respond to a vaccine or any immunotherapy. None of the other immunotherapies have had as much success in pancreatic cancer as they've had in other cancer types. So showing that this can work in pancreatic cancer could potentially unlock possibilities to apply these concepts more broadly.
ALISYN CAMEROTA: Are you saying more that theoretically you're making progress and this could open a new frontier — or are you referring to actual success in patients, because I gather there haven't been that many trials yet.
DR. VINOD BALACHANDRAN: I mean success in patients — actual clinical results. We are seeing very, very strong immune responses that we believe are strong enough to potentially prevent pancreatic cancers from returning after surgery. Multiple groups, including our own, have now demonstrated that you can treat pancreatic cancer patients — one of the most challenging patient populations — with cancer vaccines, generate a strong, lasting immune response, and potentially delay cancer from coming back.
These have been in early-phase clinical studies, specifically phase one trials. There are now larger clinical trials underway — phase two — to evaluate whether these vaccines perform better than standard treatment. So yes, there is very promising evidence, and in the coming years we'll learn more about how well these vaccines compare to current treatments.
ALISYN CAMEROTA: Thank you. That makes a lot of sense. For listeners who have been diagnosed with pancreatic cancer — who would be a good candidate to start exploring something like this?
DR. VINOD BALACHANDRAN: The first step is always to speak with your treating physician about potential clinical trials available at your institution and what you might be eligible for. These clinical trials for cancer vaccines are largely being tested in patients with tumors that are removable with surgery — earlier-stage patients. After surgery, any one of the aforementioned vaccine platforms might be used to help prevent the cancer from returning.
Right now, they are mostly being tested in earlier-stage patients, but hopefully in the years ahead we will learn how to apply what we discover here to patients with more advanced pancreatic cancer, because extending these options more broadly is clearly an extremely important goal.
ALISYN CAMEROTA: What have we missed? What else would you like to add?
DR. VINOD BALACHANDRAN: I'd just reiterate that it's a very exciting time, both for cancer vaccines and for pancreatic cancer specifically. As I mentioned, pancreatic cancer has historically been considered perhaps the least likely candidate for a cancer vaccine. Even for vaccines that target mutations, many in the field assumed this would not be the first cancer type to show results. So it is truly exciting that even in a cancer historically thought unsuitable for vaccine-based approaches, we are seeing very promising clinical activity. That could mean important strides for the field — and, more importantly, meaningful new treatment options for patients with pancreatic cancer in the future.
I'm very excited about the prospects, and to see what the coming years bring.
ALISYN CAMEROTA: That's wonderful. Thank you for sharing your excitement and such a positive outlook. It's been a real pleasure speaking with you, Dr. Vinod Balachandran. Thank you.
DR. VINOD BALACHANDRAN: Thank you so much, Alisyn. I really appreciate the time.
ALISYN CAMEROTA: And thanks to our listeners. I'm Alisyn Camerota, your host. Thanks also to our sponsor, Revolution Medicines, and I'll see you next time.
JULIE FLESHMAN: Hi, I'm Julie Fleshman, President and CEO of PanCAN — the Pancreatic Cancer Action Network. If you or a loved one has been diagnosed with pancreatic cancer, navigating this journey can feel overwhelming, but you don't have to do it alone. Be sure to explore the resources available to patients and caregivers on nutrition and healthy eating habits. You can find more at pancan.org and at Let's Win at letswinpc.org. Together, PanCAN and Let's Win are committed to guiding you through every step of the pancreatic cancer journey, offering support, information, and hope.
In our next episode, we'll be speaking with Dr. Elizabeth Jaffe about immunotherapy and personalized treatments for pancreatic cancer. Don't forget to follow PancChat to get new episodes delivered twice a month right in your podcast feed. PancChat is available on all major platforms wherever you get your podcasts.