The next big advance in cancer treatment could be a vaccine.
治療癌症的下一個重大進展，可能是一種疫苗。
After decades of limited success, scientists say research has reached a turning point, with many predicting more vaccines will be out in five years.
在幾十年的有限成功後，科學家們表示，研究已經到了一個轉折點。
因為，許多人預測，更多的疫苗將於五年內問世。
These aren’t traditional vaccines that prevent disease, but shots to shrink tumors and stop cancer from coming back. Targets for these experimental treatments include breast and lung cancer, with gains reported this year for deadly skin cancer melanoma and pancreatic cancer.
這些不是預防疾病的傳統疫苗，而是縮小腫瘤並阻止癌腫復發的疫苗。除了今年有關致命之皮膚癌、黑色素瘤及胰腺癌等，經報告的進展之外，這些實驗性治療的標的，也包括乳腺癌及肺癌。
“We’re getting something to work. Now we need to get it to work better,” said Dr. James Gulley, who helps lead a center at the National Cancer Institute that develops immune therapies, including cancer treatment vaccines.
協助領導國家癌症研究所，一處開發包括治療癌症疫苗之免疫療法中心的James Gulley博士宣稱：「我們正在使某事物起作用。目前，我們需要使其更佳起作用。」
More than ever, scientists understand how cancer hides from the body’s immune system. Cancer vaccines, like other immunotherapies, boost the immune system to find and kill cancer cells. And some new ones use mRNA, which was developed for cancer but first used for COVID-19 vaccines.
科學家們比以往任何時候更為瞭解，癌腫如何躲避人體免疫系統。與其他免疫療法一樣，癌症疫苗增強免疫系統，來發現及殺死癌細胞。也就是，一些新的疫苗使用，為癌症所開發，不過最先被用於2019冠狀病毒症(COVID-19：Coronavirus Disease-19)疫苗的mRNA。
For a vaccine to work, it needs to teach the immune system’s T cells to recognize cancer as dangerous, said Dr. Nora Disis of UW Medicine’s Cancer Vaccine Institute in Seattle. Once trained, T cells can travel anywhere in the body to hunt down danger.
於美國西雅圖，華盛頓大學醫學院，癌症疫苗研究所的Nora Disis博士表示，為了使疫苗起作用，需要使免疫系統的T細胞學會，認定癌腫是危險的。一旦經訓練，T細胞會在身體任何地方移動，以追捕到危險。
“If you saw an activated T cell, it almost has feet,” she said. “You can see it crawling through the blood vessel to get out into the tissues.” Patient volunteers are crucial to the research.
她宣稱：「倘若你看到一個活化的T細胞，它近似有腳。你能看到，它爬行穿過血管，進入組織中。對該項研究而言，病患志願者是至關重要的。
Kathleen Jade, 50, learned she had breast cancer in late February, just weeks before she and her husband were to depart Seattle for an around-the-world adventure. Instead of sailing their 46-foot boat, Shadowfax, through the Great Lakes toward the St. Lawrence Seaway, she was sitting on a hospital bed awaiting her third dose of an experimental vaccine. She’s getting the vaccine to see if it will shrink her tumor before surgery.
50歲的Kathleen Jade，於2023年2月底，得知她罹患乳腺癌。就在她與丈夫準備離開西雅圖，從事環遊世界的冒險活動前幾週。她坐在醫院的病床上，等待其第三劑實驗性疫苗。而不是駕駛她們46英尺長的Shadowfax號船穿過五大湖，前往聖勞倫斯海道。她正接受這種疫苗，以瞭解在手術前，能否縮小她的腫瘤。
“Even if that chance is a little bit, I felt like it’s worth it,” said Jade, who is also getting standard treatment.
也正接受標準治療的Jade宣稱：「即使機會渺茫，也覺得值得。」
Progress on treatment vaccines has been challenging. The first, Provenge, was approved in the U.S. in 2010 to treat prostate cancer that had spread. It requires processing a patient’s own immune cells in a lab and giving them back through IV. There are also treatment vaccines for early bladder cancer and advanced melanoma.
於治療疫苗的進展上，一直是種挑戰。個人化的疫苗，Provenge於2010年，最早在美國獲准，用於治療已經擴散的前列腺癌。它需要，在實驗室中，處理病患自身的免疫細胞，並透過靜脈(IV：Intravenous)，將其送回體內。也有供早期膀胱癌及晚期黑色素瘤使用的治療疫苗。
Early cancer vaccine research faltered as cancer outwitted and outlasted patients’ weak immune systems, said Olja Finn, a vaccine researcher at the University of Pittsburgh School of Medicine. “All of these trials that failed allowed us to learn so much,” Finn said.
美國匹茲堡大學醫學院的疫苗研究員，Olja Finn表示，由於癌腫騙過且逃過病患脆弱的免疫系統，早期癌症疫苗研究跌跌撞撞。Finn宣稱：「所有這些失敗的試驗，使我們得以學到很多東西。」
As a result, she’s now focused on patients with earlier disease since the experimental vaccines didn’t help with more advanced patients. Her group is planning a vaccine study in women with a low-risk, noninvasive breast cancer called ductal carcinoma in situ.
因此，目前她專注於，罹患早期疾病的病患。因為，實驗性疫苗對罹患較晚期的病患，沒有幫助。她的團隊正計劃一項，於罹患一種低風險、非擴散性乳腺癌(被稱為原位導管癌)之女性中，進行的疫苗研究。
More vaccines that prevent cancer may be ahead too. Decades-old hepatitis B vaccines prevent liver cancer and HPV vaccines, introduced in 2006, prevent cervical cancer.
更多預防癌症的疫苗也可能即將問世。數十年的B型肝炎疫苗預防了肝癌，及2006年引進的人乳頭狀瘤病毒(HPV：Human Papillomavirus)疫苗，預防了子宮頸癌。
In Philadelphia, Dr. Susan Domchek, director of the Basser Center at Penn Medicine, is recruiting 28 healthy people with BRCA mutations for a vaccine test. Those mutations increase the risk of breast and ovarian cancer. The idea is to kill very early abnormal cells, before they cause problems. She likens it to periodically weeding a garden or erasing a whiteboard.
於美國費城，賓夕法尼亞大學醫學院巴塞爾中心主任，Susan Domchek博士正在招募28名，具有乳腺癌容易罹患之基因(BRCA：Breast Cancer Susceptibility Gene)突變的健康人，供進行一種疫苗試驗。那些突變會增加乳腺癌及卵巢癌的風險。此構想是在異常細胞引發問題之前，很早就殺死它們。她將其比喻為，定期拔除花園的草，或擦掉白板上的字。
Others are developing vaccines to prevent cancer in people with precancerous lung nodules and other inherited conditions that raise cancer risk.
其他人正在開發疫苗來預防，於具有癌前肺結節(肺部的小細胞團)，及其他增加癌腫風險之遺傳疾病者中的癌症。
“Vaccines are probably the next big thing” in the quest to reduce cancer deaths, said Dr. Steve Lipkin, a medical geneticist at New York’s Weill Cornell Medicine, who is leading one effort funded by the National Cancer Institute. “We’re dedicating our lives to that.”
在尋求減少癌症死亡上，美國紐約威爾康奈爾醫學院，正在領導一項，由美國國家癌症研究所資助之嘗試的醫學遺傳學家，Steve Lipkin博士宣稱：「疫苗可能是下一件大事。我們正在為那件事，奉獻我們的一生。」
People with the inherited condition Lynch syndrome have a 60% to 80% lifetime risk of developing cancer. Recruiting them for cancer vaccine trials has been remarkably easy, said Dr. Eduardo Vilar-Sanchez of MD Anderson Cancer Center in Houston, who is leading two government-funded studies on vaccines for Lynch-related cancers.
具有遺傳性林奇徵候群疾病的人，一生有60%至80%，罹患癌症的風險。於美國休斯頓，德克薩斯大學門羅·杜納維·安德森(MD Anderson：Monroe Dunaway Anderson)癌症中心，正在領導兩項政府所資助，針對林奇相關癌症疫苗研究的Eduardo Vilar-Sanchez博士表示，招募她們以進行癌症疫苗試驗，已經非常容易。
“Patients are jumping on this in a surprising and positive way,” he said.
他宣稱：「諸多病患正以一種，令人驚訝且積極的態度參與此試驗。」
Drugmakers Moderna and Merck are jointly developing a personalized mRNA vaccine for patients with melanoma, with a large study to begin this year. The vaccines are customized to each patient, based on the numerous mutations in their cancer tissue. A vaccine personalized in this way can train the immune system to hunt for the cancer’s mutation fingerprint and kill those cells.
製藥商，莫德納及默克公司，正在聯合開發一種，供罹患黑色素瘤病患使用的個人化mRNA疫苗，包括於今年開始的一項大型研究。此些疫苗是根據每位病患癌腫組織中，諸多突變定製的。以此方式的個人化疫苗，能使免疫系統得悉，如何尋找癌腫的突變特徵，並殺死那些細胞。
But such vaccines will be expensive.
不過，這種疫苗會是昂貴的。
“You basically have to make every vaccine from scratch. If this wasn’t personalized, the vaccine could probably be made for pennies, just like the COVID vaccine,” said Dr. Patrick Ott of Dana-Farber Cancer Institute in Boston.
於波士頓，達納-法伯癌症研究所的Patrick Ott宣稱：「基本上，必須從頭開始生產每種疫苗。倘若這不是個人化疫苗，大概能如同冠狀病毒症(Covid：Coronavirus Disease)疫苗一樣，生產這種疫苗只需幾辨士。」
The vaccines under development at UW Medicine are designed to work for many patients, not just a single patient. Tests are underway in early and advanced breast cancer, lung cancer and ovarian cancer. Some results may come as soon as next year.
於華盛頓大學醫學院開發中的疫苗，旨在適用於許多病患，而不只是單一病患。試驗正於早期及晚期之乳腺癌、肺癌及卵巢癌病患中進行。 可能很快明年會有一些結果。
Todd Pieper, 56, from suburban Seattle, is participating in testing for a vaccine intended to shrink lung cancer tumors. His cancer spread to his brain, but he’s hoping to live long enough to see his daughter graduate from nursing school next year.
來自西雅圖郊區，56歲的Todd Pieper正參與一種，意圖縮小肺癌腫瘤的疫苗試驗。他的癌腫擴散到了大腦，不過他希望能活得夠久，以看到女兒明年從護士學校畢業。
“I have nothing to lose and everything to gain, either for me or for other people down the road,” Pieper said of his decision to volunteer.
有關其自願參與的決定，Pieper宣稱：「對我或對未來的其他人而言，我沒有失去什麼，反而得到一切。」
One of the first to receive the ovarian cancer vaccine in a safety study 11 years ago was Jamie Crase of nearby Mercer Island. Diagnosed with advanced ovarian cancer when she was 34, Crase thought she would die young and had made a will that bequeathed a favorite necklace to her best friend.
在11年前的一項安全研究中，最先接受卵巢癌疫苗之一的是，默瑟島(Mercer Island，位於美國華盛頓州金縣)附近的Jamie Crase。當Crase 34歲時，被診斷罹患晚期卵巢癌。她認為會英年早逝，並已經立下了，將一條最喜歡的項鍊，遺留給其最好朋友的遺囑。
Now 50, she has no sign of cancer and she still wears the necklace. She doesn’t know for sure if the vaccine helped, “But I’m still here.”
目前50 歲，沒有任何癌症跡象，因此她仍然戴著上述項鍊。她不確切知曉，是否此種疫苗有所助益，「不過，我仍然健在。」
網址：https://time.com/6290087/cancer-treatment-vaccine/?utm_medium=email&utm_source=sfmc&utm_campaign=newsletter+brief+default+ac&utm_content=+++20230626+++body&et_rid=207513678&lctg=207513678
翻譯：許東榮
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