Sarah Blagden, oncologist: ‘We should eventually have a vaccine that you get at age 40 that protects you from cancer’

One in two people will have cancer during their lifetime, warns English oncologist Sarah Blagden, from the University of Oxford. It is the same probability as flipping a coin and getting tails. Blagden, however, argues that malignant tumors are not inevitable. The researcher is the head of a revolutionary project, which is attempting to develop the first preventive vaccine against lung cancer, the most common and lethal in the world, causing nearly two million deaths a year. The initial goal is for the injection, called LungVax, to prevent the appearance of the cancer in an upcoming trial with 600 smokers and high-risk ex-smokers.

Blagden compares cancer to a disease that was seen as an inexorable curse for centuries: tuberculosis, which today is largely preventable with a childhood vaccine. The 55-year-old oncologist was born in a military hospital in the city of Aldershot, because her father, Brigadier General Paddy Blagden, was stationed there. Her father was an international leader in the dangerous removal of land mines after wars, who worked in countries filled with hidden explosives, such as Rwanda, Iraq and Afghanistan. Now it is Sarah Blagden who is trying to deactivate another kind of hidden bomb: the cells that form the so-called pre-cancer.

The oncologist recently visited Madrid to participate in a symposium organized by the CRIS Cancer Foundation, the Spanish entity that has co-financed the development of her experimental vaccine with half a million euros. Blagden’s team uses technology similar to that of the Covid vaccine developed by Oxford and the pharmaceutical company AstraZeneca. They take harmless chimpanzee cold viruses and modify the virus to introduce a stretch of DNA that generates defenses against specific proteins in pre-cancerous cells. Blagden speaks with urgency. In the hour that the interview lasts, 200 people have died from lung cancer in the world. “Every minute counts,” she warns.

Question. You say that today we have the same “culture of resignation” in the face of cancer as we did a century ago in the face of tuberculosis. Why do you believe this?

Answer. We accept that cancer has been around for a long time and is part of living. That’s wrong. We need to think of it as a preventable condition. Many oncologists work with established cancer, but we know that it takes years or even decades to being in our bodies. Pancreatic cancer, for example, takes about 15 years to form in your body, and when you get it, you die within six months. Why are we not researching those 15 years? Why are we not trying to understand the biological changes that cause normal cells to turn into cancer? It is an area of research that is empty, even though it seems so obvious that we should try to understand it. When cancer is in that phase of development, we call it pre-cancer, it can last decades and is reversible. You can prevent it from progressing to pancreatic, colon, ovarian, lung or any other cancer.

Q. Can we stop cancer before it even starts?

A. Exactly. It seems incredible, but it already happened with tuberculosis. It was said that it was the price you paid for being poor: you got TB and died of it. The mentality now is the same: the price you pay for a poor lifestyle is cancer, and you die of it. It isn’t true. I suspect that most cancers could be detected in the latency phase if we knew how to look for them.

Pre-cancer can last decades and is reversible: you can prevent it from becoming cancer

Q. Pre-cancers usually go undetected in blood tests and scans. What pre-cancers are detectable?

A. There are two very good examples where you can save lives. In cervical cancer, you can detect pre-cancerous lesions with a smear. In colon cancer, you can locate polyps with a colonoscopy. However, most of our organs, such as the pancreas and ovaries, are internal and you cannot see them.

Q. And what can be done with the pre-cancers that are undetectable?

A. We have to understand what biological events happen so that we can start to detect biomarkers in the blood. There is already early work underway in many laboratories, including mine.

Q. At what stage of development is your LungVax vaccine?

A. We will begin recruiting patients in January 2026. We have been developing the vaccine, trying to find the best combination of epitopes [the part of the molecule that antibodies recognize] to provoke the strongest immune reaction possible. We’ve decided on the one that’s best, and we are going to manufacture it in Oxford, in the same facility where the AstraZeneca vaccine against Covid was made.

Q. If all goes well, when could the vaccine to prevent lung cancer be available?

A. Within 10 years, at the earliest.

Q. Ten years until you can have an injection in an arm?

A. To have the vaccine in your arm, yes, because we are not in the pandemic situation, so we can’t fast track it in the same way.

Q. Why can’t it be fast tracked? Lung cancer is the leading cause of cancer death in the world.

A. It is a horrendous disease. I think that if there is evidence that the vaccine works, it could be fast tracked, but it is still difficult to know.

Q. Your group has received about €2 million ($2.14 million) from two non-profit organizations: Cancer Research U.K. and the CRIS Cancer Foundation. The United States government invested $1 billion to develop the Oxford and AstraZeneca vaccine against Covid. Why is the difference so big?

A. If the vaccine is proven to work, a lot of countries will want to have it, because lung cancer is a horrible killer and it costs billions to treat.

Q. Lung cancer kills 1.8 million people every year. Why doesn’t it already have $1 billion on the table?

A. Well, I think we don’t need a billion yet, because we still have to prove that it works in a small number of people. It’s not like the pandemic, where they just had to hope that experimental vaccines would work. Now we’re trying something very different. We are applying the methodology of the vaccine against a cancer. It is the first time it has been tried anywhere in the world. Vaccines work well against infections, but this is not an infection: we are targeting the cancer itself, the first changes that occur in lung pre-cancer. Currently, there are other experimental vaccines to treat cancer, but no one has developed a vaccine to prevent it.

Q. This would be the first.

A. Yes.

Q. The first against any type of cancer?

A. In the United States, vaccines are being developed to prevent colorectal cancer, specifically in people with Lynch syndrome, which is a hereditary condition. Ours will be the first vaccine that’s ever been designed to prevent lung cancer.

Q. New cancer treatments cost hundreds of thousands of dollars per patient and often have little clinical value. Do you think pharmaceutical companies are making too much money?

A. It’s a difficult question. The pricing of cancer drugs is really complicated. I like the idea of a vaccine, because it completely changes the paradigm.

Q. AstraZeneca CEO Pascal Soriot earned about €20 million ($21 million) last year, 10 times more than the initial cost of the lung cancer vaccine project. Soriot has made a total of €140 million ($150 million) in the last decade. What do you think?

A. I don’t know what to say about it, honestly.

Q. Would you say it’s immoral?

A. I prefer not to comment. I’m certainly not getting €20 million [laughs].

Q. What would you say to a friend who smokes?

A. There is overwhelming evidence that smoking causes cancer, but it is also really bad for your cardiovascular health and all kinds of diseases related to aging. I would tell my friend to stop smoking. All the vaccines in the world are not going to do anything compared to the main thing: quitting smoking.

Q. What if your vaccine works?

A. This is just the tip of the iceberg. At Oxford, we are developing vaccines against other types of cancer as well, such as colorectal cancer caused by Lynch syndrome, just like in the United States. Ultimately, what I would love to see is a vaccine given to everyone at a certain age, around 40 or 50, to protect them from the major cancers later on in life. That’s where I think we should be, but we have to start somewhere.

Q. That would be wonderful.

A. If you think about it, there is a 50% chance that we will get cancer in our lifetime. Why don’t we try to prevent it? It goes back to that culture of resignation that we have about cancer: “Oh well, it just happens.” But it will happen to 50% of us! With Covid, we stepped up, even though we knew that the chance of dying was 1 in 70. We all got vaccinated. And our chance of having cancer is 1 in 2, it is enormous. We need to do something.

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