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When Dr. Ana Maria Hernández Vazquez discusses the years of work she has pursued with the research group she leads at the Center for Molecular Immunology in Havana, Cuba, she talks about how a scientist’s work is a “never-ending story,” how finding one answer can so often lead to more questions and, in turn, more inquiry.

Such is the case with a vaccine Dr. Hernández and her team have developed in Cuba that is designed to induce production of antibodies against a glycolated ganglioside, which is uniquely found in tumor cells, especially lung cancer tumor cells. In published clinical trials, the Cuban vaccine, Vaxira, has extended the lives of patients with advanced non-small cell lung cancer with a median survival rate for vaccinated patients of 10.9 months compared to 6.9 months for patients who were given a placebo.��

Even more promising is that the survival rate of vaccinated patients two years after treatment was 22 percent compared to 8 percent of patients in the placebo group.

“The vaccine extends the life of the patients, but as with all the other cancer treatments, it doesn’t do it as much as we would wish and it doesn’t do that in as many patients as we want,” she said.

In hopes of changing that, Dr. Hernández reached out to Dr. Thomas L. Rothstein, professor of Biomedical Sciences, assistant dean for Investigative Medicine and director of the Center for Immunobiology at WMed, in 2008. At the time, Dr. Rothstein, an internationally recognized researcher in the field of immunology, was at the Feinstein Institute where he was the head of the Center for Oncology and Cell Biology and an investigator and professor in the Elmezzi Graduate School of Molecular Medicine.

Dr. Hernández invited Dr. Rothstein to a biennial meeting on the immunotherapy of cancer in Havana with the hope of laying the groundwork for a collaboration to improve the cancer vaccine her team had produced.

“It was just because of the science,” Dr. Hernández said. “All of those who are working in B cells have read Dr. Rothstein’s work forever … he was super famous. I was trying to start to understand the relationship between B cells and our vaccinations in Cuba.”

Dr. Hernández said she knew that learning more about B cells could help her team to better understand the mechanisms of the cancer vaccine and more specifically which cells were producing the antibodies the vaccine triggered. That knowledge, she said, can lead to improving the vaccine to make it work better for more patients.

“It was just a fascinating, intriguing area of study and clinical treatment,” Dr. Rothstein said. “The vaccine was there, now the question was which cells was it activating and how to make it better. I thought, ‘This is cool, this is really, really cool.’”

The collaboration between Dr. Hernández’s team and Dr. Rothstein’s lab has proven beneficial. To identify which cells were making the antibodies triggered by the vaccine, Dr. Rothstein said Dr. Hernández and her team needed to be able to isolate different populations of B cells with the kind of cell sorter technology that exists in the U.S. but is not available in Cuba.

Given that reality, Dr. Hernández and a member of her team, Dr. Nely Rodríguez Zhurbenko, have visited the U.S. seven times and five times, respectively, to work in Dr. Rothstein’s labs – first at the Feinstein Institute and now at WMed.

Dr. Rothstein said Dr. Hernández and Dr. Rodríguez have been able to show that healthy individuals naturally express antibodies that recognize lung cancer tumor cells by binding glycolated ganglioside, and that these antibodies are missing in lung cancer patients. Together the two groups have worked to identify which cells are responsible for producing these natural antibodies that are capable of binding to and destroying lung cancer tumor cells in healthy individuals.

Additionally, as part of the collaboration, Dr. Rodríguez has conducted important research that has shown that there is an age-related decline in beneficial natural antibodies. That decline may have the effect of reducing protection against many diseases associated with aging beyond lung cancer, such as heart disease, atherosclerosis and neurodegenerative diseases like Alzheimer’s and Parkinson’s disease.

“I think we’ve made a lot of progress,” Dr. Rothstein said. “I think we’ve done a lot to identify the B cells that normally make anti-lung cancer natural antibodies and now we are focusing on how (the B cells) are activated by vaccination. It’s really thrilling to be involved in this.”

As their collaboration continues, Dr. Hernández and Dr. Rothstein said one of their most important next steps is to begin figuring out how to put the technology in Dr. Rothstein’s lab to use to analyze the blood of vaccinated patients in Cuba. The vaccine, as of right now, cannot be administered to patients in the U.S. and the task of obtaining samples from vaccinated patients is difficult, if not impossible, because of the U.S. embargo against Cuba.

The ability to analyze samples from vaccinated patients is important, Dr. Hernández and Dr. Rothstein said, because the analysis will shed light on which specific B cells are responding to the vaccine which will, in turn, allow their teams to begin looking at adjusting the adjuvant in the vaccine to elicit a better and more intense therapeutic response for more patients.

Additionally, Dr. Rothstein said the teams will continue to collaborate on the work done by Dr. Rodríguez, as well, which could prove beneficial for older adults. Dr. Rothstein said he could envision that someday aging patients may get an infusion of the beneficial antibodies that decline with age to help protect them against several diseases, including cancer.

Dr. Hernández said she is proud of the work her team has done and is looking forward to continued work with Dr. Rothstein’s lab at WMed.

“At the end, you’re extending people’s lives … and the quality of life,” she said. You’ve giving a longer life with a better quality of life.”

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