Özlem Türeci: "In a year or two, we will know whether our cancer vaccines work"

Our call is answered by an assistant with an executive air who, once she has checked that everything is in order,at the time we had agreed upon, brings on screen Dr. Özlem Türeci (Lastrup, Germany, 1967), co-founder and medical director of BioNTech, the company from which, together with Pfizer, she was able to develop one of the vaccines against covid-19. Dr. Türeci attends this interview from Mainz and expresses herself with the clarity of someone who is used to explaining scientific concepts with profane expressions and the simplicity of those who have achieved gigantic success. The biographical notes on this researcher and entrepreneur of Turkish parents present her as one of the richest women in Germany (it is estimated that in 2022 alone Pzifer-BioNTech will have a turnover of 37.77 billion euros for the covid vaccine). Özlem Türeci received the Catalonia 2020 International Award this week, which honored her and three other women, all fighters against the coronavirus.

What did it mean to you to be recognized with the Catalonia International Award?

— Oh, it is a special honor for me. I already knew about the award because one of my colleagues, also an oncologist, Dr. Josep Baselga, had already received it in the past. And it is wonderful to be recognized with other strong and brilliant women, with these sisters, I would say, in the service of a greater cause. I hope it will help further to highlight even more how important it is to mobilize women and girls as role models in science and technology.

You and your team came up with the vaccine against the virus only eight months after the WHO declared the pandemic. How do you recall those months?

— It was a roller coaster ride, I have to say. We felt a moral obligation to contribute and to embark into this journey, which we called Project Lightspeed, which already tells you, the name itself, that we had to move fast. We had tens of decisions per day which would contribute to whether the project would be successful or not, and for quite a long time because we were on new territory we were not sure whether we would hit the target at the end of the day, so it was very exciting and consuming time as well. But we are very happy that we were blessed with success.

At what point did you realize that the possibility of getting the vaccine was real?

— So there were two very important incidents or moments. One was that in our phase one clinical trial, we got the first data which showed that we can in fact raise a very strong immune response precisely against the spike protein of the virus, and that this immune response recruits several systems of immune system, so several task forces. So this was already a very important finding because it showed that our vaccine does what it is supposed to do. However, because the virus was new, and we did not know much about this virus, we could not be sure whether even a very strong immune response would be capable of preventing disease and becoming infected. And this we only learnt with data from our Phase three trial, which came in November.

You adopted a new scientific approach of injecting part of the genetic code of the virus to train the immune system.

— Yes, we used mRNA, a new technology which has not been used before in an approved vaccine or in any approved drug. So, in principle, the general approach of vaccines is that you present one part of the virus or the entire virus to the immune system, and we did exactly that. So that was not different from other vaccines. But what mRNA allowed us to do was that we did not need to construct this virus part. We just delivered the blueprint, the manual, how to generate this virus,part of a spike protein to the human body and the cells of a human body generate them with a protein, which is like a wanted poster for the immune system. So using MRNA and allows you to be faster to communicate better with the body and to ensure higher precision. This was an important piece for the success of our project Lightspeed.

To what extent can we be sure that the COVID vaccines your team and you produced will not cause any harm or side effect to those who were injected with them?

— There are two pillars. One pillar is what science tells us in terms of understanding the mechanism. And the mechanism of an mRNA vaccine is such that safety risks which come late are not to be expected because, you know, the mRNA enters the body, it builds the spike protein, the spike protein is recognized by the immune system, the immune system builds an immune response precisely against the spike protein, and the mRNA disappears within a couple of days. So these mechanistic, which are well studied, tell us that there is no situation where long term safety issues would arise or even shorter. This is one pillar. The other pillar is the clinical data, and our mRNA vaccine is the drug which is actually best studied as compared to anything in medicine, because so many people have been immunized with it. And all the safety data in clinical trials, but also in the vaccination campaigns, is being collected and assessed by regulatory authorities and public health authorities so that we have a good understanding what the safety profile is, and it is very, very unlikely that safety issues which are not recognized early on would appear sometime late because there's no mechanism by which after two, three, five years, all of a sudden something which you have not picked up earlier would occur.

You are all well aware that the world is plenty of theories and misinformation, but also understandable precautions, about what kind of product we are putting in our bodies.

— Yes, yes, and it is quite normal. It is the reaction that everybody usually has to anything that is administered, and the way I have learned to deal with it as a scientist and a physician is to be very transparent and to explain to people in the words that they can best understand exactly what we are doing there. I already did that when I was treating cancer patients, because there are also people who wonder, "What exactly is this, what will happen to me?" Still, the public, the media and governments have an obligation to disseminate very accurate, data based information.

Do you see Omicron as the end of the pandemic and the beginning of the endemic?

— I am very hesitant to speculate. We are just learning how this virus reacts over time. Everyone was expecting that there would be mutations, from which it would be more difficult to protect against with existing vaccines, but we did not know when they would appear and now we have to deal with it. So it is very difficult to predict how the evolution will continue.

Do you think it is possible, in the near future, to have a pan coronavirus vaccine, effective against all variants?

— I'm not sure whether we can really speculate again in this regard because we don't know again how the virus would evolve. We cannot predict how it would look like and against which types of potential new mutations one would need to prepare preemptively a vaccine. I think it is a very wise way, the way we handle now to chase the virus and understand where we need to adapt the vaccine

Pfizer-BioNTech has generated billions in revenue from vaccines. You will have more money for research. In which field of research do you plan to invest it?

— To multiple therapeutic areas. One important area for us is obviously still cancer because it is the much higher hanging fruit. Also, infectious diseases, diseases which still are also high medical need in particular in countries where the most vulnerable people are affected, like kids, for example, diseases like malaria, tuberculosis and HIV are areas in which we are actually already active. And from those two therapeutic areas, cancer and infectious diseases, we are also entering into new ones. Autoimmune diseases and regenerative medicine in order to just name two of those

You are a pioneer in research on stimulating the immune system to treat cancer. What is the current state of research being done in this field?

— We are using our mRNA platform again to develop vaccines against cancer. We have our cancer vaccines come in two flavours. We have highly personalized vaccines where we indeed on demand and tailor made generate vaccines for each and every patient which are unique. And then we have approaches where we have off-the-shelf mRNA cancer vaccines, which fit to a certain tumour type. And both these approaches have reached what we call phase two clinical trials. The second phase of in total three phases of clinical trials, which is how drugs are developed. And what we are testing in phase two, is that we compare against the standard of care these patients would normally get. And the task here is to show in so-called randomized trials that our vaccine is better when as compared to whatever patients with the specific cancer type would get nowadays. If we can show that this works out and we add a benefit and we will know this within the next one to two years, then we can better predict how fast we could be close to market with our vaccines.

You mean they could end up replacing the classic treatments of chemotherapy and radiotherapy?

— Exactly. So that is the development path one has to compare against the standard treatment and the standard treatment, depending on the tumour type, either chemotherapy or our antibodies, targeted therapies or so-called checkpoint inhibitors, which are also widely used. And one has to show that the vaccine works better and it's about replacing or adding on top of those treatments.

So, we are on the right track for cancer to become a chronic disease.

— That is exactly the objective, to make cancer a disease which is chronic and which allows the patients to have a life of normal quality. That's one of the main work streams, and another work stream is that we not only work in advanced cancers, we are very interested in using our vaccines in patients who get surgery and seem to be tumour free. But the cancer comes back because surgery could not delete all of the tumour cells. This is, for example, the case in colorectal cancer, where if you catch the disease early, patients don't have metastasis and there is a surgery and patients appear tumour free. However, 40 to 50 percent of these patients will relapse. And where at the end of the day succumb to their disease? And what we are doing is to develop cancer vaccines, which are used directly after surgery in order to enable the immune system to clean up the residual dormant and hidden cells so that this would be here. The objective would be to have a cure of cancer in these early stages of disease

The Berlin newspaper Tagesspiegel wrote that his success was a "balm for the souls of Germans with Turkish roots after decades of being stereotyped as lowly educated people." Is this your perception as well?

— It is true that the vaccine has averted millions of deaths, so it serves to motivate and be a role model for people who have our nationality. We feel blessed by all these side effects, which can also help us to have some more energy as a global community in these difficult times.

Did you really celebrate the fact that the effectiveness of the vaccine was 90 percent with a simple cup of tea?

— Yes, that's true [laughs]. Specifically, with Oolong tea, which is very, very, healthy, I recommend it! Also, you have to understand that we were really exhausted, so we didn't have much energy left to do other types of celebrations.

This reminds me of something else that I also read about you: that the day you got married, you went back to the lab after the ceremony.

— Yes, this is also true! I am actually very lucky because I have managed to make what I love to become my job and, therefore, it doesn't feel like work to me. It's just fun.