Cancer vaccine slashes risk of relapse, death in melanoma patients by 44%

A cancer vaccine that uses the same technology as COVID-19 shots has been shown to slash the risk of tumours returning in advanced melanoma patients, according to a report published by Daily Mail UK.

The shot, combined with an immunotherapy drug, reduced the chance of relapse or death in sufferers after surgery by 44 percent, compared to the drug on its own.
Using pieces of genetic code from patients’ tumors, the vaccine effectively “teaches” the body to fight off cancer. Every shot is tailored to a specific patient, meaning no two will be the same.

Pharma giants Merck and Moderna – who are co-developing the technological advance – heralded the results as a ‘tremendous step forward’ and a ‘new paradigm’ moment. They will now ‘rapidly’ seek approval for a final stage clinical trial that will confirm the vaccine’s efficacy on a much larger group of patients. If successful, it could be approved within six months of the study’s end.

They added that the results are statistically significant, but have not been reviewed by independent scientists. Nevertheless, it suggests promise for an emerging but unproven class of vaccines that aim to treat diseases rather than prevent infections, as typical vaccines do.

The companies are already making plans to test the vaccine on other cancers. Another experimental cancer vaccine — developed at the famous Mount Sinai hospital in Manhattan, New York — rapidly melted away the tumors of three patients in a trial.

It works using DNA taken via a biopsy of each patient’s tumour. Then it analyzes the cancer sample and identifies mutations in the tumor’s cells known as neoepitopes.
Moderna selects several dozen neoepitopes that it believes would generate the strongest immune response from a patient, and inserts the genetic codes for these neoepitopes into a vaccine.

The vaccine uses messenger RNA — the molecule that carries a cell’s instructions for making proteins. Once inside the body, the mRNA instructs the patient’s cells to make the neoepitopes.

This in turn is supposed to trigger an immune response that can better target and destroy cancer cells. The vaccine is given in nine doses every three weeks, along with one course of Keytruda every three weeks.

Merck’s immunotherapy drug works by releasing the brakes on the body’s immune system so it can fight the cancer. If approved, the shot could be hugely expensive. Similar cancer vaccines being trialed cost around $100,000 (£91,000) per shot.

In the latest phase 2 study, 157 patients were given the personalized vaccines alongside Merck’s immunotherapy drug Keytruda. All had stage three or four melanoma, the most dangerous types, and were given the treatment after tumors were surgically removed.

They were compared to a control group with high-risk melanoma who had received surgery, but only received the immunotherapy Keytruda. MRNA has been at the forefront of potential cancer cures, after it was rapidly accelerated during the pandemic, leading to the two most successful COVID-19 vaccines — made by Pfizer and Moderna.

These latest results further indicate the gene-editing technology has promise against cancer too.

“It’s a tremendous step forward in immunotherapy,” Eliav Barr, Merck’s head of global clinical development and chief medical officer, said in an interview. Paul Burton, Moderna’s chief medical officer, claimed the combination “has the capacity to be a new paradigm in the treatment of cancer.”

Stephane Bancel, Moderna’s chief executive, said: “Today’s results are highly encouraging for the field of cancer treatment.

“MRNA has been transformative for COVID-19 and now, for the first time ever, we have demonstrated the potential for mRNA to have an impact on outcomes in a randomised clinical trial in melanoma.

“We will begin additional studies in melanoma and other forms of cancer, with the goal of bringing truly individualized cancer treatments to patients.

“We look forward to publishing the full data set and sharing the results at an upcoming oncology medical conference, as well as with health authorities.”

The firms are now seeking to launch phase three trials ‘rapidly’. A drug for fighting lung cancer has been approved for use in the United States.

The treatment — named adagrasib — will now be available for patients at an advanced stage of the disease that had at least one prior therapy. The Food and Drug Administration (FDA) gave the green light to the drug today, which was developed by California-based Mirati Therapeutics.

Adagrasib is taken orally and designed to target a mutated gene — dubbed KRAS — that occurs in 13 percent of non-small cell lung cancer patients (NSCLC). Clinical trials showed 43 percent of patients responded to treatment. Mirati said it would be sold under the brand name Krazati at a price of $19,750 (£15,929) for a 180-tablet bottle.

Its chief executive David Meek said in a recent interview: ‘I think physicians and patients are going to appreciate having an effective option.’
Previous trials of mRNA shots for cancer showed promise against head and neck cancer, but were not effective for colorectal cancer.
Moderna and Merck have been running trials of the cancer shot together after forming a ‘strategic partnership’ in 2016.
The American Cancer Society says that the rates of melanoma have been growing significantly over the past years.
It estimates that about 99,780 new melanomas will be diagnosed (around 57,180 in men and 42,600 in women) in the United States (US) in 2022.
And about 7,650 people are expected to die of melanoma (roughly 5,080 men and 2,570 women).
The lifetime risk of contracting melanoma is about 2.6 per cent (one in 38) for white people, 0.1 per cent (one in 1,000) for black people, and 0.6 per cent (one in 167) for Hispanic people.

The type of cancer is more common in men, but before age 50 it is more prevalent in women.
The older you are, the more at risk you are from melanoma. The average age of diagnosis is 65, but it is not unusual in those under 30 either. It is one of the more common cancers in young adults, particularly young women. Melanoma occurs after the DNA in skin cells is damaged (typically due to harmful UV rays) and then not repaired, triggering mutations that can form malignant tumours.

It is currently treated in a few different ways.
The melanoma can be removed by taking out the entire section of the tumor or by the surgeon removing the skin layer by layer. In the latter case, the surgeon is able to figure out exactly where the cancer stops so they don’t have to remove more skin than is necessary.

The patient can decide to use a skin graft if the surgery has left behind discoloration or an indent. Immunotherapy, radiation treatment or chemotherapy may be needed if the cancer reaches stage III or IV. That means that the cancerous cells have spread to the lymph nodes or other organs in the body.

How mRNA tech could cure cancer: For over a decade, cancer researchers have been working on individualized cancer vaccines, using technology including mRNA.
Messenger RNA, or mRNA, is genetic material, which tells the body how to make proteins.

The mRNA COVID-19 vaccine teaches cells in the body how to make a protein, which sets off an immune response.
The immune response generates antibodies, so that if the body is exposed to the real virus later, the body will recognize it and know how to fight it off.
With a cancer vaccine, researchers aim to bring out an immune response to fight abnormal proteins, known as neoantigens, made by cancer cells.
The manufacturing process for the vaccine begins by identifying the genetic mutations in a patient’s tumor cells that could release neoantigens.
The patient will have had the tumor surgically removed, meaning scientists can easily look at the tumor’s cells.
Computer algorithms judge which neoantigens are most likely to latch onto receptors on white blood cells and trigger an immune response.
The personalised shot can hold genetic sequences for up to 34 different neoantigens.
It is hoped that the mRNA vaccine will then activate white blood cells, which can recognize individual cancer cells thanks to the cancer cells’ neoantigens.
The vaccine will effectively teach the immune system that cancer cells are different to the rest of the body.
This will hopefully not be too hard, as neoantigens do not form on normal cells.
Once tissue samples have been gathered from a patient, it takes between one and two months to make a personalised mRNA cancer vaccine.

A previous Moderna-sponsored study of a personalized cancer vaccine on patients with head and neck cancer saw the biotech company produce each individualized shot in around six weeks. Because of the specialised nature of the vaccines, each one can cost up to $100,000.