A personalised mRNA vaccine for melanoma, the deadliest form of skin cancer, is expected to be approved for use in the US, Europe and the UK next year. The vaccine is designed to stimulate immune responses against genetic mutations that are unique to an individual’s cancer. When used alongside standard treatment in a late-stage trial, it substantially cut the risk of cancer recurrence or death within the next two years.
Thousands of people in the UK alone could benefit from this, based on the trial’s patient population, she says. However, producing the vaccine is very expensive, and it may not be deemed cost-effective for use on the UK’s National Health Services (NHS), she says. In August, drugmaker Modern announced that the vaccine had positive results in a late-stage trial.
More specific findings have now been released. The trial recruited more than 1100 adults who had surgery to remove high-risk melanomas that were likely to recur or spread to distant sites. In the UK, 19,400 melanoma cases are diagnosed annually, of which about 25 per cent are deemed high risk.
Two-thirds of the participants were randomly assigned to receive a bespoke vaccine on top of standard immunotherapy, called pembrolizumab, which helps the immune system find and destroy cancer. Both were delivered every 3 weeks for up to a year. The remaining participants received placebo injections plus pembrolizumab.
The vaccine is made by genetically sequencing a small sample of a person’s cancer and comparing that sequence with the DNA in the individual’s healthy blood cells. This enables researchers to pinpoint mutations specific to the cancer. Based on the same technology used in covid-19 vaccines, the cancer vaccine contains mRNA molecules that encode for proteins with up to 34 of those mutations.
Side effects were similar between the two groups. The results combine cancer recurrence and death rates into one figure, but since a treated cancer has to recur for it to cause death, this combined measure should be interpreted mostly as a sign of the vaccine reducing recurrence, says Melcher. The participants haven’t been tracked for long enough to robustly determine whether the vaccine improves survival rates.
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