Health
Cancer mRNA vaccine shows promise against melanoma relapse
Messenger RNA vaccines are no longer just for COVID.
of vaccine technology What America learned during the pandemic was originally targeted at cancer, but the pandemic began its use against infectious diseases. It has been suggested that it may help prevent the cancer, melanoma, from recurring.
The study, presented Sunday at a research conference, found that patients who received the personalized mRNA vaccine created by Moderna and Merck had a 44% higher survival rate than those who received standard treatment alone, and new tumors. The possibility of avoiding it was shown about two years later. .
If the results hold up in a larger, longer-term study due to begin later this year, it would mark a dramatic turnaround for decades of failed cancer vaccines.
“This is probably the first real data to suggest that this individualized approach to vaccination is worthy of further investigation,” said co-author of the study, an oncologist at the Mass General Cancer Center. said one Dr. Ryan Sullivan.
Instead of using vaccines to try to prevent or shrink tumors, new mRNA vaccines aim to reduce the chances of high-risk cancers coming back.
“This represents a major shift in how cancer vaccines are used,” said program chair at the American Association for Cancer Research annual meeting, where the study was presented, although he was not involved in the study. said one Dr. Robert Vonderheide. .
Pandemic, mRNA vaccine Already being developed for cancer, Vonderheide, who is also director of the University of Pennsylvania Abramson Cancer Center, said it could be safe to use and could be developed quickly.
The benefits seen in melanoma, a cancer known to be controlled by the immune system, are likely to be maintained in other cancers affected by the immune system, he and several other experts say. said the next thing to be tested for is non-small cell lung cancer. kill about 100,000 Americans Year.
But it makes sense to try it in melanoma first.
“No cancer is more amenable to immunotherapy than melanoma,” said Dr. Rodave Amalia, a melanoma oncologist at MD Anderson Cancer Center in Houston. “We need to prove it in melanoma before trying it in other cancers.”
Graphic description:Mechanism of mRNA vaccine
How do mRNA cancer vaccines work?
These vaccines are designed to prevent the cancer from recurring and not in the early stages of the disease.
After surgical removal of the tumor or another biopsy, scientists send tissue and blood samples for gene sequencing, looking for proteins that are unique to cancer and not present in healthy tissue.
An mRNA vaccine is then designed to target these characteristic 34 proteins, making the immune system recognize them and kill the cells that make them without damaging healthy tissue. is expected.
Because there can be so many neoantigens due to the patient’s own genetics and tumor cell evolution, vaccines must be tailor-made, specifically designed for each individual.
Researchers aren’t sure how many neoantigens to target, or which ones are likely to provide the most benefit.
Each vaccine takes about eight weeks to manufacture and is based on tumor cells removed during surgery. The patient will begin pembrolizumab (brand name Keytruda), manufactured by Merck, while awaiting a personalized vaccine. This drug unleashes the immune system to attack the cancer.
Pembrolizumab is given as a 30-minute infusion every 3 weeks for 1 year. The patient will receive pembrolizumab, she will receive 2 or 3 doses, and when the vaccine is ready, along with her next 9 infusions, he will receive 9 doses before completing pembrolizumab.
Of the 107 volunteers who received both the vaccine and pembrolizumab, 24 (22%) developed cancer within two years, according to findings released Sunday by the researchers but not yet peer-reviewed. Relapsed. Of the 50 patients who received pembrolizumab alone, 20 (40%) had a relapse.
(Keytruda sells for a list price of $185,000 per year, but most people won’t pay the list price. According to MerckIt is too early to know how much companies will charge for mRNA vaccines. )
melanoma is About 100,000 Americans are diagnosed annuallyIf detected early, nearly everyone will live for at least five years, but only one-third of patients with widespread cancer will live longer than five years.
“Pembro” has already dramatically reduced relapses, but a new study showed an additional effect of 44% with the addition of an mRNA vaccine called mRNA-4157/V940.
“We are already reaping these benefits[from Pembro]and now it is very exciting to have additional therapies that build on that progress in such a short time. said Amalia.
Side effects of mRNA vaccines against cancer
The addition of an mRNA vaccine did not appear to significantly increase the side effects already seen with pembrolizumab.
Pembro often affects the endocrine system and can cause diabetes and permanent thyroid problems. Other common side effects Fatigue, muscle pain, rash, diarrhea, fever, cough, loss of appetite, itching, shortness of breath, constipation and nausea.
These side effects are becoming more pronounced as more patients live longer with melanoma, Amaria said. It could be a sign that the treatment is working.
“In some patients, it fundamentally alters their quality of life,” she said, but “most people recover from the side effects and live a normal life.”
What are mRNAs?
Messenger RNA conveys instructions from the cell’s DNA code to the cellular machinery that manufactures proteins, telling them what to make. Short-lived mRNAs administered as vaccines turn cells into factories that produce proteins of interest.
In COVID, an mRNA vaccine produces a spike protein on the surface of the SARS-CoV-2 virus, training the immune system to recognize and clear viral cells.
For these cancer vaccines, mRNA triggers the body to produce 34 neoantigens, training the immune system to recognize and target them.
In cancer that has spread beyond the original tumor, surgeons cannot remove all the cancer cells. Patients with stage 2 or higher melanoma have already started this dangerous spread and are at a very high risk of recurrence after surgery.
A vaccine should help prevent these dangerous relapses, Barr said.
Barr said mRNA vaccines cannot be used to prevent disease, as they can for COVID, because neoantigens are not present until there is a tumor. However, when designed to target a specific person’s cancer and hopefully provide long-term memory, it appears to work so well that even future cancer cells are killed.
The German company BioNTech, which has helped develop other mRNA vaccines against COVID, We are also working on cancer vaccinesas well as several other companies for ovarian and lung cancer.
Some experts say it’s unclear why mRNA vaccines are effective against cancer when many other approaches have failed. Sullivan said the technology could simply boost a response from the tumor.
more:German scientists focused on cancer, then came COVID. It was her “duty” to help develop a vaccine.
what happens next?
The new study, which started in 2018, was relatively small and only lasted a few years, so Merck hopes to start a larger Phase 3 trial later this year. open to people with melanoma.
Amaria said she and colleagues at MD Anderson are considering joining. Patients often come to her for mRNA vaccines against cancer, she said.
Dr. Jeffrey Weber, who led the new study and is deputy director of NYU Langone’s Perlmutter Cancer Center, said he was optimistic about the future of mRNA vaccines against cancer.
“It has a way to go, but we believe these results will persist over time,” he said.
Please contact Karen Weintraub at [email protected].
Health and patient safety coverage on USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial opinion.
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