An anti-cancer vaccine that is now in clinical trials shows promise as a preventative agent. However, experts are unsure when it will be widely available.
Patients’ risk of recurrence or death from melanoma was significantly improved following immunization with a new anti-cancer vaccine, according to a press release. This promising vaccine is a combination of an mRNA vaccine by Moderna called mRNA-4157/V940, and pembrolizumab (Keytruda; Merck & Co), an anti-PD-1 therapy. It is the first anti-PD-1 therapy approved for the treatment of advanced melanoma.
Compared to pembrolizumab alone, the combination of the mRNA vaccine and the anti-PD-1 therapy decreased risk of death or recurrence by 44%. Findings lead experts to expect resurgent efforts in the field of therapeutic cancer vaccines.
“While Keytruda and other immunotherapy drugs have revolutionized the outlook for patients with melanoma, a significant proportion of patients still fail to respond to therapy, or experience disease relapse. A combination of Keytruda with mRNA-4157/V940 primes the ‘unleashed’ immune system against tumors expressing the neoantigens incorporated in the mRNA vaccine,” said Avigayil Chalk, PhD, an oncology and hematology analyst, GobalData, in a press release.
Keytruda is an immune checkpoint inhibitor (ICI), blocking the interaction between T-cell receptor PD-1 and programmed death-ligands 1 and 2 (PD-L1/PD-L2), which are immune checkpoint inhibitors on tumor cells. In turn, T-cells are activated and multiply, allowing them to fight the tumor cells. These results show a potent and durable response in patients with any disease levels.
Additionally, Chalk describes mRNA-4157/V940 as a personalized therapeutic.
“The vaccine contains a single mRNA molecule encoding up to 34 tumor-specific antigens, which are selected based on the patient’s individual tumor mutations,” Chalk explains. “Once administered, the mRNA is translated, and the resultant peptides are processed and presented to the immune system, thereby stimulating an anti-tumor immune response.”
Chalk explained further that the use of mRNA vaccines for the treatment of cancer has become a promising approach.
“Particularly when combined with ICIs to enable a more ferocious anti-tumor immune response,” Chalk said in the press release.
However, there are limits to this therapeutic alternative. Its personalization adds a heavy burden to cost and an oncologic mRNA vaccine is still considered to have a long manufacturing process. These could act as barriers to accessibility.
Despite these limitations, manufacturers are producing other mRNA anti-cancer vaccines to treat a variety of indications and oncological diseases with efficacy.
Melanoma is the primary cancer type that anti-cancer mRNA vaccines are being tested for. GlobalData said that other agents—like the BNT-111 from BioNTech and the BNT-122 from Genentech and BioNTech—are currently undergoing clinical trials as “off-the-shelf” mRNA vaccines to target the 4 most common antigens in cutaneous melanoma cases.
“It remains to be seen whether a personalized therapy such as mRNA-4157/V940 is required for maximum efficacy, or whether an ‘off-the-shelf’ product can demonstrate equivalent efficacy,” Chalk said in the press release.
Historically unimpressive field of therapeutic cancer vaccines gets revitalized with Moderna and Merck mRNA data, says GlobalData. News Release. December 20, 2022. Accessed on December 20, 2022.