The Personalised Vaccine That Could Cut Skin Cancer Death Risk, Pg9

Key Highlights:

• A new personalized mRNA cancer vaccine, intismeran (also known as mRNA-4157 or V940), developed by Moderna and Merck, has shown significant clinical benefits.
• When administered with the immunotherapy drug Keytruda, intismeran reduced the risk of death from recurrence of melanoma (skin cancer) by 49%.
• The combination therapy also lowered the risk of death due to the spread of melanoma by 59% compared to Keytruda alone.
• This marks the first time a personalized cancer vaccine has successfully completed a Phase 3 clinical trial, demonstrating the efficacy of targeting individual tumor mutations.
• The impact for India is currently limited due to the low incidence of melanoma among the Indian population and the high cost of Keytruda and the combination therapy.

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Detailed Insights:

• The personalized vaccine works by identifying unique mutations, called neoantigens, present only on a patient's cancer cells.
• mRNA technology is used to create a vaccine that instructs the body's immune system to recognize and target these specific neoantigens.
• Keytruda (pembrolizumab) is an immune checkpoint inhibitor that helps restore the immune system's ability to attack cancer cells by blocking the PD-1 pathway.
• The study involved over 1,000 patients with advanced melanoma whose tumors had been surgically removed but were at high risk of recurrence.
• Globocan data indicates that melanoma accounts for only about 0.26% of all cancer cases and 0.17% of cancer deaths in India.
• The high cost of existing immunotherapy drugs like Keytruda already limits access for many Indian patients, posing a challenge for the adoption of this new combination therapy.
• This breakthrough could pave the way for personalized cancer treatments for other cancer types, with ongoing trials for bladder and lung cancers.

Scientific/Technical Concepts Involved:

• mRNA (messenger RNA): A single-stranded molecule carrying genetic instructions from DNA to make specific proteins, used here to train the immune system.
• Neoantigens: Unique proteins found only on cancer cells due to tumor mutations, serving as specific targets for personalized cancer vaccines.
• Immunotherapy: A type of cancer treatment that boosts the body's natural defenses to fight cancer.
• PD-1 Inhibitor: A class of drugs, like Keytruda, that block the PD-1 protein on immune cells, preventing cancer cells from evading immune detection.