CHICAGO - Adding an experimental mRNA-based vaccine from Moderna Inc and Merck & Co reduced the risk that the most deadly skin cancer would spread by 65% over treatment with an immunotherapy alone in a mid-stage trial, the companies reported on Monday.
The data followed earlier promising data from the trial showing the customized mRNA vaccine given in combination with Merck's Keytruda cut the risk of death or recurrence of melanoma by 44% compared with Keytruda alone. The hope is for"a completely new treatment paradigm in cancer that will be better tolerated and unique to individual patients' tumors," said Dr. Jane Healy, an executive overseeing in early cancer treatment development at Merck.
The vaccines all target neoantigens, new mutations that are only present on tumors. Aiming at these unique proteins allows the immune system to kill cancer cells while leaving healthy tissue unscathed.To accomplish this, tumors are removed and their genetic makeup is mapped using next-generation DNA sequencing. Companies use artificial intelligence to predict which mutations will be the most effective targets.
At that time, there was already proof that immunotherapy could work in so-called"hot" tumors, or highly mutated cancers, such as melanoma. There was little hope it would work in"cold" cancers with few mutations, such as pancreatic cancer, said MSK's Dr. Vinod Balachandran.
The approach first primes the immune system with an older technology called a chimpanzee adenovirus vaccine that targets patients' tumors. That is followed by a personalized self-amplifying mRNA vaccine, which includes an enzyme that makes extra copies of the antigens, reducing the required dose.
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