by The world’s first personalized mRNA cancer job for melanoma – which also has the potential to stop lung, bladder and kidney cancer – is being tested in British patients.
The “gamechanger” job, which offers hope for a cure, is customized for everyone in a few weeks.
It works by telling the body to hunt down cancer cells and prevent the deadly disease from coming back.
A phase 2 trial of the job, involving pharmaceutical firms Moderna and MSD, found that it significantly reduced the risk of the cancer returning in melanoma patients.
A final phase 3 trial has now been launched, led by University College London Hospital (UCLH) NHS Foundation Trust.
Dr Heather Shaw, national co-ordinating investigator for the trial, said the pill had the potential to cure people with melanoma and was being tested in other cancers.
Sharing details of the trial exclusively with the PA news agency, she said: “This is one of the most exciting things we’ve seen in a long time.
“This is a very detailed tool. To be able to sit there and tell your patients that you’re effectively offering them something like the Fat Duck at Bray versus McDonald’s – that’s the level of cordon bleu they’re coming to.
“These things are highly technical and delicately generated for the patient. The patients are very impressed.”
The new job is individualized antigen therapy (INT) and is sometimes called a cancer vaccine.
It is designed to stimulate the immune system so that it can fight back against the patient’s specific type of cancer and tumor.
Called mRNA-4157 (V940), the job is designed to target tumor neoantigens, which are expressed by tumors in certain patients.
These are markers of the tumor that the immune system can recognize.
The jab carries the coding for up to 34 new antigens and activates an anti-tumor immune response based on the unique mutations in the patient’s cancer.
To prove the job, a tumor sample is removed during the patient’s surgery, followed by DNA sequencing and the use of artificial intelligence.
The result is a personalized anti-cancer job specific to the patient’s tumor.
Dr Shaw said: “This is very much an individualized therapy and is in some senses much smarter than a vaccine.
“It’s completely tailored to the patient – you couldn’t give this to the next patient down the line because you wouldn’t expect it to work.
“They may have shared some new antigens, but they’ll probably have their own unique new antigens that are important to their tumors so it’s really personal.”
The ultimate aim is to cure patients of their cancer, said Dr Shaw.
“Really, that’s the drive. With (this) therapy, what you are doing is dealing with the theoretical risk that the cancer could come back.
“So nothing shows up on scans, but if there are certain cells that have escaped that are below imaging detection… what we’re trying to do, on a patient-by-patient basis, is treat any of delete the ones. those rogue cells that might be sitting around.
“What we’re trying to do is push more patients into that recurrence-free survival bucket, which should translate into an overall survival and recurrence-free benefit for those patients over time, which it is like medicine.”
Phase 2 data, published in December, found that people with serious, high-risk melanomas who received the job along with MSD’s Keytruda immunotherapy were almost half (49%) as likely to die or develop their cancer returned after three years than those who were given. but Keytruda.
Patients received one milligram of the mRNA vaccine every three weeks for a maximum of nine doses, and 200 milligrams of Keytruda every three weeks (maximum of 18 doses) for about a year.
The global phase 3 trial will now include a wider range of patients, and hopes to recruit around 1,100 people.
The UK arm aims to recruit at least 60 to 70 patients across eight sites, including London, Manchester, Edinburgh and Leeds.
The combination therapy is also being tried in lung, bladder and kidney cancer.
Steve Young, 52, from Stevenage is one of the first patients on the trial at UCLH.
His “bump on the head” was melanoma – something he thinks he’s had for about ten years.
He told PA that being diagnosed was a “huge shock”.
“I spent two weeks just thinking ‘this is it’,” he said.
“My father died of emphysema when he was 57 and I really thought ‘I’m going to die younger than my father’.”
Mr Young said being told about the trial at UCLH “really ticked my geek radar”.
He added: “It really piqued my interest. As soon as they mentioned this mRNA technology that was being used to fight cancer, I was just like, ‘that sounds interesting’ and I still feel the same way. I’m really excited.
“This is my best chance to stop cancer in its tracks.”
Dr Shaw said: “I think there is real hope that these will be game changers in immunotherapy.
“We’ve been looking for a long time for something that would complement our existing immunotherapies – that we know can be life-changing for patients – but with something that has an acceptable side effect profile Seriously.
“And these therapies look like they might offer that promise.”
Dr Shaw said side effects include fatigue and a sore arm when given the job.
“So it seems to be quite acceptable and really no worse than having a flu vaccine or a Covid jab for most patients,” she said.
Professor Lawrence Young, from the University of Warwick, said: “This is one of the most exciting developments in modern cancer therapy.
“Combining a personalized cancer vaccine to target a specific immune response to the patient’s tumor and using an antibody to block the body’s immune response has already shown great promise in patients who have had their original skin cancer (melanoma) removed. released.
“Interest in cancer vaccines has been fueled in recent years by a deeper understanding of how the body regulates immune responses and by the advent of mRNA vaccines, which make it much easier to develop a vaccine based on the immune profile of the patient’s own tumors.
“It is hoped that this approach could be extended to other cancers such as lung and colon cancer.”
Vassiliki Karantza, associate vice president of MSD Research Laboratories, said: “At MSD, we are committed to advancing research for innovative modalities in the earlier stages of cancer, where we can have the most meaningful impact on patients.
“This trial demonstrates our continued efforts to advance novel treatment options for patients with melanoma and we look forward to expanding our comprehensive clinical development program into additional tumor types.”
