There is still no mRNA vaccination against cancer. Now the research results for an mRNA therapy against black skin cancer, which the American pharmaceutical company Moderna has published, give hope. This skin cancer vaccine mRNA-4170 is a new personalized cancer vaccine. It aims to update the immune system so that the patient can produce a tailored anti-tumor response.
The cancer therapy examined in the study combines Moderna’s mRNA vaccine with the well-known Keytruda therapy from manufacturer Merck. Keytruda is a monoclonal antibody therapy that improves the immune system’s ability to recognize and fight tumor cells. Keytruda is already used individually when the melanoma has progressed so far that it can no longer be removed surgically.
Research results over three years of use now show that mRNA therapy in combination with Keytruda reduced the risk of relapse and death by 49 percent in 157 patients with high-risk melanoma. Compared with patients who received Keytruda alone, the risk of distant metastases or death decreased by 62 percent.
“The results achieved with the combination in this study are absolutely remarkable and likely represent the breakthrough of this technology in the field of cancer. At least once with black skin cancer,” says Roger von Moos, director of the Tumor and Research Center of the Canton Hospital of Graubünden and skin cancer specialist at the Swiss Working Group for Clinical Cancer Research (SAKK).
Individualized vaccination together with immunotherapy is currently very promising. This is also comparable to other skin cancer therapies. “For example, the side effects of this therapy are significantly lower than those of combination immunotherapy.”
Such an mRNA vaccination is not used to prevent the development of the disease, as is the case with flu or corona. This is not possible because for this personalized mRNA therapy you need to know what the tumor is like. Of course, you don’t know that if someone doesn’t have a tumor at all. This mRNA therapy can therefore only be applied to patients who already have skin cancer, explains Roger von Moos.
The US Food and Drug Administration (FDA) has now granted the mRNA cancer therapy ‘Breakthrough Therapy Designation’ status following the completion of Phase 2b study. And the European Medicines Agency EMA has approximately the same status as ‘Priority Medicines’. “This means that these authorities consider the results promising and are accelerating the approval process,” von Moos explains.
The study data can be viewed at a very early stage and further key effectiveness data can be provided on an ongoing basis during the approval process. In general, such drugs usually receive approval sooner.
Further research is still needed, the skin cancer specialist explains. “And you should not forget that it takes six to eight weeks before an individual vaccination is made, because this requires tumor tissue from the patient.” It may well be that this therapy is not optimal for very rapidly growing melanomas.
The mRNA technology has already been used successfully against Sars-CoV-2. But a vaccination against cancer is much more complicated than a vaccination against a virus, as Burkhard Ludewig, head of research at St.Gallen Cantonal Hospital, recently explained. The only thing that is easier is vaccination against HPV cervical cancer, because it is caused by a virus against which the active substance can be used.
However, in other types of cancer, the cancer cells have a high degree of variability. Therefore, the immune cells must be activated strongly and in large numbers by the vaccination, which complicates the production of a vaccine.
It is obvious that the new mRNA vaccination will initially be used against black skin cancer, says Ludewig. These tumor cells are very well recognized by the immune system, making combined immunotherapies effective against skin cancer. This also applies to lung cancer and therefore mRNA therapy could also be successful against this cancer.
In fact, the US company has just started a phase 3 trial in lung cancer, which is recruiting patients worldwide. Roger von Moos also says that mRNA therapy could likely be used on other types of tumors soon.
Moderna also plans to quickly expand the mRNA development program to other tumor types. All mRNA medicines are being expanded, not only in the field of cancer, but also against rare diseases and infectious diseases such as influenza and the respiratory syncytial virus RSV.
Moderna’s skin cancer vaccination is now entering its final phase. The final phase of clinical testing, the Phase 3 trial for mRNA-4170, has been ongoing since July. Roger von Moos is also involved. “The Cantonal Hospital of Graubünden is one of the few Swiss centers selected to conduct this study.” Unfortunately there were delays due to the authorities. He now hopes every day that the ‘go’ will come soon to open the study. “Especially because the approval authorities of other countries have already given their approval,” says von Moos. There’s no time to lose. (aargauerzeitung.ch)
Source: Blick
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