Melanoma, the therapeutic vaccine reduces the risk of metastases
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In the treatment of advanced melanoma, immunotherapy has produced results never seen before. Not for everyone though and, as always, there is room for improvement. For example, pressing the accelerator pedal of the immune system thanks to the addition of a personalized mRna therapeutic vaccine. A strategy that has attracted attention because it has seen the entry of Moderna, the company that became famous for one of the vaccines against Sars-Cov2, into the arena of the fight against tumors. The studies that are evaluating the effectiveness of this combination are ongoing and we are still in the so-called phase 2, i.e. a phase in which there are few patients and we look at the risk-benefit ratio more than at efficacy, but the accumulated data begins to show what the final action could be. Some of these had already been revealed in recent months, now new ones are arriving at the congress of the American Society of Clinical Oncology: compared to pembrolizumab alone (an immunotherapy molecule widely used in these patients), the combination of the two therapies leads to a reduction in the formation of distant metastases or the risk of death by 65%.
The potential of the vaccine
“Patients who experience distant metastases have, on average, a worse prognosis and shorter survival, so the reduction in the risk of distant recurrence shown by the study underscores the potential of neoantigen therapy,” he told us. Kyle Holen, head of oncology development at Moderna. “Our vaccine is produced from tissue resected at the time of surgery and is therefore customized for each individual patient”. In the study, involving 157 women and men with stage III or IV melanoma, in which the disease had been surgically removed from the lymph nodes or other organs where it had spread, they were given 9 doses of the vaccine every 3 weeks and pembrolizumab for one year. The data presented in Chicago add to those discussed last April during another American congress, that of the AACR, which indicated, two years after administration, a 44% reduction in the risk of recurrence or death in those who had received the combination versus those who received immunotherapy alone.
Melanoma, the first data on the combination of the mRNA vaccine and immunotherapy are positive
by Tiziana Moriconi
How does it work
Just like the anti-Covid vaccine, the new product is also based on messenger RNA and is designed for our immune system to learn to recognize specific proteins (called neoantigens) present, this time, on cancer cells instead of a virus. The vaccine is called personalized because it is developed from samples of the tumors removed in each patient. According to the researchers, it takes 6 to 8 weeks to prepare each product, which can recognize up to 34 different neoantigens.
Cancer vaccines: study underway also for metastatic melanoma
by Tiziana Moriconi
The prospects
“We are ready to start phase 3 of this metastatic melanoma study but we are also preparing to study the efficacy of this strategy in other types of cancer: non-small cell lung, breast, liver. But the road is long. The possibility of developing preventive vaccines is also in the sights, but obviously we still need to do a lot of research”, underlines Holen. Meanwhile, to try to bring therapies closer to patients, Moderna is planning the opening of production sites in other areas of the world, including Europe. To date, in fact, tumor tissue samples have to travel to the USA where the vaccine is produced, which is then sent to the center that treats the patient. As happened with Car-T cell therapies, once produced only in the United States, if these personalized therapeutic vaccines are approved by regulatory bodies, the problem will arise of shortening the time between patient withdrawal and therapy administration.
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