Clinical Trials Show Potential of mRNA Vaccine in Melanoma Prevention

Connie Franciosi, age 80, participated in a trial exploring an mRNA vaccine and immunotherapy drug’s potential to prevent melanoma recurrence. Diagnosed with late-stage melanoma in 2020 after noticing a concerning skin spot, Franciosi faced a high risk of relapse. Melanoma can spread if not detected early, with about 112,000 cases and 8,500 related deaths annually in the U.S.

After surgery to remove her melanoma, Franciosi joined a clinical trial testing an mRNA vaccine paired with Keytruda, an immunotherapy drug. This trial involved 157 patients in Australia and the U.S., aiming to use mRNA technology, known from Moderna’s COVID-19 vaccine, to create personalized cancer vaccines.

Dr. Janice Mehnert, a melanoma specialist at NYU Langone Health, emphasizes the uniqueness of this personalized immunotherapy tailored to each tumor. Patients remained cancer-free five years after receiving the combination therapy, with 68.8% success, compared to 49.1% with only Keytruda.

The trial, presented at the American Society of Clinical Oncology and published in the Journal of Clinical Oncology, shows strong evidence of reduced mortality risk. At five years, 92% who received the combined treatment were alive, versus 71% with Keytruda alone.

Melanoma recurrences can be unpredictable, affecting lungs, liver, or brain, complicating treatment. A preventive strategy leveraging the immune system early on can improve outcomes.

Dr. Sarah Arron, not involved in the study, highlights mRNA vaccines’ transformative potential for treating advanced melanomas. Unlike the uniform COVID vaccine, each cancer vaccine is customized to the patient’s tumor.

Combination Therapy Explained

T cells in the immune system target threats like cancer, but tumors can evade detection. Keytruda removes this shield, allowing T cells to target the cancer. A personalized mRNA vaccine enhances this effect by identifying neoantigens in a tumor and training T cells to attack them.

In the trial, mild side effects occurred, such as chills and injection site pain. Understanding the technology’s mechanism is crucial, given the politicization of the COVID-19 vaccine.

Research is ongoing into using mRNA vaccines to prevent other cancers, like lung cancer.

Future Directions

With encouraging findings, Moderna’s chief development officer, Dr. David Berman, notes the Phase 3 trial of nearly 1,000 patients. The goal soon is to seek FDA approval for the vaccine, Intismeran, developed with Merck’s Keytruda.

For Franciosi, the impact is clear. She remains cancer-free, celebrating life with activities like gardening, golfing, and library involvement. Her outlook reflects the trial’s positive outcomes: “Life is good.”