What Is Moderna’s Cancer Vaccine? 4 Things You Should Know
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During the COVID-19 pandemic, the coronavirus vaccines developed by biotechnology companies BioNTech and Moderna attracted enormous attention. Their work on “therapeutic” cancer vaccines also made the news on several occasions. We reported BioNTech’s cancer vaccine trials in April 2022; this week, Moderna’s cancer vaccine is being discussed around the world.
NOTE: There are 2 approaches to cancer vaccination: preventive and therapeutic vaccines. Hepatitis-B and HPV vaccines are preventive cancer vaccines. They reduce future cancer risk associated with chronic infections caused by HPV and hepatitis viruses. Therapeutic cancer vaccines are a highly desirable development, but so far have been approved within the United States only for particular situations involving 2 cancers: sipuleucel-T, a dendritic-cell vaccine for prostate cancer, and T-vec, an oncolytic-virus vaccine for melanoma.
Moderna’s COVID-19 vaccine was developed using messenger RNA (mRNA) technology, which involves decoding, copying and carrying information from DNA. These processes are needed for cells to encode genes in DNA and determine the proteins they produce.
An mRNA-based cancer vaccine showed promising results when given with the immune checkpoint inhibitor immunotherapy pembrolizumab (Keytruda) in an open-label phase 2b trial. According to Moderna, compared with pembrolizumab alone, the vaccine combination reduced the risk of cancer recurrence or death among patients with the aggressive skin cancer melanoma by 44 percent.
This article presents four things to know about the mRNA-4157/V940 cancer vaccine and the company’s plans for future clinical trials.
The mRNA Cancer Vaccine Is a Personalised Treatment
Moderna’s mRNA vaccine is personalised for each patient. It primes the immune system so that the patient can produce an individually tailored antitumour response.
To identify a patient’s specific mutations, researchers isolate and sequence DNA from the patient’s normal tissue and tumour. Comparing normal and tumour DNA identifies a set of mutations specific to that cancer. They then develop a single synthetic mRNA code for 34 neoantigens designed around tumour-specific mutations. The aim is for mRNA-4157/V940 to help the patient’s immune system not only recognise tumour cells but also attack them specifically.
Vaccine Development and Distribution Are Fast
According to Kyle Holen, Moderna’s Head of Oncology Development, producing a personalised vaccine takes several weeks.
“RNA sequencing has a development process that takes only 2 hours; it is remarkable how quickly this happens,” Holen says. “Preparing the vaccine this quickly is important for people with cancer.”
Taking samples, sequencing them, running an algorithm to identify specific mutations, producing RNA and distributing the vaccine to patients takes approximately 6 weeks in total.
More Adverse Effects in the Combination Arm
Serious treatment-related adverse effects occurred in 14.4% of patients receiving mRNA-4157/V940 with pembrolizumab, compared with 10% receiving pembrolizumab alone. These effects were consistent with those seen in the phase 1 trial, and Merck/Moderna reported no new treatment-related safety signals in the phase 2b study.
Moderna’s Vaccine Plans Beyond Melanoma
Moderna is still developing a phase 3 trial for mRNA-4157/V940 and hopes to begin it in 2023. It also plans to test its personalised mRNA vaccine approach in other tumour types beyond melanoma, but has not yet started this stage.
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