What You Need To Know
- An investigational messenger RNA (mRNA) vaccine, used in combination with an FDA-approved immunotherapy for certain cancers, reduced the possibility of melanoma from reoccurring or causing death by 44 percent, compared to the use of immunotherapy alone.
- The results were presented at the American Association of Cancer Research meeting April 17.
- Dr. Andrew Pecora worked collaboratively with NCI designated Georgetown Lombardi Comprehensive Cancer Center Consortium (which JTCC is a part of) and with other national investigators in this phase II clinical trial.
Study Included Adults At High Risk For Melanoma Recurrence In Other Areas Of The Body
The study, “mRNA-4157 (V940), a Personalized Cancer Vaccine, in Combination with Pembrolizumab, Demonstrates Trend for Improved Recurrence-Free Survival Compared to Pembrolizumab Alone in Adjuvant Melanoma Patients Across Tumor Mutational Burden Subgroups,” enrolled men and women who had surgery to remove melanoma from lymph nodes or other organs. The patients studied were at high risk of the cancer returning in areas of their body distant from the original cancer. Among 107 study participants who received both the investigational vaccine and the immunotherapy drug, the cancer recurred in 24 patients (22.4 percent) within two years of follow-up, compared with 20 patients out of 50 (40 percent) who received only the immunotherapy, pembrolizumab. The vaccine, similar to many of the vaccines for COVID-19, is based on messenger RNA, which provides instructions for cells to make proteins. Messenger RNA cancer vaccines are designed to teach the body’s immune system to recognize cancer cells as different from normal cells. In this case, the vaccine strives to trigger an immune response to specific abnormal proteins called “neoantigens” that are made by cancer cells. Because the study participants all had their tumors removed, researchers were able to analyze their cells for neoantigens that were specific to each melanoma and create a personalized vaccine for each patient. As a result, T cells were produced specific to the neoantigen proteins encoded by the mRNA. Those T cells could then attack any melanoma cells attempting to grow.
Findings Demonstrate How Immunotherapy ‘Educates’ The Patient’s Immune System
“The science employed in this study and its results are particularly exciting because they said study co-investigator Andrew Pecora, MD, FACP, a skin-cancer specialist at the John Theurer Cancer Center at HUMC. “Using mRNA technology allows isolation of the RNA that results in the production of proteins that are specific to antigens to be recognized by the immune system.” Promising clinical research with this vaccine has resulted in the U.S. Food and Drug Administration granting Breakthrough Therapy Designation to mRNA-4157/V940 in combination with pembrolizumab, a designation that may reduce the length of FDA review of clinical trial results
