Melanoma Vaccine Enters Phase 3 Trials

Phase 3 trials of a “personalised” melanoma vaccine-based treatment began this month at University College London. The treatment centres on an mRNA vaccine developed by Moderna and Merck, who have similar trials for lung cancer treatment in the works.

As you might remember from the COVID vaccine wait, phase 3 trials are large-scale drug efficacy trials where the drug is tested on people. They’re the final hurdle before a medicine can be released to the public.

Phrase 2b studies on melanoma patients, published in February, reported a 44% decrease in the chance of either death or recurrence of the melanoma after receiving the mRNA vaccine/immunotherapy combo. 

While testing a melanoma vaccine in London seems a little like testing a COVID vaccine in New Zealand, the Phase 2b trial also recruited patients from the US and Australia.

How does it work? The melanoma treatment has been called a “personalised” vaccine. Because cancer is a mutational disease of the body’s own cells, it can’t be treated with vaccines in the usual way, where a known virus or bacteria that is external to the body is targeted.

In the new treatment, the patient first has the melanoma surgically removed. The cancer is then taken to a lab and sequenced, and a customised “vaccine” is manufactured that teaches the body’s immune system to counter their specific cancer.

“A major goal of a cancer vaccine is to drive the generation and expansion of an army of T-cells that specifically recognizes the tumour cells,” said Professor Catherine Wu, “and carry a program to eradicate that cancer.”

So while it is not a preventative vaccine in the traditional sense, it is expected to dramatically improve the body’s capacity to fight off cancer, in the first instance, and prevent recurrence afterwards.

Time is of the essence in these treatments. As Nature reported last year, manufacturing this sort of personalised vaccine can take 1-4 months. It takes time for the immune system to respond after receiving the vaccine, and of course it also takes time for the cancer to be diagnosed in the first place.

Everything needs to occur before the cancer becomes too large and virulent for the immune system to control. The possibility of getting everything done within the treatment window is where mRNA manufacturing advances since COVID are really showing their value.

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