As mentioned in the previous post, melanoma cases have been increasing over the past few years [1,2]. While there are currently a few treatment options, new therapies are being researched to reduce adverse effects and the probability of recurrence. What are the newest advancements?
On April 16th, 2023, the results of a stage 2 clinical trial were presented at the American Association for Cancer Research meeting. This trial consisted of patients that have been diagnosed with metastatic melanoma (spread to other body parts) and are in relatively good health [4]. The first group were 107 patients assigned to receive a combination of personalized mRNA vaccine and Pembrolizumab, while in the second group, 50 patients, only received the latter [3]. After 18 months, the first group showed a reduction in recurrences, mild adverse effects, and a much lower number of serious adverse effects than the second group. How does this treatment work?
Pembrolizumab is a medication in the group of drugs called “immune checkpoint inhibitors” [5-7]. The immune system has checkpoints (proteins on immune cells) that regulate its response by being turned on/off. However, cancer cells sometimes use these checkpoints to hide from the immune system and avoid being attacked [6]. Pembrolizumab works by blocking the checkpoints (specifically PD-1 on T-cells), which boosts the immune response against cancerous cells [5-7].
In addition, a personalized mRNA cancer vaccine is created for each individual to enhance their immune response against melanoma. Unlike COVID-19 or flu vaccines, this attacks the cancer already present in the body, rather than preventing it. First, researchers identify the unique proteins on the melanoma cells’ surface (antigens) for each patient [8]. Then, a synthetic mRNA for those antigens is created. When the vaccine is administered, the cells will create copies of those antigens, which the immune system will recognize and eliminate any cell presenting them. Check out this post or video for more information on how the immune system functions.
There are many advantages of using an mRNA vaccine [9]:
Simpler, cost-effective, and faster to produce.
Safer, and does not require as much testing compared to DNA vaccines or viral vectors. More information about their differences here.
Can be used for a multitude of diseases.
The use of mRNA vaccines for cancer treatment is undeniably innovative, but it has required extensive research over the years to reach this stage (read more here and here). The results obtained thus far are showing great promise, and since the use of mRNA vaccines can potentially be applied to other types of cancers, it offers hope for the future. However, it is crucial to acknowledge that despite these breakthroughs, research is still at stage 2 (more information about the phases of drug development in this post and this video). Further studies are necessary to fully understand the efficacy and safety of using mRNA vaccine to treat melanoma.
Clinical trials play a crucial role in advancing medical research and shaping future treatments. Participants in these trials contribute significantly to the progress of science, paving the way for better outcomes. If you are interested in exploring different clinical studies conducted worldwide, check out this website [10]!
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Written by: Maria
Edited by: Natasha
BioDecoded is a volunteer group committed to sharing accurate scientific information. We cannot offer any specific health advice. If you have any doubts about your personal health, please speak with your healthcare professional or family physician. Your doctor can revise your medical history and advise you on the best path to follow. If you have any questions about this topic or would like to learn more, please comment below, or send us your questions.
References:
Melanoma of the Skin - Cancer Stat Facts (2023). National Cancer Institute. Available at: https://seer.cancer.gov/statfacts/html/melan.html (Accessed: 6 June 2023).
Saginala, K. et al. (2021) "Epidemiology of Melanoma", Medical Sciences, 9(4), 63. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8544364/
Adding a Personalized mRNA Cancer Vaccine to Immunotherapy May Prolong Recurrence-free Survival in Patients With High-risk Melanoma (2023). American Association of Cancer Research. Available at: https://www.aacr.org/about-the-aacr/newsroom/news-releases/adding-a-personalized-mrna-cancer-vaccine-to-immunotherapy-may-prolong-recurrence-free-survival-in-patients-with-high-risk-melanoma/ (Accessed: 22 June 2023).
An Efficacy Study of Adjuvant Treatment With the Personalized Cancer Vaccine mRNA-4157 and Pembrolizumab in Participants With High-Risk Melanoma (KEYNOYE-942) (2023). National Cancer Institute. Available at: https://www.cancer.gov/about-cancer/treatment/clinical-trials/search/v?id=NCI-2019-04957&r=1 (Accessed: 22 June 2023).
Pembrolizumab: Uses, Dosage, Side Effects & Warning (2023). Drugs.com. Available at: https://www.drugs.com/pembrolizumab.html (Accessed: 22 June 2023).
Melanoma Skin Cancer Immunotherapy (2023). Skin Cancer Immunotherapy. Available at: https://www.cancer.org/cancer/types/melanoma-skin-cancer/treating/immunotherapy.html (Accessed: 22 June 2023).
Pembrolizumab (2014). National Cancer Institute. Available at: https://www.cancer.gov/about-cancer/treatment/drugs/pembrolizumab (Accessed: 22 June 2023).
FDA Greenlights BTD of a Personalized mRNA Vaccine for High-Risk Melanoma (2023). Targeted Oncology. Available at: https://www.targetedonc.com/view/fda-greenlights-btd-of-a-personalized-mrna-vaccine-for-high-risk-melanoma (Accessed: 22 June 2023).
Bidram, M., et al. (2021). “mRNA-Based Cancer Vaccines: A therapeutic Strategy for theTreatment of Melanoma Patients”, Vaccines 9, 1060. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540049/pdf/vaccines-09-01060.pdf
ClinicalTrials.gov is a place to learn about clinical studies from around the world. Available at: https://clinicaltrials.gov/ (Accessed: 22 June 2023).
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