Our fight against cancer is about to get a new weapon: customized vaccines that use patients’ immune cells. The vaccine trial uses mRNA and it’s given alongside other drugs that push the immune system to attack cancer.

“This is one of the most exciting things we’ve seen in a really long time,” said one of the doctors behind the trials.

mRNA vs cancer

For the past few years, Moderna has been known as one of the companies that developed one of the first COVID-19 vaccines, helping us keep the pandemic under control. But Moderna actually started out as a company that wanted to make vaccines against cancer — specifically, mRNA vaccines.

Against the coronavirus, mRNA vaccines work by using a piece of messenger RNA to instruct cells to produce a protein that triggers an immune response. Thus, it teaches the body how to recognize and fight the actual virus if infected in the future. The same approach can be used against cancer, but there’s a catch.

Different tumors can have different genetic signatures. So instead of targeting a virus, researchers are targeting that signature. The idea isn’t just to use immunotherapy to kick the cancer out — but also to ensure it doesn’t come back again.

This is an international trial first launched in the UK. The UK part of the trial aims to recruit 60-70 or more patients. The patients in the trial must have had their melanoma surgically removed in the past 12 weeks. Some of them will get a placebo shot and others will get the vaccine. None of them will know which they are taking.

Expanding it to other types of cancer

This is part of a phase 3 trial — a larger-scale study than phase 1 or 2. At this phase, researchers test the effectiveness and safety of a new treatment with a diverse group of people. The aim is to assess its efficacy and monitor side effects before it can be approved for public use. The previous phase 2 study was recently published in The Lancet, finding a 49% reduction in the risk of recurrence or death after 3 years compared with the standard treatment.

The University College London Hospitals NHS Foundation Trust (UCLH) is leading this trial, in collaboration with Moderna and Merck Sharp and Dohme (MSD). Researchers in other countries (such as Australia) are also carrying out this trial. Doctors also want to try it against lung, bladder and kidney cancer.

“This is one of the most exciting things we’ve seen in a really long time,” said UCLH investigator Dr Heather Shaw, for the BBC. “It is absolutely custom built for the patient — you couldn’t give this to the next patient in the line because you wouldn’t expect it to work. It’s truly personalised.”

Speaking to Sky News, Lawrence Young, from the University of Warwick, also called it “one of the most exciting developments in modern cancer therapy”.

“Interest in cancer vaccines has been reignited in recent years by a deeper understanding of how the body controls immune responses and by the advent of mRNA vaccines which makes developing a vaccine based on the immune profile of a patient’s own tumour much more straightforward,” said Prof Young.

“The hope is that this approach could be extended to other cancers such as those of the lung and colon.”

The treatment is not yet routinely available outside of clinical trials, but if it is deemed successful and safe, it can become part of cancer treatment.

Melanoma and the ABCDE checklist

Melanoma, if caught early, is often treatable with a high rate of survival; however, it can quickly become life-threatening if it spreads to other parts of the body. Educating the public and healthcare providers about the signs of melanoma through tools like the ABCDE checklist empowers individuals to monitor their skin for any changes and seek medical advice promptly. This proactive approach can lead to early diagnoses, reducing the complexity and extent of treatment needed and improving the chances of successful recovery.

The ABCDE checklist is a set of criteria used to evaluate moles and skin lesions for signs of melanoma, a type of skin cancer. Each letter stands for a key characteristic to watch for:

• A (Asymmetry): One half of the mole does not match the other half.
• B (Border): The edges are irregular, ragged, notched, or blurred.
• C (Color): The color is not uniform, with shades of brown, black, tan, red, white, or blue.
• D (Diameter): The spot is larger than 6mm across (about the size of a pencil eraser), though melanomas can be smaller.
• E (Evolving): The mole is changing in size, shape, or color.

If you think you are eligible and are interested in joining this study, please visit the Be Part of Research website and get in touch with the study team directly.