World's first personalised skin cancer vaccine begins testing on British patients

The world’s very first personalised mRNA cancer jab for melanoma has began being tested on British patients.

The injections, which have been labelled a “gamechanger”, offers patients hope of a cure for their skin cancer. Each jab is customer-built for each individual case in just a few weeks.

The innovative medicine works by telling the body to hunt down cancer cells and prevent the disease from coming back. There is also possible potential that it may be able to stop lung, bladder and kidney cancers.

During a stage 2 jab trial, which involved pharma firms Moderns and MSD, researchers found that it dramatically reduced the risk of cancer returning in melanoma patients. The third and final phase of testing has now been launched by the University College London Hospitals NHS Foundation Trust (UCLH).

Dr Heather Shaw, national co-ordinating investigator for the trial, said that the jab had the potential to cure people with melanoma and is being tested for its effectiveness against other cancers. She said: “This is one of the most exciting things we’ve seen in a really long time.

“This is a really finely honed tool. To be able to sit there and say to your patients that you’re offering them something that’s effectively like the Fat Duck at Bray versus McDonald’s – it’s that level of cordon bleu that’s coming to them. These things are hugely technical and finely generated for the patient. The patients are really excited about them.”

The so-called ‘cancer vaccine’ is an individualised neoantigen therapy (INT) and it is designed to trigger the immune system so it fights back against a specific type of cancer in the patient. Known as mRNA-4157 (V940), the medicine targets tumour neoantigens, which are express by tumours present in the specific patient.

The jab carries coding for up to 34 neoantigens. To create the jab, a sample of a tumour is taken from the patient in surgery, with DNA sequencing and artificial intelligence used to create their personalised jab.

Dr Shaw added: “This is very much an individualised therapy and it’s far cleverer in some senses than a vaccine. 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. They may have some shared new antigens, but they’re likely to have their own very individual new antigens that are important to their tumour and so, therefore, it is truly personalised.”

She added: “With (this) therapy, what you’re doing is dealing with the theoretical risk that the cancer could recur. So there’s nothing to see on scans, but if there are some cells that have escaped that are below the detection of imaging… what we’re trying to do is, on a patient-by-patient basis, give treatment to eradicate any of those rogue cells that might be sitting about. What we’re trying to do is to push more patients into that recurrence-free survival bucket, which should translate into overall survival benefit and a non-recurrence of those patients over time, which equals cure.”

According to Phase 2 data, which was published in December, patients with serious high-risk melonomas who received the jab alongside MSD’s immunotherapy Keytruda were almost half (49%) likely to die or have their cancer come back after three years compared to those who were only given Keytruda. Patients were administered one milligram of the mRNA vaccine every three weeks for a maximum of nine doses, and 200 milligrams of Keytruda every three weeks for about a year.

Phase 3 will involve around 1,100 people taking part in the trial. One of the first patients on the trial at UCLH is 52-year-old Steve Young from Stevenage. He said: “It really piqued my interest. As soon as they mentioned this mRNA technology that was being used to potentially fight cancer, I was just like, ‘it sounds fascinating’ and I still feel the same. I’m really, really excited. This is my best chance at stopping the cancer in its tracks.”

Dr Shaw said: “I think there is a real hope that these will be the gamechangers in immunotherapy. We’ve looked for a long time for something that would be additive to the immunotherapies that we already have – that we know can be life-changing for patients – but with something that’s got a really acceptable side-effect profile. And these therapies look as if they may offer that promise.”

Professor Lawrence Young, from the University of Warwick, called the jab “one of the most exciting developments in modern cancer therapy”, adding: “The hope is that this approach could be extended to other cancers such those of the lung and colon.”

Vassiliki Karantza, associate vice president of MSD Research Laboratories, said: “At MSD, we are committed to driving research forward for innovative modalities in earlier stages of cancer, where we can have the most meaningful impact on patients. This trial demonstrates our continued efforts to advance novel treatment options for patients with melanoma and we look forward to the expansion of our comprehensive clinical development programme into additional tumour types.”