NHS trials first personal skin cancer jab that can halve risk of death
The world’s first personalised vaccine for skin cancer is to be offered to British patients as part of a “cordon bleu” treatment plan.
The jab, based on the mRNA technology pioneered in the production of Covid vaccines, is custom-made for each patient and offers the hope of a cure for melanoma. It is also undergoing early testing on other cancers.
Around 70 Britons are set to take part in a final trial with initial results showing that when taken in combination with immunotherapy drug pembrolizumab, the jab – known as an individualised neoantigen therapy (INT) – cuts the risk of death in half.
Scientists take a sample of the patient’s tumour during surgery and use DNA sequencing and artificial intelligence to create a jab specific to the patient’s cancer.
Known as mRNA-4157 (V940), the jab is created to target tumour neoantigens, which are expressed by tumours in a particular patient.
The jab carries coding for up to 34 neoantigens and activates an anti-tumour immune response based on the unique mutations in a patient’s cancer.
A phase two trial of the jab, involving pharma firms Moderna and MSD, found that people with serious high-risk melanomas who received the jab alongside pembrolizumab were 49 per cent less likely to die or have their cancer come back after three years than those who were given only pembrolizumab.
Now a final phase three trial has been launched, led by University College London Hospitals NHS Foundation Trust (UCLH).
Patients ‘really excited’ about therapy
Dr Heather Shaw, the national coordinating investigator for the trial, said it “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.”
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.”
She said the aim was to cure patients of their cancer by “eradicating any of those rogue cells” that may lead to the cancer returning.
“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,” she added.
The phase three global trial will now include a wider range of patients and aims to recruit around 1,100 people.
The UK arm aims to recruit at least 60 to 70 patients across eight centres, including London, Manchester, Edinburgh and Leeds.
Patients will receive one milligram of the mRNA vaccine every three weeks for a maximum of nine doses, and 200 milligrams of pembrolizumab every three weeks for about a year.
Experts say the vaccine is as tolerable as the flu or Covid jabs, with side effects including tiredness and a sore arm the most common.
The therapy combination is also being trialled to treat lung, bladder and kidney cancer.
‘My best chance at stopping cancer in its tracks’
One of the first patients on the trial at UCLH is Steve Young, 52, from Stevenage, Herts.
Mr Young had a “bump on the head” for around a decade which, in a “massive shock”, turned out to be melanoma.
He explained: “I literally spent two weeks just thinking, ‘This is it’. My dad died of emphysema when he was 57 and I actually thought, ‘I’m going to die younger than my dad’.
“As soon as they mentioned this mRNA technology that was being used to potentially fight cancer, I was just like, ‘It sounds fascinating’. I still feel the same. I’m really, really excited.
“This is my best chance at stopping the cancer in its tracks.”
There are around 12,700 cases of skin cancer in the UK each year according to Cancer Research UK and while survival rates after 10 years stand at around 87 per cent, there are around 2,300 deaths from the disease every year.
Vassiliki Karantza, the 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.”
Iain Foulkes, the executive director of research and innovation at Cancer Research UK, said: “Research into tailored cancer treatments is so important, as it’s unlikely there will ever be a single cure that works for everyone.
“That’s why it’s vital that research like this continues to be funded so that more people with cancer can have personalised treatment options to help them live longer, better lives.”
