How does the groundbreaking skin cancer vaccine work? When can patients go there? And could it really be a cure for deadly melanoma? All your questions answered…
It could be just over a year before Brits get a ‘game-changer’ jab from the NHS to treat one of the deadliest forms of skin cancer.
Early results from the treatment – developed by pharmaceutical giants Moderna and MSD – showed it dramatically improved survival rates from melanoma and prevented the cancer from returning.
Now University College London Hospitals NHS Foundation Trust (UCLH) is now leading the final phase of trials into the personalized mRNA jab, which scientists hope could also be used to stop lung, bladder and kidney cancer.
So how does it work? When will it be available? And can the treatment be used to treat other types of cancer?
Here, MailOnline explains everything you need to know about the therapy.
What are mRNA vaccines?
Although the science dates back to 2005, the first vaccines to use mRNA technology were those from BioNTech and Moderna against the Covid virus.
Messenger RNA, or mRNA, is a genetic blueprint that instructs cells to produce proteins in the body.
Unlike other traditional vaccines, live or weakened virus is not injected or required at any time.
For Covid, the mRNA vaccine instructed cells to produce the spike protein found on the surface of the virus itself.
These harmless proteins ‘train’ the immune system to recognize the virus and then make cells that fight it if someone later becomes infected with the real virus.
One of the first patients to take part in the trial at UCLH is Steve Young, 52, from Stevenage.
His ‘bump on his head’ – which he thinks he has had for ten years – turned out to be a melanoma.
He said it was a “huge shock” to be diagnosed.
One of the first patients to take part in the trial at UCLH is Steve Young, 52, from Stevenage. His ‘bump on his head’ – which he thinks he has had for ten years – turned out to be a melanoma
“I literally spent two weeks thinking, ‘This is it,’” he said.
“My father died of emphysema when he was 57 and I actually thought, ‘I’m going to die younger than my father.'”
Mr Young said that when he was told about the trial at UCLH it “really triggered my nerd radar”.
He added: ‘It really piqued my interest.
‘As soon as they mentioned this mRNA technology potentially being used to fight cancer, I thought, ‘it sounds fascinating’ and I still feel the same way. I’m really excited.
“This is my best chance to stop the cancer.”
How does melanoma treatment work?
The shot, known as mRNA-4157 (V940), triggers the immune system to fight back against the patient’s specific type of cancer and tumor.
To achieve the treatment, a tumor sample is removed from the patient during surgery.
DNA sequencing is then performed to identify proteins produced by cancer cells, known as neoantigens, that will trigger an immune response.
These are then used to create a personalized mRNA vaccine that tells the patient’s body to generate the tumor-specific neoantigen proteins.
Once injected, the immune system responds to the proteins by creating fighter T cells attack the tumor and kill the cancer cells.
The immune system should recognize future malignant cells, hopefully preventing the cancer from returning.
What have the tests shown?
Scientists have given trial participants the shot alongside an immunotherapy drug, pembrolizumab or Keytruda, which also helps the immune system kill cancer cells.
Data from the Phase 2 trial published in December showed that people with high-risk severe melanoma who received the injection alongside Keytruda were almost half (49 percent) more likely to die or have their cancer come back after three years than those who only received the injection. Keytruda.
Patients received one milligram of the mRNA vaccine every three weeks for up to nine doses, and 200 milligrams of Keytruda every three weeks for about a year (up to 18 doses).
Dr. Heather Shaw, national co-ordinating investigator for the UCLH trial, said there was real hope the therapy could be a “game-changer”, especially as it appeared to have “relatively tolerable side effects”.
These included fatigue and a sore arm when the jab was given, she said, adding that for the majority of patients it seemed no worse than getting a flu or Covid vaccine.
When will the shot be available?
The combined treatment is not yet routinely available on the NHS, apart from clinical trials.
But Stéphane Bancel, director general of Moderna, believes an mRNA vaccine for melanoma could be available by 2025.
The global phase three trial will include a wider range of patients and researchers hope to recruit around 1,100 people.
At least 60 to 70 patients will be recruited across eight UK centers – including London, Manchester, Edinburgh and Leeds.
The twin therapy combination will also be tested in lung, bladder and kidney cancer.
To guarantee the best results, the test patients must have had their high-risk melanoma surgically removed within the past twelve weeks.
Dr. Heather Shaw, national coordinating investigator for the trial, described it as “one of the most exciting things we’ve seen in a very long time”
Why is melanoma so deadly?
The disease occurs after the DNA in the skin cells is damaged, causing mutations that become cancerous.
Melanoma starts in cells called melanocytes. These produce the pigment melanin, which gives the skin color.
About 15,000 Britons and 100,000 Americans are diagnosed with melanoma every year. It is the fifth most common cancer in Britain.
The incidence in Britain has risen faster than any other common cancer.
Increased UV exposure from the sun or tanning beds is blamed for this increase.
Despite enormous advances in treatment, with survival rates increasing from less than 50 percent to more than 90 percent over the past decade, more than 2,000 people still die every year.
Melanoma often grows quickly and can quickly burrow through the skin and into the underlying blood vessels. Once the cancer cells enter the bloodstream, the disease can spread throughout the body.
Patients with melanoma are offered surgery, especially if it is detected early. Radiation therapy, immunotherapy drugs and chemotherapy are also used.
Can the shots work for other types of cancer?
Major pharmaceutical companies are all competing to produce successful cancer vaccines. Last May, BioNTech, in collaboration with Roche, proposed a phase 1 clinical trial of a vaccine against pancreatic cancer.
The following month, Transgene presented its conclusions on its viral vector vaccines against ENT (ears, nose and throat) and papillomavirus-related cancers at the American Society of Clinical Oncology conference.
And in September, Ose Immunotherapeutics made headlines with its vaccine against advanced lung cancer.