A world-first melanoma vaccine which personalises treatments for patients may put an end to melanoma as a "death sentence", according to Australian experts.
Results of an early trial by Biotech company Moderna indicate the personalised treatment reduces the risk of recurrence or death from melanoma by 44 per cent, compared with results from its immunotherapy drug alone.
The vaccine calls on the same technology used in certain mRNA COVID vaccines, and relies on the vaccine being administered in conjunction with Moderna's immunotherapy drug, Keytruda.
The trial is the first to make use of personalised vaccines in cancer treatment, and to show that combining mRNA technology with Keytruda delivers better results for melanoma patients — and possibly patients with other cancers too.
Professor Georgina Long of the Melanoma Institute of Australia said while a much larger trial would be run next year, early results were promising.
"It may be the penicillin moment in cancer therapy," Professor Long said.
"It is possible to see that (patients) may have cancer as a long-term disease rather than a death sentence," she said.
Melanoma is Australia's most deadly skin cancer. More than 17,000 people will be diagnosed with the condition this year, and nearly 1,300 people are expected to die from the disease.
'I want to live to 100'
Pam Morey had a melanoma removed from her nose 16 years ago.
In the following years she had three secondary tumours removed from her legs and arm.
This is because even when a cancer tumour is removed, cancerous cells can remain in the body and lead to a recurrence of the disease months or years later.
Doctors warned Ms Morey a melanoma could eventually form in her lungs or her brain.
"If it did that, I wouldn't have any quality of life, no life," she said.
So when they offered her the option of joining the Moderna trial, she jumped at it.
She hasn't had any cancer show up on her scans in the two years since she completed the trial.
Now she expects to meet one of her life goals.
"I want to live to 100", she said.
How it works
The aim of combining a vaccine with immunotherapy is to target and kill cancerous cells so that recurrence is delayed or prevented.
While immunotherapy stimulates the body's immune system to find and fight cancerous cells, mRNA vaccine technology can be tailored to target the specific mutation in a patient's tumour.
Personalised vaccines make use of genetic sequencing to identify unique mutations in the cells of the patient's tumour.
The mRNA vaccine is then formulated to prompt the patient's immune system to discover and destroy cells showing those characteristics.
Molecular biologist Professor Archa Fox from the University of Western Australia said the outcome of the trial was exciting because it offered an alternative to broad and non-specific cancer treatments.
"What we've been wanting for a while is a more targeted, tailored treatment," she said.
She said mRNA vaccine technology was originally focused on treating diseases like cancer, before being directed towards COVID-19.
Once the pandemic hit, she said huge investment was made in mRNA technology, which has resulted in a win for cancer patients.
"It's really sped up the development of these other non infectious disease vaccine products," she said.
Researchers across the world are currently looking into whether mRNA vaccine technology can be used to treat many other types of cancer, but it is melanoma that has led the way.
Professor Fox expects many more diseases, including genetic conditions, will eventually be treated with mRNA therapies.
Treating all cancer with mRNA
The Phase II clinical trial of the melanoma treatment involved 157 patients with stage three or stage four melanoma whose tumours had been surgically removed.
It was conducted in Australia and the US targeting patients who were at high risk of their cancer returning, and has not yet been peer-reviewed, or published in a scientific journal.
Moderna and the researchers will now present the results to regulatory authorities with a view to conducting a trial of 1000 patients next year.
Professor Long said research into treating melanoma had driven the development of immunotherapies and was now forging a way to treat cancer with mRNA vaccines.
"It is absolutely a world first, to show you can personalise a cancer vaccine in patients who already have cancer."
