Messenger RNA (mRNA) vaccines have shown some promise against pancreatic cancer and are being evaluated in melanoma and colon cancer as well. Results published in the May 2023 issue of Nature suggest that personalized pancreatic cancer vaccines cause an effective and lasting immune response, potentially delaying a cancer relapse.1,2
About Pancreatic Cancer
There will be approximately 40,000 individuals diagnosed with pancreatic cancer this year, and pancreatic cancer is the fourth leading cause of cancer death in the United States. Treatment for early pancreatic cancer typically includes surgery to remove as much of the cancer as possible and the administration of adjuvant chemotherapy with Gemzar, 5-fluorouracil (5-FU) or other chemotherapy regimens producing a modest survival benefit. New treatment approaches are clearly needed for this difficult to treat cancer.
Researchers at Memorial Sloan Kettering Cancer Center have been working to develop personalized mRNA vaccines which are designed to train the immune system to identify and attack pancreatic cancer cells. The researchers first remove the cancer and analyzed the genetic makeup of specific proteins on the surface of the cancer cells. The doctors then produce personalized mRNA vaccines against some of the proteins found on the cancer cells to teach each patient’s immune system to attack the cancer by provoking an immune response against pancreatic cancer cells.
In the recently reported clinical trial custom vaccines were successfully created for 16 patients and the process took 16 weeks from surgery to delivery of the first dose of the vaccine. Following administration of the vaccine which was well tolerated cancer recurred within an average of just over a year in patients whose immune systems did not respond to the vaccine but in those patients with an immune response as measured by T cell activation the time to cancer recurrence was improved to over a year and a half. Immune effector T-cells produced by the vaccine were also reported to eliminate a small area of cancer that had spread to the liver in one patient.1
Scientists have struggled for decades to create cancer vaccines, in part because they trained the immune system on proteins found on tumors and normal cells alike. MRNA vaccines train the immune system to only focus on cancer cell related proteins. Following these promising results, the next step is to launch a larger, randomized clinical trial involving patients at multiple sites in various countries. MSKCC expects to begin enrolling patients in the trial.
A similarly constructed personalized mRNA cancer vaccine developed by Moderna, and Merck has also been reported to reduce the risk of relapse in patients who had surgery for melanoma,2 and there is an ongoing pivotal clinical trial in early-stage colon cancer.
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References
- Rojas LA, et al. Personalized RNA neoantigen vaccines stimulate T cells in pancreatic cancer. Nature. 2023 May 10:1-7. doi: 10.1038/s41586-023-06063-y
- Vaccine produces long-lasting anti-tumor response in patients with melanoma
