mRNA vaccine cuts skin cancer recurrence and death by 42% in two years

What does the skin cancer trial show?

Skin cancer recurrence and death fell 42% over two years in the first major successful trial of mRNA vaccines for skin cancer, reported by Merck and Moderna. The drugmakers released the results last month.

The strategy combines mRNA, genomics and artificial intelligence, technologies that helped create these vaccines. Researchers are testing similar products in lung, kidney, bladder and brain cancers. Some trials have failed while others have produced striking results. Scientists still do not know why outcomes differ.

The skin cancer finding is a clear efficacy signal, but it does not resolve that uncertainty.

Who received the first pancreatic cancer mRNA vaccine?

At 72, retired accountant Donna Gustafson hikes, travels and lifts weights. She splits her time between New Jersey and Florida. She and Ed, her husband of 50 years, still exchange affectionate looks. All of this continues seven years after her Stage II pancreatic cancer diagnosis, with no evidence of the cancer that was expected to kill her years ago.

Gustafson became the world’s first recipient of an mRNA vaccine designed to treat pancreatic cancer seven years ago. Her vaccine was personalized. Scientists used samples from her tumor to reprogram immune cells, training them to recognize distinctive mutant proteins on cancer cells and kill them.

“I have had 100% quality of life; I am back to where I was prior,” Gustafson said. Ed said she is sassier and in the best shape of her life. Her three grown daughters found the trial. Gustafson was not afraid to be first. Facing low survival odds, she treated the offer as obvious and welcomed the hope it provided.

What did the 16-patient trial show?

About 70,000 Americans receive a pancreatic cancer diagnosis each year. The highly lethal disease has few effective treatments. The small clinical trial involving Gustafson included 16 patients. Researchers said the vaccine worked in half of them. Eight patients responded, and seven of those eight remain alive today.

She received nine doses of the vaccine along with surgery and chemotherapy. Her response came swiftly. Ed contrasted the hours-long chemotherapy infusions and severe after-effects his wife endured with the vaccine shots. Donna said the shots caused no symptoms or side effects. At times, she even worried that the treatment was not helping.

Seven of the eight responders remain alive today, a durable result from a 16-patient trial.

What did the immune system do?

Surgeon and scientist Vinod Balachandran ran the trial at Memorial Sloan Kettering Cancer Center in New York City. The center’s mRNA laboratory contains long hallways of freezers, desks, centrifuges and cytometers. The team measures patients’ treatment responses there. Oncologists and mathematicians work to decode pancreatic cancer, then reverse-engineer the mRNA needed to fight it.

A research analyst displayed dozens of superimposed green lines on a computer. Each line represented the number of times an immune cell reproduced. For Gustafson, the lines rose sharply and then stayed high and flat. Balachandran said that pattern reflected a 10,000-fold increase. Her immune system had mass-produced cancer-attacking cells and sustained them for years beyond her final shot.

“It just tells us that this response lasts,” Balachandran said. He sees the strength and durability in half the cohort as evidence that similar vaccines could be developed for a broad range of human cancers.

The laboratory finding matches the clinical outcome: some patients mounted unusually strong and sustained immune responses.

What happens next?

The field now commands attention from patients, doctors, researchers and investors. The National Cancer Institute is working on a partnership with private companies to accelerate research and development of more mRNA cancer vaccines. Balachandran and Memorial Sloan Kettering plan to expand on-site production of personalized vaccines for patients.

Gustafson and Ed feel overwhelmingly lucky. She has seen two grandchildren born and grow, and has celebrated many birthdays, holidays and Christmases with her family. Together they completed bucket-list items including skydiving, summiting and marking their 50th anniversary, with more milestones ahead. Ed said the experience pushed them to accomplish more and live more fully in the present.

The next test is whether planned partnerships and on-site manufacturing can turn exceptional responses like Gustafson’s into a repeatable strategy across pancreatic cancer and the other tumors already in trial.