Think of conquering cancer, without that punishing side of chemotherapy, but instead a special personal injection. Such future is not as far as it seems. The trial shows the experimental mRNA cancer vaccines, Moderna, and Merck just cut melanoma recurrence rates by half. Still, this is not enough to take you off the ground? Then, think over that we may see the greatest oncology breakthrough since immunotherapy. OK, but how does it work though? And who will ever have a chance of using it?
From COVID Shots to Cancer Killers: The mRNA Revolution
When mRNA vaccines made an appearance during the pandemic, doubters labeled it as a one time success. Skip three years and the same technology is being used against one of mankind oldest enemies, cancer. They are nothing like traditional vaccines which block infection, but instead a kind of wanted poster to your immune system: targeting unusual mutations (neoantigens) that happen in a tumor in a particular patient. The mRNA-4157 developed by Moderna, together with Keytruda, a blockbuster drug by Merck, is not treatment, it is a reprogramming of the immune system.
The figures are self explanatory:
- At 18 months of cancer-free existence, 44.6 percent of vaccinated patients remained cancer-free compared to 27.7 percent patients who were using Keytruda on its own.
- The probability of shrinking of the tumor was twice in vaccine group.
- Side effects? Pretty much just fatigue and soreness in the arms- nothing as bad as chemo.
“And this is not science fiction any longer“, says Dr. Paul Burton, Chief Medical Officer of Moderna. We are not referring to simple diseases here, we are referring to curing diseases like cancer; things that used to be untouchable.”
Why Melanoma? The Right First Test
Melanoma is an unkind opponent it is fast-spreading, and it is often unresponsive to therapy. Yet its mutational rate is high, which makes it peculiar to work as an mRNA vaccine. It can be said like a thief who left fingerprints all over; the more errors a tumor contains in its genetic code, the easier it is to identify with immune system.
Consider Sarah Wilkinson, a trial participant aged 54-year-old. She joined Moderna study on the back of her stage III melanoma not being stopped by the surgery. In just a matter of months, residual cancer cells that could not even be scanned with the immune system activated supercharged by the vaccine were cleared from her body. Her reasoning is, she went to preparing the worst, to living like nothing happened.
But it is not just melanoma. Clinical trials of lung, pancreatic and bladder cancer are already in the early stages. In case mRNA manages to breach those then it is a game-changer in the field of oncology.
The Catch? Personalization = complexity
The twist is that all the vaccines are tailor-made. DNA sequencing, identification of the most devastating mutations and vaccination design takes a few weeks after a tumor biopsy is performed. Building a custom suit, essential though it might be, is somewhat like it. But, except that the suit is the difference between life and death.
However bespoke is not inexpensive:
- The latest estimates put the cost at 100k+ per patient.
- In manufacturing, there is the need of advanced labs and AI-based design.
- It is something that not all hospitals can tackle at the present.
According to the top immunologist, Dr. Nina Bhardwaj, the science is blazing: “The science is dazzling. The logistics? A nightmare.”
What’s Next—And Who Gets Left Behind?
Phase 3 trial by Moderna starts this year, with 1,000+ subjects in mind. In the event of success, FDA might accelerate approval by 2026. However, the itchy question to put is, would it become a luxury treatment?
- Its mRNA cancer vaccines are already being developed by BioNTech (the providing partner in COVID vaccination at Pfizer).
- The U.S. government invested only recently 5 billion dollars in “Cancer Moonshot” projects.
- Nevertheless, this entire decade can pass before rural hospitals and low-income countries get access.
Final Thought: A Cure—But at What Cost?
We are at a cross road. The difference this time around is that we are no longer merely poisoning cancer but we are beating cancer at its own game. However, innovations are worth nothing when they are hidden behind so-called paywalls. Even when Moderna vaccines become reality, the big experiment will not be scientific. It will be ethical.
Oncologist Dr. Vinod Balachandran says, “We can not afford to have this turn out into another: haves v. have-nots story”. There is no discrimination with cancer. Neither its cure.”