mRNA technology has revolutionized the world of medicine. Known for its role in the creation of COVID-19 vaccines, mRNA has been lauded as a game-changer in the fight against infectious diseases. But mRNA’s impact extends far beyond pandemic control. It’s now making waves in another critical area of healthcare: cancer treatment and prevention.
mRNA stands for ‘messenger RNA’. It’s a type of molecule that carries the instructions from our DNA to our body’s cells, telling them how to make proteins. Scientists have harnessed this natural process to create mRNA vaccines, a new class of medicines that train our immune systems to recognize and destroy harmful invaders, including cancer cells.
Understanding mRNA Vaccines: A Simple Analogy
To understand how mRNA vaccines work, consider this analogy: Imagine your body as a fortified base under the protection of a well-trained army, your immune system. The base is under threat from enemy spies – these are the cancer cells or the covid virus. These spies are dangerous because they are disguised as your own soldiers, making it difficult for your army to identify and neutralize them.
Now, an mRNA vaccine is like a top-secret intelligence report. This report (the mRNA) contains detailed descriptions of the unique uniforms (specific proteins) that these enemy spies (cancer cells) are wearing as part of their disguise.
When this intelligence report (mRNA vaccine) is delivered to your base (injected into your body), your factories (cells) start producing replicas of these unique uniforms (the protein). These replicas are then used in training exercises where your army (immune system) learns to recognize the unique uniforms as a sign of an enemy spy (cancer cell).
Armed with this knowledge, your army (immune system) can now effectively identify, engage, and neutralize the enemy spies (cancer cells), protecting the base (your body) from harm.
Remember, the intelligence report (mRNA vaccine) only trains your army (immune system) to identify and engage the enemy spies (cancer cells). It doesn’t turn any of your soldiers into enemy agents. Similarly, mRNA vaccines train your immune system to recognize and destroy cancer cells, but they don’t cause cancer.
The KEYNOTE-942 Trial: mRNA Vaccines in Action
This theory of mRNA vaccines is currently being put to the test in a groundbreaking study known as the KEYNOTE-942 trial. This study is exploring the impact of an mRNA vaccine, known as mRNA-4157/V940, in combination with a standard treatment for high-risk melanoma.
Participants in the trial were divided into two groups. One received the standard treatment with intravenous immunotherapy alone, while the other received the standard treatment along with the mRNA vaccine. The results were promising: those who received the mRNA vaccine experienced significantly lower rates of cancer recurrence corresponding to a risk reduction of 44%.
But what’s truly exciting is that the mRNA vaccine seemed to provide benefits regardless of a patient’s Tumor Mutational Burden, or TMB. This is a measure of the number of mutations within tumor cells, and it can influence how well a patient responds to certain treatments. The fact that the mRNA vaccine was beneficial regardless of TMB status suggests it could potentially help a broad range of patients.
While these early results are encouraging, it’s important to remember that the KEYNOTE-942 trial is still ongoing. More research is needed to confirm these findings to a broader population and to understand more about who might benefit most from this kind of treatment. Meanwhile, the trial is continuing to enroll high-risk, completely resected melanoma patients at participating hospitals. In addition, there are several other adjuvant and neoadjuvant melanoma trials looking at adding newer classes of immunotherapy such as LAG3 inhibitors or TIGIT inhibitors to standard PD1-based immunotherapy, as well as upfront immunotherapy prior resection where the tumor itself is used as a battleground for cancer cell recognition/immune cell priming prior to complete resection.
The advent of mRNA technology has ushered in a new era in cancer treatment. It’s an exciting time, full of promise for the future. As we continue to explore and understand the full potential of mRNA vaccines, we move ever closer to a world where cancer is a disease we can effectively control, and perhaps even prevent. The study actively enrolling at these sites and further information can be found here.
About the author
Dr. Sajeve Thomas is a distinguished medical professional and a compassionate guide in the field of oncology. With over a decade of dedicated experience as a board-certified medical oncologist/internal medicine specialist, Dr. Thomas has become a trusted expert in the treatment of melanoma, sarcoma, and gastrointestinal conditions. Currently practicing at the renowned Orlando Health Cancer Institute, he brings a wealth of expertise to the complex and challenging world of oncology.