Moderna, Merck Show Progress Toward Cancer Vaccines
An mRNA shot helped prevent relapse in high-risk melanoma patients
A Moderna and Merck trial offers some of the strongest evidence yet of vaccines that could benefit cancer patients.
By Brianna Abbott, WSJ
Updated April 16, 2023 1:36 pm ET
Moderna Inc. and Merck & Co.’s cancer vaccine helped prevent relapse for melanoma patients, results from a midstage trial showed, demonstrating progress in the pursuit of shots to ward off cancer by jump-starting the immune system.
About 79% of high-risk melanoma patients who got the personalized vaccine and Merck’s immunotherapy Keytruda were alive and cancer-free at 18 months, compared with about 62% of patients who received immunotherapy alone, researchers said Sunday. The 157-person trial offers some of the strongest evidence yet that such vaccines could benefit cancer patients.
“I am fairly encouraged that this will open up a whole new set of trials,” said Jeffrey Weber, the senior investigator on the trial and deputy director of the Perlmutter Cancer Center at NYU Langone Health.
Moderna and Merck said they would expand their research into other tumor types including non-small cell lung cancer. The companies have said they plan to run a larger study to confirm the vaccine’s safety and efficacy in treating high-risk melanoma. They released a limited overview of the results in December.
Fuller results were presented at an American Association for Cancer Research conference in Orlando, Fla., where other researchers plan to present data on vaccines meant to treat cancers including pancreatic and head and neck. The work, which needs to be confirmed in more advanced trials, represents progress after decades of ambition but limited success in developing vaccines to treat or prevent cancer.
“It feels as though harvest time is coming,” said Dr. Andrew Allen, co-founder and chief executive officer at Gritstone bio Inc., which is conducting a midstage trial for a personalized vaccine that aims to treat metastatic colorectal cancer.
Many experimental cancer vaccines aim to treat cancer or prevent it from coming back rather than preventing it from developing in the first place. Advances in immunotherapies, genomic sequencing and artificial intelligence have helped make cancer-targeting vaccines more promising than in the past, oncologists said. The Covid-19 pandemic demonstrated the power of mRNA technology that Moderna and others are testing in cancer shots.
“This is the first time we’ve been able to use vaccine technology to really be able to change the course of a cancer,” said Dr. Eliav Barr, Merck’s head of global clinical development and chief medical officer.
Moderna’s shot is tailored to each patient. The company analyzes a patient’s tumor for mutations and chooses up to 34 targets called neoantigens that it suspects will create the strongest immune response to incorporate into a vaccine. The patient receives nine doses of the vaccine, one every three weeks, on top of up to 18 cycles of immunotherapy. The vaccine took around six to seven weeks to develop for each patient, Dr. Weber said.
Some 157 patients with stage three or four melanoma were enrolled in the trial and underwent surgery to remove the cancer. Around 107 patients received the shot and immunotherapy after surgery, while 50 were treated with immunotherapy after surgery alone.
After about two years, recurrence of cancer or death was reported in 22% of patients who got the shot and the immunotherapy Keytruda and in 40% of patients who received immunotherapy alone. The combination with the vaccine helped reduce the risk of recurrence and death for the melanoma patients in the trial by some 44% compared with Keytruda alone, the researchers said.
“That approach could be a game-changer,” said Dr. Robert Vonderheide, director of the Abramson Cancer Center at the University of Pennsylvania and a chair of the AACR conference, who wasn’t involved in the research.
The researchers found that the vaccine appeared to help regardless of the total number of mutations in a patient’s cancer cells, which can influence a patient’s response to immunotherapy drugs. “It’s early days, but it provides a high degree of confidence,” said Dr. Stephen Hoge, Moderna’s president.
Fatigue was the most common side effect, along with pain at the injection site and chills, the companies said. No life-threatening side effects from the shot were reported. The data haven’t been published in a scientific journal.
“I’m cautiously optimistic,” said Dr. Nina Bhardwaj, medical director of the Vaccine and Cell Therapy Laboratory at Mount Sinai Tisch Cancer Center, who wasn’t involved in the research. “We’ll have to wait and see what survival over time looks like.”
Derek Vogel, a 57-year-old software developer who lives near Bangor, Pa., and a patient on the trial, said he is nearing his third year since treatment without relapse. He was diagnosed with melanoma in April 2019 and after surgery traveled to and from NYU Langone for treatment.
Mr. Vogel said that at first he was worried about his chances because survival data for his cancer wasn’t reassuring. NYU’s Dr. Weber, who enrolled him in the trial, told him much of that data predate the use of newer drugs, Mr. Vogel said.
“That was an affirmation that I made the right choice, not only for myself but to further advance things if possible” Mr. Vogel said.
Peter Loftus contributed to this article.
Write to Brianna Abbott at brianna.abbott@wsj.com
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