Cancer is one of the toughest health challenges we face, and even after decades of progress in detection and treatment, many patients still succumb to it, with over nine million deaths recorded worldwide in recent years.

A promising new approach is cancer immunotherapy, which uses the body's immune system to attack cancerous tumours. A big challenge in deploying immunotherapy has been the tumour microenvironment, which can protect the cancer by weakening the immune system’s responses.

Researchers led by Elias Sayour at the University of Florida have developed a new strategy using specially designed structures that better deliver tumour-fighting materials to the immune system. They used a newly engineered mRNA vaccine that combines RNA with lipid particle aggregates to fight cancer, as their study published on May 1 in the scientific journal, Cell, shows.

mRNA technology, which became a household name during the Covid-19 pandemic, is based on using a synthetic version of messenger RNA to instruct cells to produce a protein that triggers an immune response. Its adaptability and speed of development made it ideal for responding to the Covid-19 virus – attributes that are helpful in the treatment of cancer.

The new mRNA vaccine can be tailored to an individual patient's own cancer cells. This personalised approach utilises the power of mRNA technology as used in Covid-19 vaccines but with a twist. Instead of single particles, this vaccine uses clusters of lipid nanoparticles that mimic the structure of onions, delivering the genetic material more effectively.

The cancer vaccine activates a part of the immune system within the tumour microenvironment, which then releases signals attracting immune cells to the tumour. These cells travel to the tumour and attack cancer cells.

Earlier, this method has been successful in animal studies, most notably in dogs with severe brain tumours. The treatment ensured not only longer survival but also made the tumours more susceptible to attacks from the immune system.

The first trial in humans, with four patients suffering from glioblastoma, a very aggressive brain cancer, has also been promising. The trial was not designed to evaluate the overall effectiveness of the approach, which is being determined now in larger clinical trials. However, the patients in the preliminary study either lived without signs of the disease for longer than anticipated or had an extended overall survival.

These early successes indicate that RNA lipid particle aggregates might be a big step forward in fighting cancer. They not only help reprogram the environment around the tumour to allow for a better immune attack but also create fast and lasting immune responses. Researchers are hopeful that this technology could be used for other types of cancer as well.

The optimism of cancer vaccines extends beyond glioblastoma. Another mRNA vaccine approach is revolutionising the treatment of melanoma (a kind of skin cancer). In a study led by University College London Hospital’s NHS Foundation Trust and reported by The Guardian on April 26, a vaccine named mRNA-4157 (V940) significantly reduced the risk of melanoma returning in patients when used alongside the immunotherapy drug Keytruda. These promising results have paved the way for a phase 3 trial, which aims to further validate these findings across a larger cohort of patients.

Recent efforts by industry giants like Moderna, Merck, and BioNTech in collaboration with Genentech, have also yielded encouraging results. Moderna and Merck reported from their melanoma trials that their vaccine, when combined with an immune checkpoint inhibitor, nearly halved the risk of recurrence or death compared to the inhibitor alone. Similarly, BioNTech and Genentech's pancreatic cancer trial showed promising early results, with a significant number of patients remaining cancer-free three years post-treatment.

However, mRNA vaccines won’t work for all cancers. The complexity of how the immune system interacts with cancer means that what works in one cancer type, or one patient might not work in another. The field is also grappling with the cost and complexity of creating personalised vaccines.

But even after acknowledging those challenges, exciting days are ahead. Each study that shows positive results brings us closer to a new era in cancer treatment care, where vaccines could play a critical role. Overall, mRNA vaccines offer an exciting new approach to treating intractable cancers through personalised treatment.

Anirban Mahapatra is a scientist and author, most recently of the popular science book, When The Drugs Don’t Work: The Hidden Pandemic That Could End Medicine. The views expressed are personal.

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New mRNA vaccines show promise in fighting cancer

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08.05.2024

Cancer is one of the toughest health challenges we face, and even after decades of progress in detection and treatment, many patients still succumb to it, with over nine million deaths recorded worldwide in recent years.

A promising new approach is cancer immunotherapy, which uses the body's immune system to attack cancerous tumours. A big challenge in deploying immunotherapy has been the tumour microenvironment, which can protect the cancer by weakening the immune system’s responses.

Researchers led by Elias Sayour at the University of Florida have developed a new strategy using specially designed structures that better deliver tumour-fighting materials to the immune system. They used a newly engineered mRNA vaccine that combines RNA with lipid particle aggregates to fight cancer, as their study published on May 1 in the scientific journal, Cell, shows.

mRNA technology, which became a household name during the Covid-19 pandemic, is based on using a synthetic version of messenger RNA to instruct cells to produce a protein that triggers an immune response. Its adaptability and speed of development made it ideal for responding to the Covid-19 virus – attributes........

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