Melanoma is/was a highly aggressive and deadly skin cancer. Early detection often results in an elimination of the lesion. However many patients fails to get checked even when they note a problematic lesion.
As new mRNA vaccine developed by Merck et al, notes:
Intismeran autogene (intismeran; formerly V940 or mRNA-4157) is an mRNA-based individualized neoantigen therapy. We report 5-year outcomes of intismeran plus pembrolizumab from the phase IIb KEYNOTE-942 study (ClinicalTrials.gov identifier: NCT03897881). Eligible patients with resected stage IIIB to IV cutaneous melanoma were randomly assigned 2:1 to receive nine doses of intramuscular intismeran 1 mg once every 3 weeks plus 18 doses of intravenous pembrolizumab 200 mg once every 3 weeks or 18 doses of intravenous pembrolizumab 200 mg once every 3 weeks. The primary end point was recurrence-free survival (RFS); secondary end points included distant metastasis-free survival (DMFS) and safety. Five-year analyses were descriptive. Among 157 randomly assigned patients (intismeran plus pembrolizumab, n 5 107; pembrolizumab, n 5 50), the median planned follow-up at data cutoff (December 15, 2025) was 60.3 (range, 50.5-76.4) months. Intismeran plus pembrolizumab continued to prolong RFS (hazard ratio [HR], 0.510 [95% CI, 0.294 to 0.887) and DMFS (HR, 0.411 [95% CI, 0.200 to 0.843]), with a favorable trend in overall survival (HR, 0.471 [95% CI, 0.165 to 1.345]) versus pembrolizumab. Safety profile continued to be manageable, with no new safety signals. Intismeran plus pembrolizumab was associated with increased T-cell receptor clonality and novel clonotypes versus pembrolizumab; greater novel clone expansion was observed in patients without versus with recurrence in the combination arm. After a 5-year follow-up, intismeran plus pembrolizumab demonstrated sustained, durable treatment benefits versus pembrolizumab alone in resected high-risk melanoma.
The NY Times notes:
Scientists create intismeran by sequencing the patient’s tumor and selecting what are called “neoantigens,” which teach the immune system how to attack the cancer. They use the fast, flexible mRNA technology to create a vaccine with neoantigens selected for each patient — a process that takes about six weeks. “It is certainly gratifying to see these exciting results — to come full circle, from our early proof-of-concept results to now,” Dr. Catherine Wu, a professor of medicine at Harvard Medical School and the Dana-Farber Cancer Institute and a leader in the field, wrote in an email. “It is highly conceivable that this treatment paradigm will be extendable to other cancers as well.”
We have recently examine cancer vaccines of this type. They may have significant results.
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