As the COVID-19 pandemic unraveled in 2020, the world witnessed another stunning occurrence—medical researchers across the globe dropped nearly everything to commit to the development of a vaccine that would protect the population as soon as possible. In less than one year, the time, money and effort that went into fueling such research also fueled a monumental triumph in U.S. medical history—the FDA approval of the first-ever vaccines utilizing mRNA.
Of course, everyone is now abuzz with discussions about mRNA given its important role in combating the novel coronavirus. But while mRNA vaccines are new, they’re certainly not an unfamiliar topic to researchers. They also hold the potential to fight a greater array of diseases and viruses than just COVID-19—including cancer.
You may recall your high school biology teacher explaining how mRNA, or messenger ribonucleic acid, is a molecule that carries genetic instructions from the body’s DNA strands to the cytoplasm, where proteins are made. Because proteins help cellular functions in our body like fighting against illnesses, research began in the 1990s to discover how to harness mRNA’s protein-making power into custom-made protection from diseases or viruses.
When it comes to more traditional routine vaccines, like the flu shot, our body receives a weakened or inactivated form of the targeted virus. This is not the case with mRNA-based vaccines.
In mRNA technology, synthetic mRNA is developed in a lab and, when entering the body, instructs the host to form a predetermined protein in order to trigger an immune response. After producing the appropriate antibodies, the body now wields a blueprint on fighting the virus were it to pop up again—all without the risk of becoming infected or seriously ill to do so.
With COVID-19, the key protein chosen for the vaccine is the “spike” protein, found on the surface of the virus. For other viruses or diseases, it could be a different protein. The magic of synthetic mRNA’s potential is its customization. This flexibility bodes well for other areas of focus, like cancer research.
“The most significant potential of mRNA research is cancer vaccines,” says Sean Marchese, a registered nurse and oncology writer at The Mesothelioma Center who has experience in respiratory and thoracic oncology clinical trials. “The specific targeting mechanisms of mRNA vaccines make them excellent candidates for cancer treatment. We’re seeing this level of effectiveness now with the COVID-19 vaccine.”
Moderna Inc., the biotech giant responsible for one of two current mRNA vaccines for the COVID-19 virus, doesn’t take the potential of mRNA technology lightly. It’s also applying its research toward immune-oncology, or immunotherapy, to create a cancer vaccine.
“Immunotherapy is taking off in the oncology world, and mRNA vaccines are the next step in that field,” explains Marchese.
Immunotherapy has shown some promise in using the body’s immune system to identify and fight cancerous cells. Just like synthetic mRNA strengthens an immune system’s response to a pathogen, immunotherapy can strengthen an immune system’s response to cancer cells. But it’s not perfect. Studies have found that sometimes immunotherapy drugs are only partially effective for patients, and occasionally they may not work at all.
“Cancer cells vary from patient to patient, so we must develop vaccines that target specific mutations,” says Marchese.
Moderna is aiming to do just that through its research on personalized cancer vaccines. Such a vaccine would utilize next-generation sequencing, a way to analyze genetic variations within diseases, to identify mutations found on a patient’s cancer cells. Moderna’s bioinformatics team would develop algorithms based on this information to encode for each of these mutations in a single mRNA molecule, which is then distributed through a vaccine. This would ideally assist the patient’s body in identifying cancerous cells more easily, thus creating a stronger immune response for treating cancer.
Results from studies have been optimistic. A clinical trial sponsored by Moderna at the University of Arizona expanded in November 2020 to include more participants after showing promising preliminary data on head and neck cancer patients receiving a personalized cancer vaccine in combination with immunotherapy drug Pembrolizumab.
There are setbacks when it comes to mRNA and cancer, however, which is likely why we haven’t seen a mRNA-based cancer vaccine approved just yet.
After mRNA instructs your body to form the predetermined protein, it breaks apart and eventually dissipates completely. This works well enough for the COVID-19 virus, but the short-term immune engagement isn’t as effective for cancer cell treatment as mRNA must travel all the way into the body’s lymph nodes to be productive.
A February 2021 study set out to address this shortcoming. Chinese researchers developed and tested an injectable hydrogel—synthetic biomaterials that closely resemble natural living tissue—that contains and stabilizes mRNA, allowing a slower release of mRNA. Administered to mice with melanoma, subjects experienced reductions in tumor size and no further metastasis in the lungs. These findings could be influential in cancer vaccine development if success continues in further trials.
Cancer is complex and using mRNA to develop a cancer vaccine is still in the early stages of research. But the success of mRNA-based vaccines tackling the COVID-19 virus has shone a spotlight on the potential of this versatile approach in cancer care. With a momentous mRNA landmark occurring firsthand in real time, a new era of vaccine technology may be ushered in.
“Researchers have proven the scalability of mRNA vaccine production with COVID-19 vaccines,” says Marchese. “And now we must turn that focus towards cancer prevention and treatment.”
To follow along with Moderna Inc.’s immuno-oncology progress and development of a personalized mRNA-based cancer vaccine, visit modernatx.com/pipeline/therapeutic-areas.