Melanoma vaccines coming in 2025: here’s how they work

Recently, companies Moderna and Merck announced that a melanoma vaccine could be ready by 2025. In fact, they have already begun clinical trials to develop innovative therapies against this disease.

About 325,000 new cases of melanoma are diagnosed each year worldwide. This figure highlights the need for innovative and effective strategies to combat one of the most aggressive and deadly skin cancers known.

When the skin cells responsible for producing the pigment that gives us color undergo an abnormal transformation and begin to grow uncontrollably, they form a malignant tumor called melanoma, which can expand and spread to other parts of the body.

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Exposure to ultraviolet (UV) radiation sunlight is one of the main risk factors, as well as genetic predisposition and severe and recurrent sunburn throughout life. It is estimated that about 80% of skin melanomas occur on apparently healthy skin. This means that only 20% of cases are the result of a previous skin lesion, such as a mole.

Although the appearance of new moles is common before the age of forty, it is important to monitor any changes. This monitoring is based on the ABCDE system (asymmetry, boundaries, color, diameter and evolution) for the early detection of possible malignant lesions.

The immune system plays a critical role in recognizing and destroying cancer cells, including melanoma cells. As if they were military squads, Immune cells constantly patrol our skin looking for abnormal cells. it can put our health at risk.

This process is called immunosurveillance and is based on the recognition of antigens – cell surface molecules that signal the immune system about the presence of foreign objects. They are “flags” that identify malicious cells and allow immune cells to mobilize to destroy them.

However, there are times when cancer cells manage to evade immune detection or use tactics to suppress their response, opening the way for tumor progression.

Currently, studying the ability of cancer cells to evade the immune system has become a therapeutic task of great interest and relevance. If we know what cells do to put the immune system to sleep, we can develop strategies to wake it up so it can perform its protective function.

However, these treatments are not always effective, and sometimes may cause hyperreactivity of immune cells. That is, once activated, they attack not only the tumor, but all the cells of the body.

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Faced with this dilemma, the possibility arose of selectively targeting immune cell activity only to tumor cells. This is where another branch of immunotherapy comes into play: the development of new cancer vaccines. The key is to develop tools that help the immune system recognize the tumor and target it.

Several types of melanoma vaccines are currently being studied, all of which rely on the cells’ ability to recognize surface antigens.

On the one hand, there are peptide-based vaccines. That is, those antigens that melanoma cells usually carry are selected, produced in the laboratory and administered as an antidote. In this case, the strategy is to train the immune system to look for signals.

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On the other hand, the use of specific cells of the immune system (dendritic cells) that can recognize flags, determine whether they belong to healthy or diseased cells, and teach them to the cells that should eliminate them is being studied. A clinical study showed a 70% reduction in mortality risk. combining each patient’s own dendritic cells with a compound that stimulates the immune system. Although this study had limitations such as a small number of participants, the results are encouraging.

Finally, there are RNA-based vaccines, such as the one developed by Moderna and Merck, which work similarly to the vaccine developed against Covid-19.

While Moderna’s coronavirus vaccine contains the RNA sequence of the pathogen’s S protein, the new vaccine, technically called mRNA-4157 (V940), includes genetic information to create flags specific to a patient’s tumor. When the RNA enters the body’s cells, they begin to produce large quantities of these flags, making them easier for the immune system to recognize and therefore easier for them to detect cancer cells.

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This treatment is being tested in patients with metastatic melanoma who are at high risk of recurrence. The vaccine was combined with a drug that stimulates the activation of the immune system and, according to preliminary data, reduced the risk of relapse or death by 49% compared to treatment with the drug alone. Combination therapy also led to an improvement in long-term disease-free survival, reducing the risk of developing metastases to other organs by 62%.

Without a doubt, the results are promising and aim to improve the treatment of melanoma. According to Moderna Senior Vice President and Head of Therapeutics and Oncology Development Kyle Holen, the entire team is committed to sharing these data with the community and bringing hope to people affected by this disease and their families.