What changed
The lipid-nanoparticle mRNA platform that delivered COVID vaccines at scale is now being pointed at tumours. The principle is different from a preventive vaccine: a patient's tumour is sequenced, mutations unique to that tumour are identified, and an mRNA construct is manufactured to present those neoantigens to the immune system.1
How far along it is
Randomised Phase II data in resected melanoma, combined with checkpoint inhibition, reported a meaningful reduction in recurrence versus checkpoint inhibition alone. Phase III programmes are running.2
The manufacturing story is the part worth watching. A per-patient product turns a pharmaceutical company into a logistics company — sequencing, design, synthesis and release for one person, on a clock set by their disease. That is a far harder problem than the immunology, and it is where this either scales or stalls.
Sources
- Individualised neoantigen therapy — [Journal, Year]
- Phase II randomised readout — [Journal, Year]
No corrections to date. If you can show me I am wrong, with a source, it gets fixed here and dated — send it over.