The news of the first patient trials of an mRNA vaccine against lung cancer, which experts say could save thousands of lives, has given hope to humanity.

The target of the vaccine known as BNT116is to eliminate cancer cells while preventing their recurrence by training the immune system to recognize these cancer cells and attack them.

In recent years, the use of mRNA technology has provided the platform to overcome several of the technical difficulties that limited the effectiveness of vaccines for the treatment of cancer, the former Rector of EKPA, Professor of Therapeutics – Oncology – Hematology, tells APE-MPE. Director of Therapeutic Clinic, “Alexandra” Hospital, Thanos Dimopoulos.

He notes that the development of mRNA vaccine technology to address COVID-19; it also gave new impetus to the development of therapeutic vaccines for cancer.

Currently, he adds, two main classes of mRNA cancer vaccines are being developed.

mRNA vaccines for lung cancer

As Mr. Dimopoulos reports in APE-MBE, the recent publicity on the occasion of the inclusion of the first patient with non-small cell lung cancer in a clinical trial of an mRNA vaccine in the United Kingdom has brought back to the fore the potential therapeutic actions of these vaccines in cancer.

“The idea of ​​using therapeutic vaccines for cancer is not new. It is based on the ability of vaccines to activate the immune system and direct it against cells that express these antigens. Therefore, a vaccine that introduces into the body antigens that characterize only cancer cells (mutated proteins/neoantigens) could have a therapeutic effect on the disease. Numerous clinical studies with therapeutic vaccines in previous years did not show much effectiveness.

The two main classes of mRNA cancer vaccines

Mr. Dimopoulos explains that the first category concerns personalized vaccines that are developed specifically for the cancer neoantigens that each patient has. These vaccines are created after a biopsy of the tumor and a thorough analysis of its genome. Using algorithms, it is predicted which sequences of the tumor genome can act as neoantigens and stimulate an immune response. These sequences are introduced into the body using mRNA vaccines.

The second category concerns specific mRNA vaccines for specific mutations that are frequently found in neoplasms and are known to be able to elicit an immune response. This class of vaccines can obviously be used immediately for all patients who will be identified by the molecular testing of the disease as having the specific mutation.

In the second category belongs the BNT116 vaccine which is now being tested in non-small cell lung cancer.

Where is the new vaccine targeted and how is it administered?

It is a vaccine that contains mRNAs that produce 6 different neoantigens that are often found in patients with non-small cell lung cancer. The Professor reports.

The vaccine is being tested in a phase I study to assess its safety and clinical effectiveness. In this particular study, 130 patients with non-small cell lung cancer are to be included in 6 different groups, so as to include patients with metastatic disease, unresectable locally advanced disease and also local disease after complete surgical excision, which, however, has a high risk of recurrence. In these groups of patients the vaccine will be tested either as monotherapy or in combination with chemotherapy and/or immunotherapy based on established practice for each stage of the disease. The vaccine is given intravenously initially in 6 weekly doses and then every 3 weeks.

“The results from the first 20 patients with metastatic disease who had received previous treatments were quite encouraging. This group was given the BNT116 vaccine along with chemotherapy and found significantly better clinical outcomes compared to what we knew about chemotherapy so far. In fact, the synergistic effect between the vaccine and chemotherapy was not accompanied by a particular increase in side effects and those observed in relation to the vaccine were related to the activation of the immune system and were easily treated with corticosteroids”, explains Mr. Dimopoulos.

Tests for other vaccines as well

“And other mRNA vaccines are currently being tested for lung cancer. More specifically, the personalized mRNA vaccine V940 (mRNA-4157) containing up to 34 different tumor-specific neoantigens for each patient is being tested in combination with the anti-PD1 agent pembrolizumab in a phase III study in stage II-IIIb non-small cell lung cancer after from complete exclusion of the disease”, concludes Mr. Dimopoulos.