The Future of Harnessing the Immune System to Fight Cancer: What to Know About Neoantigens and mRNA Vaccines

Neoantigens, mRNA Vaccines & the Future of Cancer Care

• Experts say that mRNA vaccines and neoantigens are a big deal. If researchers can figure out the best ways to make use of them — it could be a game-changer.
• Neoantigens are unique proteins on cancer cells that help the immune system recognize and target these cells, serving as valuable treatment targets.
• mRNA vaccines use genetic code to train the body to produce an immune response, creating antibodies that help fight and protect against diseases, including cancers like melanoma.
• Experts hope these individualized treatments can help raise immune reactions against tumors.

When you're dealing with cancer, the array of treatment options can feel overwhelming. One of the newer and promising areas of treatment is neoantigen therapies and mRNA vaccines. Experts say that mRNA vaccines and neoantigens are a big deal. If cancer researchers can figure out the best ways to make use of them — it could be a game-changer. We sat down with Dr. Scot Ebbinghaus, a medical oncologist and vice president of clinical development at Merck, to learn where research currently stands.

What are Neoantigens and mRNA Vaccines?

Neoantigens are unique proteins that appear on the surface of cancer cells but not on normal cells. They are essentially "flags" that can help the immune system recognize and target cancer cells specifically. Think of neoantigens as unique fingerprints for each tumor, which makes them a valuable target for treatment. Messenger RNA vaccines (mRNA) differ from traditional vaccines in that they don’t contain dead or weakened viruses. Instead, they use pieces of genetic code (neoantigens) to help the body produce an immune response against a specific virus or disease. "Imagine a patient with melanoma or some other type of cancer. They have surgery to take that out and [we] take a sample of that tumor and [we] send it to a laboratory to have the cancer genome sequenced. And we can do that now in a matter of days to weeks to have it sequenced," Dr. Ebbinghaus tells SurvivorNet. "Then we use a computer algorithm to predict what immunogenic proteins might be made by mutations that are in that cancer. Then our partners at Moderna can make an mRNA vaccine that will produce up to 34 of these immunogenic proteins, package it in a lipid nanoparticle and give it back as a shot in the arm, just like the other mRNA vaccines that are used for infectious diseases like Covid." "And so that's what an individualized neoantigen therapy is. What we hope that it accomplishes is to raise an immune reaction against that patient's tumor," adds Dr. Ebbinghaus.

How Do mRNA Vaccines Work?

mRNA vaccines use laboratory-created mRNA to train the cells inside our body to make proteins. These proteins activate our immune system, which then responds by making antibodies. Antibodies are key in fighting infections, and can also help protect us from disease in the future. When your body develops antibodies toward a specific virus or disease, it’s better prepared to fight that infection if it comes in contact with it again. mRNA vaccines help our body create these antibodies before we’re even infected, which could be a lifesaving measure against many serious illnesses, including melanoma and other cancers.

How Do Neoantigen Therapies Work?

Neoantigen therapies are personalized treatments designed to boost your immune system's ability to fight cancer. Here’s a breakdown on how they work:

1. Identification: Doctors take a sample of your tumor and analyze it to identify the specific neoantigens present.
2. Vaccine Creation: Using this information, they create a vaccine tailored to these neoantigens. This personalized vaccine is designed to train your immune system to recognize and attack the cancer cells.
3. Immune Response: Once administered, the vaccine helps your immune system better identify and destroy cancer cells, while sparing healthy cells.

The Benefits of Neoantigen Therapies

There are several benefits to using these types of therapies, including:

• Personalized Treatment: Because the vaccine is made specifically for your tumor, it is tailored to be as effective as possible.
• Targeted Approach: This therapy specifically targets cancer cells, which can potentially lead to fewer side effects compared to traditional treatments like chemotherapy.
• Potential for Long-Term Protection: By training your immune system to recognize the cancer, there’s a chance it could provide long-term protection against recurrence.

"Where we think these drugs are going to be, or this therapy is going to be most successful is in patients who have cancer that is removed, that's at high risk of coming back," adds Dr. Ebbinghaus. "If you think about melanoma, you can completely resect it most of the time. But the problem is that it comes back. What we want to do is reduce the risk of that cancer coming back for patients."

Moving Forward

We understand that facing cancer is incredibly challenging for you and your loved ones. It’s important to remember that treatments like neoantigen therapies represent the forefront of cancer research and offer hope for many patients. If you're interested in neoantigen therapies, talk to your oncologist. They can provide more detailed information and discuss whether this treatment might be suitable for your specific situation.