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Home » mRNA vaccine for pancreatic cancer — excellent long-term results

mRNA vaccine for pancreatic cancer — excellent long-term results


I have written about the clinical trial results for an mRNA vaccine for pancreatic cancer previously, but those were preliminary results. Recently, results were published that examined the long-term results of the clinical trial, and they were more than just encouraging, they were exciting.

I think that having a treatment for pancreatic cancer gets a lot of people’s attention because it is one of the cancers that is most difficult to treat. And it has garnered a lot of attention over the past few years. I think it may be in the top handful of cancers that scare people because it is so difficult to treat.

Lucky for the world, mRNA vaccine technology is going to be one of the leading technologies for cancer treatments, including pancreatic cancer, going forward. If it can make a meaningful dent in the course of pancreatic cancer, it may well become one of the primary tools for oncologists in treating this pernicious disease.

Of course, I like talking about these cancer vaccines because it shows the world how valuable these new vaccines will be for saving more lives. This is just further confirmation that vaccines have become one of the most important medical advances that has ever happened to humanity.

As I usually do, let’s review this vaccine and the clinical trial results.

Pancreatic cancer

Before I discuss the vaccine, here are some facts about pancreatic cancer:

  1. An estimated 66,440 people (34,530 men and 31,910 women) will be diagnosed with pancreatic cancer in 2024.
  2. About 51,750 people (27,270 men and 24,480 women) will die of pancreatic cancer in 2024.
  3. Because early symptoms of pancreatic cancer may be missed, it is usually diagnosed in later stages which leads to only a one-year lifespan after diagnosis.
  4. Treatment of pancreatic cancer usually requires surgery plus adjuvant therapies like chemotherapy and radiation therapy. Of course, the success rate of this strategy is lower with later-stage pancreatic cancer.

mRNA cancer vaccine

These mRNA cancer vaccines help create antibodies against specific antigens on the surface of the pancreatic cancer, destroying the cancer in the process. The mRNA vaccine for pancreatic cancer is individualized, that is, each person receives an mRNA vaccine that has been engineered for that person. The mRNA vaccine for cancer developed for person X will probably not work on person Y.

I need to make an important point — a cancer “vaccine” is a bit of a misnomer. These vaccines do induce an immune response, but they are not preventative like vaccines for pathogens – they are used as treatments. This mRNA cancer vaccine is individualized, meaning it codes for antigenic proteins on each person’s pancreatic cancer cells – every person has slightly different antigens even if they have the same cancer type. However, the vaccines may make the person immune to a recurrence of the cancer, so, in a sense, it is also preventative.

So how does this “vaccine” work? The mRNA cancer vaccine trains the immune system to attack the cancer cells that may have been missed by surgery or chemotherapy, or have metastasized to another location. But, and this is important, it probably would not affect another type of tumor. This pancreatic cancer vaccine will probably be useless against colorectal cancer, as an example.

Furthermore, these cancer vaccines are usually used in conjunction with surgery, and possibly chemotherapy, as part of an overall treatment strategy for cancer. These mRNA cancer vaccines ought to be considered immunotherapy rather than a preventative vaccine, but the name has stuck, so I’ll continue to use it.

The mRNA vaccine for pancreatic cancer is usually given after recovery from surgery. During the post-surgery period, the mRNA vaccine is created for that individual and given to them as part of the treatment strategy. During and after receiving the vaccine, the patient will probably also receive chemotherapy. According to clinical research, this is the best way to have the highest success rate.

Pancreatic cancer vaccine

Thus, additional tools like an mRNA vaccine to treat the cancer help increase the success rate of pancreatic cancer treatments.

The pancreatic cancer mRNA vaccine, cevumeran, was developed by BioNTech, the German pharmaceutical company that developed one of the COVID-19 mRNA vaccines in partnership with Pfizer. Phase 1 clinical trial results were published last year, which showed some promising results. At a median follow-up of 18 months after surgery, eight patients who had immune responses to the mRNA vaccine, cevumeran, had significantly longer recurrence-free survival compared with a median of 13.4 months in the eight patients who had no immune response.

BioNTech announced three-year follow-up data from a Phase 1 trial with the mRNA-based individualized neoantigen-specific immunotherapy (“iNeST”) candidate mRNA vaccine, cevumeran, in patients with resected pancreatic ductal adenocarcinoma.

The data show that in 8 out of 16 patients, cevumeran elicited an immune response up to three years post-administration measured by activated T cells. The persistence of T cells was associated with a longer median recurrence-free survival in cancer vaccine responders.

The phase 2 clinical trial, which should provide more data about the effectiveness of the vaccine, was sponsored by Genentech and BioNTech and is recruiting 260 patients to participate in 14 locations in the USA. The study will compare the endpoints of patients with pancreatic cancer who receive cevumeran plus Atezolizumab and mFOLFIRINOX, two chemotherapy drugs, to patients who receive mFOLFIRINOX alone. The goal of the study is to determine the safety and efficacy of cevumeran, the mRNA vaccine, and to determine if the vaccine improves outcomes compared to chemotherapy alone.

Patients undergo surgery to remove the tumor, which is then sequenced to make a personalized vaccine specific to the patient’s cancer. The vaccine is developed in four to six weeks while patients recover from surgery. Patients receive six weekly injections, and following six months of standard chemotherapy, patients receive six more vaccines as boosters.

Summary

This long-term follow-up of three years post-vaccination shows that the vaccine continues to be effective and may reduce the risk of recurrence of the cancer. That’s a win in medicine.

This “vaccine” may become a game changer in the treatment of pancreatic cancer. I know that many of my readers hate vaccines, based on no scientific evidence, but I wonder if they will beg to get their mother into the clinical trial if she has pancreatic cancer. I hope they will because these mRNA vaccines are changing the world of cancer treatment.

Citations

  • Rojas LA, Sethna Z, Soares KC, Olcese C, Pang N, Patterson E, Lihm J, Ceglia N, Guasp P, Chu A, Yu R, Chandra AK, Waters T, Ruan J, Amisaki M, Zebboudj A, Odgerel Z, Payne G, Derhovanessian E, Müller F, Rhee I, Yadav M, Dobrin A, Sadelain M, Łuksza M, Cohen N, Tang L, Basturk O, Gönen M, Katz S, Do RK, Epstein AS, Momtaz P, Park W, Sugarman R, Varghese AM, Won E, Desai A, Wei AC, D’Angelica MI, Kingham TP, Mellman I, Merghoub T, Wolchok JD, Sahin U, Türeci Ö, Greenbaum BD, Jarnagin WR, Drebin J, O’Reilly EM, Balachandran VP. Personalized RNA neoantigen vaccines stimulate T cells in pancreatic cancer. Nature. 2023 May 10:1–7. doi: 10.1038/s41586-023-06063-y. Epub ahead of print. PMID: 37165196; PMCID: PMC10171177.
Michael Simpson

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