Moderna's skin cancer therapy receives breakthrough tag

Moderna said on Wednesday its experimental personalised mRNA skin cancer vaccine in combination with Merck & Co’s drug Keytruda has received breakthrough therapy designation from US regulators as an additional treatment for high risk patients.

The breakthrough tag is granted by the US Food and Drug Administration (FDA) based on data from a mid-stage study of the drug that showed the therapy reduced risk of skin cancer’s recurrence or death by 44% compared with Keytruda alone.

The FDA’s breakthrough therapy designation is granted to expedite the development and review of drugs that are intended to treat a serious condition.

The companies said they plans to initiate a late-stage study in adjuvant treatment of melanoma in 2023.

About mRNA-4157/V940

mRNA-4157/V940 is a novel investigational messenger ribonucleic acid (mRNA)-based personalized cancer vaccine consisting of a single synthetic mRNA coding for up to 34 neoantigens that is designed and produced based on the unique mutational signature of the patient’s tumor. Upon administration into the body, the algorithmically derived and mRNA-encoded neoantigen sequences are endogenously translated and undergo natural cellular antigen processing and presentation, a key step in adaptive immunity.

Personalized cancer vaccines are designed to prime the immune system so that a patient can generate a tailored antitumor response specific to their tumor mutation signature. mRNA-4157/V940 is designed to stimulate an immune response by generating specific T cell responses based on the unique mutational signature of a patient’s tumor. KEYTRUDA is an immunotherapy that works by increasing the ability of the body’s immune system to help detect and fight tumor cells. Based on early clinical studies, combining mRNA-4157/V940 with KEYTRUDA may potentially provide an additive benefit and enhance T cell-mediated destruction of tumor cells.

About KEYNOTE-942/mRNA-4157-P201 (NCT03897881)

KEYNOTE-942 is an ongoing randomized, open-label Phase 2b trial that enrolled 157 patients with stage III/IV melanoma. Following complete surgical resection, patients were randomized to receive mRNA-4157/V940 (nine total doses of mRNA-4157) and KEYTRUDA (200 mg every three weeks up to 18 cycles [for approximately one year]) versus KEYTRUDA alone for approximately one year until disease recurrence or unacceptable toxicity. The primary endpoint is recurrence-free survival, and secondary endpoints include distant metastasis-free survival and safety.

Key eligibility criteria for the trial included: patients with resectable cutaneous melanoma at high risk of recurrence, patients with complete resection within 13 weeks prior to the first dose of KEYTRUDA, patients were disease free at study entry (after surgery) with no loco-regional relapse or distant metastasis and no clinical evidence of brain metastases.