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Recent trial results suggest that the next chapter of the cancer treatment story may already be unfolding through personalised, mRNA tumour vaccines. Image used for representational purposes only
| Photo Credit: wildpixel
Not long ago, a diagnosis of advanced cancer left doctors with little more than symptom control and hope. Over the course of a few of decades, however, that picture changed dramatically. Chemotherapy delivered the first meaningful survival gains, though at a steep cost in side effects, a cost later softened by a new generation of supportive drugs that made treatment safer and more tolerable. The mapping of the human genome then opened up an era of precision medicine, as whole-genome sequencing revealed mutations that could be directly targeted. Survival improved again, but a cure remained elusive: tumours kept finding new, resistant mutations to evade each targeted drug. It took a deeper understanding of the immune system to breach the next frontier: immunotherapy taught the body’s own defences to attack cancers once thought untreatable.
Now, a new contender has emerged that could rewrite the story once more: personalized mRNA tumour vaccines. Recent trial results suggest that the next chapter of the cancer treatment story may already be unfolding.
Cancer treatment has advanced in successive waves. In the 1970s and 80s, chemotherapy became the cornerstone of oncology, improving outcomes across the board and curing diseases such as Hodgkin’s lymphoma and testicular cancer. The sequencing of the human genome and subsequent advances in molecular biology then enabled targeted therapies aimed at specific genetic abnormalities — HER2 in breast cancer, EGFR mutations in lung cancer, and many others.
The most dramatic transformation of the past two decades, however, came with immunotherapy. Checkpoint inhibitors such as pembrolizumab and nivolumab (drugs that block certain proteins on T-cells of the immune system, helping to attack cancer cells) changed the outlook for metastatic melanoma, a disease that had previously carried a dismal prognosis. What began in melanoma soon spread to lung, kidney, bladder, liver and head-and-neck cancers, reshaping treatment paradigms worldwide.
