mRNA cancer vaccines are the most exciting new treatment about to hit the clinic. Moderna's Phase 2b intismeran autogene randomized trial found a 49% (!!!) reduction in the risk recurrence or death for patients with high risk melanoma already on standard treatment. Several Phase 3 trials are underway. mRNA vaccines have the potential to work for a wide variety of tumors.

(95% confidence interval is 0.294-0.887, wide but not too wide, n=157, to be expected for phase 2).

How they work is also completely fucking insane. Intismeran autogene is personalized for every patient via sequencing their tumor DNA. That's sci-fi shit. If you're not impressed by that, you should be. Fast and scalable DNA sequencing, neoantigen identification, RNA synthesis, none of this is easy and all of it relies on recent innovations across multiple fields.

The first proofs of concept for personalized vaccines like this date back to 2017[1] or 2015[2]. The process for designing the vaccines requires a machine learning algorithm first published in 2020[3]. Details of the algorithm aren't available, but it validated against data published in 2019[4], and there have been many recent advancements in algorithms and datasets for biotech ML that it likely relied on. As you might already know, mRNA vaccines were first tested in humans around the 2010s[5].

[1] https://www.nature.com/articles/nature22991 [2] https://pubmed.ncbi.nlm.nih.gov/25837513/ [3] https://aacrjournals.org/cancerres/article/80/16_Supplement/... [4] https://pmc.ncbi.nlm.nih.gov/articles/PMC7138461/ [5] https://pubmed.ncbi.nlm.nih.gov/26082837/