Personalized mRNA Neoantigen Vaccines After Surgery for Melanoma, Lung or Other Cancers

Who Is a Candidate?

Personalized mRNA cancer vaccines are available through clinical trials. The most advanced studies enroll adults with high-risk melanoma that has been fully removed by surgery; other trials include lung, pancreatic, kidney, bladder and colorectal cancers.

Because each vaccine is made from your own tumor, studies need enough tumor tissue from surgery or biopsy, and most enroll within a set window after surgery. Good overall health and adequate organ function are usually required.

What to Expect

A sample of your tumor and a blood sample are sequenced to find mutations unique to the cancer. A vaccine encoding those targets is then manufactured for you alone, which takes several weeks.

The vaccine is given as a series of injections into the muscle over several months. In many trials it is combined with an immunotherapy infusion given every few weeks.

Recovery and Follow-Up

Vaccine doses are given in the clinic, and most people return to normal activities the same day. Expect regular visits for doses, blood tests and scans, typically for a year or more, to watch for any return of the cancer.

Risks and Side Effects

Commonly reported effects include soreness at the injection site, tiredness, chills, fever and flu-like symptoms for a day or two after a dose.

When the vaccine is paired with immunotherapy, that medicine has its own risks: the immune system can inflame healthy organs such as the skin, intestines, liver, lungs or thyroid. Ask how each will be monitored.

Cost and Insurance

In a trial, the investigational vaccine is usually provided at no cost. The paired immunotherapy may be standard care billed to insurance, or provided by the study. Ask for a clear breakdown before you enroll.

Choosing a Practice

Questions worth asking in your first conversation:

• Which vaccine trials are enrolling for my cancer and stage?
• How soon after surgery do I need to start, and can my tissue come from another hospital?
• What is given with the vaccine, and on what schedule?
• Who coordinates between my surgeon and the trial team?

Alternatives to Consider

After surgery, standard options can include immunotherapy, targeted therapy for tumors with specific mutations, chemotherapy, radiation, or careful monitoring. A trial is usually considered alongside these, not instead of them, so ask how the vaccine would fit with your standard care.