After melanoma success, Moderna and Merck push mRNA cancer vaccine into broader tumour types

Following the phase 3 data confirmed at the European Society for Medical Oncology (ESMO) meeting in Madrid — which showed a 42% reduction in melanoma recurrence for the Moderna–Merck personalised mRNA vaccine intismeran (mRNA-4157) combined with pembrolizumab — both companies have now outlined efforts to extend the platform into additional tumour types. Presentations and briefings at ESMO described the strategic rationale for expanding into indications including non-small-cell lung cancer and other solid tumours with high neoantigen burden.

The vaccine works by sequencing a patient's tumour, identifying mutations unique to that individual's cancer, and generating a bespoke mRNA construct encoding up to 34 neoantigens. Paired with immune checkpoint blockade via pembrolizumab (Keytruda), the combination is designed to amplify a tumour-specific T-cell response. The melanoma phase 3 results, published earlier this week, represent the first randomised trial to confirm survival benefit for a personalised neoantigen vaccine approach.

Reporters at Stat News note that the field now faces questions of cost, manufacturing scalability, and which tumour types — and which patients within those types — are most likely to benefit. Expansion trials are under way or planned, though peer-reviewed publications covering the new indication data have not yet appeared. The programme remains investigational in all settings beyond the adjuvant melanoma approval pathway.