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above my paygrade. but i thought it important

Forums General Melanoma Community above my paygrade. but i thought it important

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        ed williams
        Participant
          Here is the other one, just wanted to make sure it was going to work the first time. https://www.genengnews.com/topics/omics/melanoma-neoantigen-vaccine-shows-strong-antitumor-response/
          ed williams
          Participant
            There is also a program by Moderna ( same company that is doing covid-19 vaccine) working with Pembro (Merck), here are a couple of links. https://www.modernatx.com/pipeline/therapeutic-areas/mrna-personalized-cancer-vaccines-and-immuno-oncology                      https://clinicaltrials.gov/ct2/show/NCT03897881
            tkoss
            Participant
              a layman’s question or 2:

              does this mean if you get a tumor, rather than surgery or long round of infusions , you simply take a shot?

               

              would this be used for a melanotic moles on discovery from a biopsy?

               

              either situation suggests radically different treatment regime than immo  infusion therapy.

              ed williams
              Participant
                To date my understanding is that they are using vaccines in a couple of different ways depending on the company(s). In the example that I will link below at Emory two companies are working together Bristol Myer Squibb (nivo) + Vaccinex Inc. VX15/2503    NCT 03769155 in 2018 started this phase one 36 patient trial. They gave the drug before doing the surgery to remove the melanoma ( so it is neoadjuvant). They wanted to see what effect the vaccine was having in the microenvironment of the tumor.  Second trial started 2019 with Moderna (MRNS-4157)+ Merck (Pembrolizumab) is and adjuvant phase 2 trial of 150 patients to see if they can keep melanoma from coming back. https://clinicaltrials.gov/ct2/show/NCT03769155?term=emory+vx15                      https://clinicaltrials.gov/ct2/show/NCT03897881
                MelMel
                Participant

                  My understanding is that one still needs surgery to get rid of the tumor burden. Then 18 weeks after the vaccine. Out of eight patients, six patients had no evidence of disease four years after followup. Two patients had intially melanoma metastases to the lungs as well and were put on checkpoint inhibitor immunotherapy following the vaccine. Even in those two patients, the researchers detected signs that T cells had made their way into the tumor tissue, where they could be most lethal to melanoma cells.

                  The problem are the melanoma cancer stem cells. Regular treatments try to kill daughter melanoma cells but the melanoma stem cells are much more resistant and seem to evade attack, eventually wreak havoc coming back even stronger than before. The analogy would be similar to a bee hive. Conventional treatment kills the worker bees (melanoma daughter cells) but somehow the Queen Bee (melanoma stem cells) remains alive and well and eventually if conditions are ripe, these seem to explode with a vengence. The vaccine teaches our own immune system to recognize the cancer cells and it has lasting memory to remember the intruder when it returns.

                  So low tumor burden seems to be the key and probably this is why all eight patients had surgery initially and vaccine 18 weeks later. This way the patient’s immune system can concentrate on just a few floating cells instead of fighting larger tumor masses at the same time.

                  It takes three months to manufacture the vaccine for each specific person’s tumor. Remember, they need your tumor to identify your specific tumor receptors so surgery is first. Thus the 18 weeks delay.

                  The nice thing is that if one does not have spread to other organs, they possibly do not need immunotherapy and mole removal followed by a personalized vaccine is all that is required for NED status.

                  This is the same study but different write-up where glioblastoma is also mentioned

                  https://gizmodo.com/personalized-skin-cancer-vaccine-shows-promise-in-new-t-1846100296

                  Best regards,

                  Melanie

                   

                Mark_DC
                Participant
                  Ed – I think BioNTech was doing something similar, applying this to melanoma, and then instead they modified it and rolled it out for COVID. I dont have the article but I think it was in a Tedtalk the founder gave or in some youtube video. Didnt know Moderna were also doing this! Do you have any idea what it means, could it be a new treatment or we just dont know since its Phase I? Sounds interesting given the seeming ability of mRNA vaccines o work against covid
                    ed williams
                    Participant
                      Mark, here are two really interesting article on the MRNA platform for cancer vaccine. https://www.nature.com/articles/d41586-019-03072-8                https://www.clinicaltrialsarena.com/comment/moderna-biontech-covid-cancer-vaccines/
                      ed williams
                      Participant
                        Also something to think about is there have been a lot of cancer vaccine attempts that have failed in the past, so you have to take the research as just that research until they show show phase 3 data that should this will work better than what we have now. Here is a link that shows that caution is a good idea with the mRNA platform. https://www.fiercebiotech.com/biotech/roche-biontech-post-low-response-rate-cancer-vaccine-trial
                        MelMel
                        Participant
                          Hello Ed,

                          Happy New Year! Thank you for your recent Ottawa study.

                          The NeoVax study has followed eight patients for a four year period and with excellent results. Excercising caution is one thing but witholding it from the seriously ill when it can perhaps save countless lives is ridiculous and unconscionable. Try that line with someone who is dying. Currently, I have two friends who are battling brain mets after conventional therapy has failed them. My own grandfather was gone in six weeks from glioblastoma which has no conventional treatment and is as deadly as it gets.

                          Best regards,

                          Melanie

                           

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