Published: 28 February 2024
Cancer patients in the UK have started receiving a new experimental therapy to help their bodies recognise and fight cancer cells.
Researchers are aiming to evaluate the safety and potential of the mRNA therapy - a type of immunotherapy treatment called mRNA-4359 - for treating melanoma, lung cancer and other ‘solid tumour’ cancers.
The first doses of the treatment were given at the NIHR Imperial Clinical Research Facility (CRF) at Hammersmith Hospital. The international Mobilize trial is run in partnership between Imperial College London and Imperial College Healthcare NHS Trust. It is sponsored by pharmaceutical company Moderna and is set to recruit patients globally over the next three years.
How the treatment works
The treatment is designed using messenger RNA (mRNA). It works by presenting common markers of tumours to the patient’s immune system. This should help to train patients’ immune systems to recognise and fight cancer cells expressing these markers. It should also potentially eliminate cells that may suppress the immune response.
Cancer vaccines have the potential to make conventional immunotherapy more effective. A number of vaccines are entering clinical trials internationally. These fall into one of two categories:
- personalised cancer immunotherapies, which rely on extracting a patient’s own genetic material from their tumours
- therapeutic cancer immunotherapies, like mRNA-4359, which are ‘ready made’ and tailored to a particular type of cancer
The trial
At this stage, the primary aim of the study is to assess if this new mRNA therapy is safe and tolerated by patients, either when administered alone or in combination with an existing cancer drug called pembrolizumab – which is a type of immune checkpoint inhibitor. But researchers are also investigating whether the combination of treatments can actively shrink tumours in patients with certain types of lung and skin cancer.
Patients on the trial will receive either mRNA-4359 alone, or mRNA-4359 and pembrolizumab. They will be followed up for a period of up to 34 months. The study is an open-label trial, so clinicians and patients know what they are receiving.
The trial is being undertaken through the Moderna-UK Strategic Partnership, which is bringing mRNA vaccine manufacturing to the UK and building resilience to future health emergencies. Under the 10-year partnership with the government, Moderna has also committed substantial investment to research and development, which includes running a large number of clinical trials, such as this one, in the UK.
‘Turning the tide’ against cancer
Dr David Pinato, a Clinician Scientist at Imperial College London and Consultant Medical Oncologist at Imperial College Healthcare NHS Trust, and investigator of the UK arm of the trial, said: “Despite huge advances in screening, detection and care, it’s estimated that half of us will experience cancer in our lifetime. New mRNA-based cancer immunotherapies, such as mRNA-4359, offer a new avenue for recruiting the patient’s own immune system to fight their cancer. This research is still in the early stages and may be a number of years from being available to patients, but this trial is laying crucial groundwork that is moving us closer towards new therapies that are potentially less toxic and more precise. We desperately need these to turn the tide against cancer.”
Dr Nichola Awosika, a member of the clinical research delivery team that delivered the first dose of mRNA-4359 in the UK at the NIHR Imperial CRF at Hammersmith Hospital, said: “It’s exciting to be involved with the Mobilize trial and provide the first doses to patients in the UK. It has been a great experience to contribute to the development of innovative new treatments like this and it all depends on the willingness of patients taking part, so we are grateful for their participation.”
Dr Matt Hallsworth, NIHR Director of Strategic Industry Partnerships, said: “The NIHR is excited to be working with Moderna on the delivery of this important study at sites across the country, demonstrating the potential of mRNA technology for the treatment of cancer. By working in partnership with innovative companies like Moderna we are not only giving UK patients access to potential cutting-edge treatments, we are also driving improvements to the broader clinical research system.”