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Moderna and Merck Melanoma Vaccine Cuts Recurrence in Phase III Trial

A phase III trial of intismeran combined with pembrolizumab showed patients survived longer without melanoma recurrence than on immunotherapy alone.

WHAT YOU NEED TO KNOW
  • Around 1,100 patients with surgically removed advanced melanoma participated in the phase III trial.
  • Intismeran combined with pembrolizumab lengthened recurrence-free survival compared to pembrolizumab alone.
  • Moderna used artificial-intelligence tools to identify the neoantigens most likely to trigger an immune response.
  • Manufacturing each individualized mRNA vaccine currently takes several months following tumor sequencing.

Moderna and Merck announced that a personalized mRNA cancer vaccine reduced the risk of melanoma returning in a phase III clinical trial, according to reporting from Nature. The treatment, called intismeran, is the first mRNA-based cancer therapy to show success in a late-stage clinical trial.

The study enrolled around 1,100 people with advanced melanoma that had been completely removed by surgery. Participants received either intismeran combined with the immunotherapy drug pembrolizumab or pembrolizumab alone. Patients who received the combination survived longer without disease recurrence than those treated solely with pembrolizumab. Merck and Moderna stated that they plan to present detailed trial data at an upcoming medical conference.

Manufacturing and AI design

To produce intismeran, researchers sequence a sample of a patient's tumor to detect mutations that create abnormal surface proteins known as neoantigens. The custom mRNA injection directs the patient's cells to produce these neoantigens, training the immune system to recognize and attack the cancer. Moderna used artificial-intelligence tools to identify which neoantigens would most likely provoke a strong immune response before narrowing them down experimentally, according to trial investigator Adnan Khattak of Hollywood Private Hospital in Nedlands, Australia.

The individualized manufacturing process presents practical limits for broader clinical use. Seth Cheetham, an mRNA scientist at the University of Queensland, noted that creating each custom vaccine takes several months, which could limit its utility for patients with fast-progressing advanced cancers. Khattak added that trial participants must be tracked for many years to confirm whether intismeran extends overall survival.

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