Q&A: Meredith McKean on melanoma research at Sarah Cannon

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Source: Nashville Post
Author: Hannah Herner
Date: January 5, 2023

The institute studied mRNA cancer vaccines, found decreased risk of recurrence in patients

Using the same technology as some COVID-19 vaccines, researchers at locally based Sarah Cannon Research Institute may have found a way to reduce the risk of recurrence for melanoma patients.

The phase II study found that adding a personalized mRNA vaccine to existing immunotherapy treatments resulted in a 44 percent decrease in the risk of recurrence for melanoma patients where the cancer was already removed or treated. All of the patients were on Keytruda, a FDA-approved immunotherapy drug, which already decreases risk of recurrence by 40 to 50 percent, said Meredith McKean, director of melanoma and skin cancer research for Sarah Cannon Research Institute, the research arm of HCA Healthcare's cancer institute, Sarah Cannon Cancer Center.

The next phase of the trial could include testing on additional cancers, she added. McKean sat down with the Post to discuss the trial and its outcomes.

How are the mRNA vaccines you used in the study different from the mRNA COVID-19 vaccines?

We've been working with Moderna on mRNA vaccines for cancer for a number of years. We were already participating in this study — in addition to other mRNA vaccine studies — prior to the pandemic. The exciting thing about mRNA vaccines is that the turnaround time to making a vaccine is very fast. If patients are diagnosed with melanoma, we would send off a small amount of the tumor to Moderna. They would evaluate the tumor to determine which proteins the immune system should recognize as … being part of a tumor that should be attacked. They make that into an mRNA vaccine and send it back to us within weeks.

When the pandemic came around, that's why mRNA vaccines were the first vaccines approved; because this technology was already in development with a goal of trying to turn around very fast and effective vaccines. Instead of having a vaccine developed against the patient's cancer, they did the same process for the COVID-19 virus.

Which patients were treated in this trial?

All patients … had a recent history of melanoma but did not have any known melanoma at the time. For the patients in the study, melanoma had either metastasized or traveled to sites around the primary tumor or to the lymph node or elsewhere in the body.

The way this technology is developed, it's really for patients that have had a diagnosis of melanoma because what's exciting about it is it's a personalized cancer vaccine. … That's really what's so powerful about this technology, across all cancer treatments. We're really trying to personalize each patient's treatment because we know every patient's cancer is different.

What are the biggest issues facing the skin cancer field at the moment?

Although we've made a lot of progress for melanoma, we still know we have a long way to go. There was a recent study that came out [using] medication similar to Keytruda — a drug called Opdivo and another called Yervoy. For patients with metastatic melanoma treated with that combination, six-and-a-half years out, half of those patients were still alive, which is significant progress from where we were 10 years ago. At that time, less than 5 percent of patients with metastatic melanoma were still alive. That shows some really exciting progress, but that also means that there are still 50 percent of patients that weren't alive and that we still have so much more to do for these patients.

That's why this study is so exciting. If we can prevent patients from developing metastatic disease, preventing that cancer from coming back once we've surgically removed it for patients, that would be a huge, huge advantage for our patients.