The conversation at ESMO has already moved past whether intismeran worked in melanoma, STAT reported on October 25, to how melanoma specialists should adopt it and how widely personalised cancer vaccines can be deployed. James Larkin of London’s Royal Marsden Hospital, a scientific co-chair of this year’s ESMO meeting, said at an opening press conference that in principle this type of approach may be applicable to other types of tumours. Vinod Balachandran of Memorial Sloan Kettering put the melanoma result against what STAT quoted him calling a long history of cancer vaccine failure.
The melanoma figures themselves are last week’s news and are not repeated as new here: intismeran plus Keytruda cut the risk of recurrence or death by 42 percent against Keytruda alone in the Phase 3 INTerpath-001 trial in 1,137 patients, with two-year recurrence-free survival of 82.2 percent against 70.0 percent, as covered in the October 22 story. What is new is the expansion schedule around it. Moderna presents early pancreatic cancer results for intismeran on October 25 and the design of a Phase 3 trial in early-stage lung cancer on October 26, according to Becker’s Hospital Review’s summary of the program. The companies are also testing the approach in kidney, bladder and non-small cell lung cancer, and in three late-stage lung trials.
Two questions decide whether expansion is a platform or a single product. The first is biological: overall survival benefit is not yet shown, and a recurrence result in melanoma, an immunologically responsive tumour, does not establish activity in pancreatic cancer, where immunotherapy has repeatedly failed. The second is operational: each vaccine is manufactured from an individual patient’s tumour, within weeks, so cost, turnaround and factory capacity are part of the efficacy question at scale, a point outside analysts raised again this weekend.
STAT’s framing from Madrid is the right one for today: the race is on to expand the impact, and a race is not a result. The pancreatic presentation today and the lung trial design tomorrow are the next dated evidence points.