Moderna gets some skin in the cancer vaccine game

Melanoma is a low-hanging fruit when it comes to testing immunotherapies, but Moderna investors are apparently unconcerned: success in the adjuvant phase 2b Keynote-942 trial of mRNA-4157, a neoantigen cancer immunotherapy, sent the stock up a remarkable 25% today, adding $15bn the group’s market cap. Merck had licensed the project a couple of months ago for $250m up front, so expectations were already high. The partners unveiled a 44% reduction in disease recurrence or death for mRNA-4157 plus Keytruda, versus Keytruda alone. Statistical significance was claimed for the finding, but purists will note that the company used a one-side p value of 0.0266, and that the confidence interval crossed 1.0; the phase 2b study also only recruited 157 patients. Further details are under wraps. SVB analysts wrote that they would look to see if the Keytruda arm performed as expected and whether the benefit correlated with neoantigen expression. This finding needs replicating in more patients, of course, while moving into less immunogenic tumour types will also be a big test. But this is an encouraging result for the nascent world of personalised neoantigen immunotherapies, which has piqued the interest of certain large developers and has several small biotechs flying solo. 

For a full list of projects and a deeper look at this space, see Evaluate Vantage's recent article: Cancer "vaccines" enter the neoantigen stage.

Personalised tumour neoantigen therapies
Project Company Approach Clinical stage
Granite-001 (GRT-C901 + GRT-R902)* Gritstone Bio Lipid-encapsulated mRNA Ph2/3 (Tecentriq, Yervoy, Avastin, chemo combo)
Slate-001 (GRT-C903 + GRT-R904)* Gritstone Bio Lipid-encapsulated mRNA Ph1/2 (Opdivo + Yervoy combo)
mRNA-4157 Moderna/ Merck & Co Lipid-encapsulated mRNA Keynote-942, ph2 (Keytruda combo)
Source: Evaluate Pharma,

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