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Dallas clinical trial explores slowing skin cancer recurrence with COVID-19 technology

Dermatologist examines a mole of a male patient
Dermatologist examines a mole of a male patient

Dallas and Austin are part of a worldwide clinical trial underway to find a more effective treatment to lower the recurrence of melanoma or high-risk skin cancer.

It involves a highly advertised drug called Keytruda and the technology used for COVID-19 vaccines.

KERA’s Sam Baker talks with Dr. Charles Lance Cowey, a medical oncologist at the Sammons Cancer Center of Texas Oncology–Baylor. He's an investigator on the studies for the melanoma vaccine.

Melanoma is becoming more and more common. And all of the habits of sun exposure, including tanning beds and being outdoors, over the last several decades is really increasing the rate of those.

Melanoma is one of the aggressive forms of skin cancer. And so, after surgery, there is still a high rate of recurrence for a lot of patients. This trial is trying to help reduce the risk of recurrence and improve cure rates.

Keytruda increases the ability of the body's immune system to help detect and fight tumor cells. Why not use that alone?

That has been the standard for many years. Keytruda alone can reduce the risk of recurrence for these patients.

But while Keytruda is activating the patient's immune system and helping the immune system overcome cancer, there are still resistance mechanisms. There are still patients’ immune systems that do not recognize their cancer well. And while Keytruda is activating the immune system, it doesn't point it towards melanoma.

This new approach tries to help the immune system along and guide it toward the target. It does this using technology that people may be familiar with from COVID vaccines.

Moderna and Merck, who are developing this together, are taking the patient's tumor and doing genetic sequencing, and then, making an mRNA-based vaccine that targets that person's cancer. So, each person gets their version of this treatment. Not every vaccine is the same. Each one is unique to the person's tumor. It's using the patient's tumor to create the vaccine.

How did the idea of this come along?

To begin with, the idea of a cancer vaccine has been around for a long time. And there's been many attempts to do this. But using this mRNA approach is really what made this novel and kind of set Moderna.

There are a couple of other companies trying similar techniques apart from other vaccines, which were taking cancer proteins in general and designing targets kind of like the annual flu vaccine where people guess the flu virus.

And then, you know, there's a one-vaccine-for-all-product that is made in this case because it's more individualized. We're already seeing signs that this vaccine is improving outcomes on top of Keytruda already.

Does it work for everyone you've tested or certain types of people?

You know it does appear to be improving outcomes. At least in the phase two study, there's an additional approximately 44% improvement on top of Keytruda.

So, while this combination is promising, this current study we're doing will tell us in more granularity how effective this is in the clinical trial.

Are there any requirements for participants beyond having high-risk skin cancer or melanoma?

This is a study for patients with melanoma who are newly diagnosed and have had surgery, and they're primarily looking for stage two and higher melanoma patients. These patients tend to have a higher risk of recurrence.

Stage one patients have a good prognosis already. But for stage two, that's when we start thinking about preventive therapies. Keytruda is already FDA-approved. So, this is looking at that population and trying to add one extra benefit on top of Keytruda.


A Clinical Study of V940 Plus Pembrolizumab in People With High-Risk Melanoma (V940-001)

Texas Oncology: Skin Cancer
American Cancer Society: Treatment for melanoma

Take Steps to Prevent Skin Cancer

Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.