Reacción a "A personalised cancer vaccine improves the effectiveness of melanoma treatment, according to a phase 2 trial"

What do you think of the article overall? Is it of good quality?

“Yes. It is a solid, clinically relevant piece of work and probably one of the most important studies to date on personalised neoantigen-based RNA vaccines. It has a sound methodological design, long-term follow-up and consistent clinical data. Furthermore, it provides mechanistic data that reinforces the biological rationale.”

How does it fit with the existing evidence, and what implications might it have?

“It fits very well with the idea that neoantigen-based vaccines can enhance the efficacy of anti-PD-1/PD-L1 antibodies by generating new anti-tumour T-cell responses. The key point is that, unlike other combinations of adjuvant immunotherapy, here we do observe a sustained reduction in the risk of relapse and metastasis. If the phase 3 clinical trial confirms these results, it could establish the first real standard for personalised RNA vaccines in oncology.”

Are there any significant limitations to bear in mind?

“Yes. The study remains relatively small, with few overall survival events, so the benefit in OS [overall survival] is not yet conclusive. The subgroup analyses are exploratory and some have very low statistical power. Furthermore, the mechanistic basis is indicative but indirect: it demonstrates peripheral clonal expansion, but not direct anti-tumour functional activity. Finally, melanoma is a particularly immunogenic tumour, so it is unclear whether these results can be extrapolated to other types of cancer.”