Nobel Prize for mRNA Vaccines Reflects Work in Cancer Immunotherapy

Robert L. Ferris, MD, PhD

Director Hillman Cancer Center

University of Pittsburgh Medical Center

Pittsburgh, PA

The recent announcement of the 2023 Nobel Prize in Physiology or Medicine has turned attention again to RNA therapeutic vaccines and a better understanding of RNA biology. Despite a skeptical scientific community, the 2 awardees, Katalin Karikó, PhD, and Drew Weissman, MD, PhD, persevered with their findings that labile RNA fragments could effectively translate into human immunotherapy. Indeed, several companies demonstrated that RNAs were sufficiently stable and could be very rapidly modified, a feature that turned out to be crucial during the early and terrifying months of the global COVID-19 pandemic. With a strong, concerted effort that led to its eventual use in the clinic, and through collaboration with scientists and pharmaceutical companies worldwide, the translation of rapid antigen discovery and molecular biology created lifesaving and life-prolonging COVID-19 vaccines.

Now that these RNA vaccines will take their place alongside the influenza vaccine, which is based on a protein subunit-based strategy, what are the implications for cancer immunotherapy and vaccines?

A couple of factors are in play. One is the amount of investment that has been poured into this RNA-based platform; another is a sense of rapidity as pattern recognition and innate inflammatory signals move moieties that are conferred through an attuned antigen and adjuvant strategy, and paved the way for various manipulable genetically engineered cancer vaccines.

Quick development is warranted, given the need for personalized vaccines after whole exome sequencing and other tumor antigen-specific approaches that must conform to the time frame of a patient with recurrent or metastatic disease who needs their tumor genomically profiled.

Thus, the scientific community is leveraging knowledge of infectious disease, much as the medical field advanced during the HIV epidemic 30 years ago, to clarify the cancer immunotherapy and vaccination approach. This is a time to reflect and remind ourselves not to disregard scientific or clinical outcomes that may seem obvious, because ultimately the experiment always needs to be performed and trialed in humans, and sometimes crisis is the mother of opportunity and accomplishment.