First UK patients receive experimental mRNA therapy for cancer at Imperial College Healthcare

Some patients with cancer at Imperial College Healthcare NHS Trust have become the first in the UK to receive a new treatment that could help their bodies recognise and fight cancer cells.

The new experimental mRNA therapy – a type of immunotherapy treatment called mRNA-4359 – is being evaluated for safety and its potential for treating melanoma, lung cancer and other ‘solid tumour’ cancers in a global trial.

Training the immune system

The new treatment uses messenger RNA (mRNA) to present common ‘markers’ of tumours to the patient’s immune system. This should help train patients’ immune systems to recognise and fight cancer cells that have these markers, but also potentially remove cells that could stop the immune system from attacking cancer cells.
A number of cancer vaccines are entering clinical trials across the globe and researchers believe these have potential to make immunotherapy more effective. They fall into one of two categories: personalised cancer immunotherapies, which rely on taking genetic material from a patient’s tumour; and therapeutic cancer immunotherapies, like mRNA-4359, which are ‘ready-made’ and tailored to a particular type of cancer.

New treatment options for patients

An 81-year-old man from Surrey with treatment-resistant malignant melanoma was the first person in the UK to receive mRNA-4359 at the Trust in late October. He said:

“Taking part in a trial gives you a sense that you’re contributing to something which can help a lot of other people. You're also clearly doing it for personal reasons, but it's a mixture of those two.

“I'm extremely grateful to the hospitals and the individuals that are running these trials. You know, somehow we have to change the fact that one in every two people get cancer at some point and we have to make the odds better.”

As well as understanding if this new mRNA therapy is safe and tolerated by patients, researchers are also investigating whether combining the treatment with existing cancer drugs can shrink tumours in patients with certain types of lung and skin cancer.

Researchers say that while the experimental therapy is still in the early stages of testing, they hope it may ultimately lead to a new treatment option for difficult to treat cancers.

Dr David Pinato, consultant medical oncologist at Imperial College Healthcare NHS Trust and a clinician scientist at Imperial College London, who is lead investigator of the UK arm of the trial, said:

“Despite huge advances in screening, detection and care, it’s estimated that half of us will experience cancer in our lifetime.

“New mRNA-based cancer immunotherapies, such as mRNA-4359, offer a new avenue for recruiting the patient’s own immune system to fight their cancer. This research is still in the early stages and may be a number of years from being available to patients, but this trial is laying crucial groundwork that is moving us closer towards new therapies that are potentially less toxic and more precise. We desperately need these to turn the tide against cancer.

“We’re only able to do this kind of research thanks to our patient volunteers – their involvement is crucial. We’re grateful to all of the patients who take part and make these trials possible.”

Dr Nichola Awosika, a member of the clinical research delivery team that delivered the first dose of mRNA-4359 in the UK at the NIHR Imperial Clinical Research Facility at Hammersmith Hospital, said:

“It’s exciting to be involved with the Mobilize trial and provide the first doses to patients in the UK. It has been a great experience to contribute to the development of innovative new treatments like this and it all depends on the willingness of patients taking part, so we are grateful for their participation.”

Nearly 1 in 2 people in the UK will be diagnosed with cancer in their lifetime. While a range of therapies are available to treat patients, including chemotherapy and immune therapies, cancer cells can become resistant to drugs, making tumours more difficult to treat.

The trial – known as Mobilize – is run in partnership with Imperial College London and the first patients received the treatment at the National Institute for Health and Care Research (NIHR) Imperial Clinical Research Facility at Hammersmith Hospital. The trial is sponsored by pharmaceutical company Moderna and is set to recruit patients globally over the next three years

Clinical trials at Imperial College Healthcare are supported by funding from NIHR Imperial Biomedical Research Centre (BRC), a translational research partnership between Imperial College Healthcare NHS Trust and Imperial College London, which was awarded £95m in 2022 to continue developing new experimental treatments and diagnostics for patients.

Prioritising pioneering research to treat cancer

Professor Peter Johnson, NHS national clinical director for cancer, said:

“The NHS is at the vanguard of trials of cancer vaccines, which could be revolutionary if we are successful in vaccinating people against their own cancers to prevent them growing back after treatment.

“This trial at Imperial is a brilliant example of the pioneering work happening at hospitals up and down the country, with teams of experts looking into ways of harnessing the body’s own immune system to treat a range of cancers.

“We all know how worrying a cancer diagnosis can be for people and their loved ones, but access to these groundbreaking trials – alongside other innovations to diagnose and treat cancers earlier – provides hope, and we expect to see thousands more patients taking part in trials of this kind over the next few years.”

The UK Government has an agreement with several pharmaceutical companies to facilitate the development of novel, anti-cancer mRNA-based immunotherapies. Several such therapies are currently in development aimed at treating resistant cancers. All are in the early phases of clinical testing, with trials aimed at evaluating the feasibility, safety, and preliminary activity of the approach.

Researchers at Imperial College London alongside clinical staff at Imperial College Healthcare NHS Trust have successfully set up the first clinical site in the UK to help deliver this strategy and assess the potential for ‘off-the-shelf’ mRNA cancer immunotherapies, beginning a trial for the treatment of solid tumors.

The trial is being undertaken through the Moderna-UK Strategic Partnership, which is bringing mRNA vaccine manufacturing to the UK and building resilience to future health emergencies. Under the 10-year partnership with the government, Moderna has also committed substantial investment to research and development, which includes running a large number of clinical trials, such as this one, in the UK.

Health and Social Care Secretary Victoria Atkins said:

“Cancer can affect any of us – be it through devastating diagnosis, the difficulties faced during treatment or the loss of a loved one - but huge progress is being made, and survival rates are at an all-time high.

“This vaccine has the potential to save even more lives while revolutionising the way in which we treat this terrible disease with therapies that are more effective and less toxic on the system. It underlines our position as a life sciences superpower and our commitment to research and development.

“As we mark World Cancer Day today, I want to extend my deepest gratitude to the researchers behind this groundbreaking development and the patients taking part in the trial which could make such a difference to countless lives.”

Image credit: Human melanoma cell dividing. Paul J.Smith &Rachel Errington. Attribution 4.0 International (CC BY 4.0). Source: Wellcome Collection.