The lab doesn’t look unusual — until you see the lines on the floor.
These marks are a reminder that a very different kind of medicine is being made. Instead of churning out a Covid vaccine for the world, these Moderna Inc. workers are creating customized cancer treatments, one patient at a time. The boundaries remind them not to cross the room and potentially contaminate a different patient’s bespoke drug.
The scene, which I saw on a recent visit to Moderna’s manufacturing facility in the Boston suburb of Norwood, is seen as a new frontier in cancer research. Doctors have long given cancer patients radiation and chemotherapy, a blunt approach with major side effects. Now, thanks to advances in DNA sequencing, companies like Moderna and its partner, Merck & Co. Inc., are trying to attack cancer with more precision.
As I wrote recently, Moderna’s business faces big challenges in the near-term. But in the long term, its tailor-made approach to cancer could be a scientific breakthrough and a lucrative opportunity.
For years, drugmakers have tried and failed to develop such treatments, often called personalized cancer vaccines. Yet cancer experts are optimistic that newer treatments, which use messenger RNA technology, could work better, says Julie Gralow, chief medical officer of the American Society of Clinical Oncology.
“These mRNA vaccines look like they're much more effective at stimulating the immune system so that’s why there’s so much excitement around it,” Gralow says.
The early results have been promising. In a mid-stage study, patients with severe skin cancer who got the treatment — a combination of the vaccine and Merck’s cancer drug, Keytruda — saw their chances of dying or cancer returning cut by half.
Moderna believes it will succeed because it has improved the odds of picking the right target, says Kyle Holen, who leads development of Moderna’s cancer program. Moderna sequences the DNA of each cancer patient’s tumor then matches it with a list of 34 neoantigens, or protein fingerprints, to create a unique treatment. The goal is to train the immune system to spot and destroy the cancer.
“It takes the guesswork out of the picture,” Holen says.
But Moderna’s melanoma treatment, if approved, is at least a year away. It’s unclear whether the approach will work in other types of tumors. And some are skeptical that Moderna can deliver individual vaccines to the masses.
“Imagine you want to treat tens of thousands of patients a year and each one requires a completely new vaccine,” says Drew Pardoll, an oncology professor at Johns Hopkins University School of Medicine. Even if Modern’s vaccine gets approved, he says, “it remains to be seen whether they’ll be able to scale up and deliver it broadly enough.”
To that end, Moderna is finishing construction of a new facility in Marlborough, Massachusetts, where it hopes to make the cancer treatments if they’re approved by regulators. The company has worked with robotics firms to speed up manufacturing at the plant.
Moderna tracks a metric called “needle to needle,” which is the amount of time between taking a biopsy of a cancer patient’s tumor and injecting her or him with Moderna’s cancer treatment. Right now, Moderna averages 75 days. The company wants to get that under 60 days.
“We know we have a very sick patient waiting for this,” says Elizabeth Sullivan, executive director of operations for Moderna’s cancer program during my tour of the manufacturing facility. “So every minute counts.”