Given the Scottish political shenanigans of the past ten days, you could be forgiven for missing a rather exciting developing in cancer research.

On April 26, it emerged that doctors have begun trialling the world's first personalised mRNA cancer vaccine for melanoma skin cancer.

Around 60 to 70 patients are being recruited at eight UK sites, including Edinburgh, for a treatment dubbed the "cordon bleu" of cancer medicine - and one of the most exciting developments in decades.

It could hardly come at a better time.

In Scotland, rates of melanoma are projected to increase by 52% by the end of the 2030s - with an even steeper rise of 75% expected for males.

On current forecasts, by 2038-40 there will be more than 2,500 new diagnoses of melanoma skin cancer each year compared to 1,400 currently.

The Herald: Melanoma skin cancer rates in Scotland are expected to increase steeply over the next 15 yearsMelanoma skin cancer rates in Scotland are expected to increase steeply over the next 15 years (Image: PHS)

The hope is that vaccines, tailored specifically to each melanoma patient, can destroy the cancer cells and stop the disease ever coming back.

The Phase Three clinical trial - which aims to enrol around 1,100 patients globally - is being led by University College London Hospitals (UCLH) NHS Foundation Trust following positive results for participants in the Phase Two stage.

The Phase Two findings, published in the Lancet in February this year, compared outcomes in patients with serious high-risk melanomas who were given up to nine 1mg doses of the vaccine over a 27-week period in addition to the immunotherapy drug, Keytruda, against those who only received Keytruda along with a placebo vaccine.

The randomised control study, which was double-blinded - meaning that neither the patient nor clinician knew which patients were getting the real vaccine - found that those in the vaccination group were 49% less likely to die or have their cancer return over the subsequent three years.

The melanoma vaccine, developed by pharmaceutical giants Moderna and MSD (Merck Sharp and Dohme), uses the same mRNA technology first deployed during the Covid pandemic.

Unlike traditional vaccines, which use dead or weakened viruses and take months to scale up, mRNA vaccines be rapidly manufactured once a genetic sequence for a pathogen has been obtained.


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They act as a "messenger", delivering an instruction manual to our cells on how to recognise a virus, bacterium, or - in this case - cancer.

The immune system uses this information to produce antibodies capable of attacking the real thing, if it is detected again.

In the case of the melanoma vaccine, scientists custom-build it for each patient by taking a tissue sample from their tumour after it has been removed during surgery.

From this, they extract its unique DNA signature and an artificial intelligence programme designs a vaccine capable of targeting the specific proteins - known as neoantigens - which are being expressed on the surface of the cancer cells.

The vaccine can code for up to 34 of these neoantigens, making it capable of responding to a vast range of different mutation combinations.

The idea is that it trains the body's immune system to recognise and destroy the melanoma tumour cells, and prevent the cancer recurring.

In simple terms, it cures the patient of their cancer - permanently.

The Herald: Dr Heather Shaw, who is leading the melanoma cancer vaccine trial in the UK, with trial participant Steve YoungDr Heather Shaw, who is leading the melanoma cancer vaccine trial in the UK, with trial participant Steve Young (Image: PA)

Dr Heather Shaw, a consultant medical oncologist and the UK's national coordinating investigator for the trial, told the Guardian that the jags were "one of the most exciting things we’ve seen in a really long time".

She added: “This is a really finely honed tool.

"To be able to sit there and say to your patients that you’re offering them something that’s effectively like the Fat Duck at Bray versus McDonald’s – it’s that level of cordon bleu that’s coming to them."

Steve Young, a melanoma patients from Stevenage in Hertfordshire, is among the first to be enrolled in the Phase Three trial.

The 52-year-old was diagnosed after a melanoma growth was cut from his scalp in August last year.

While scans show no sign that the tumour had spread, cancer cells may be floating undetected in his body.

Mr Young described his participation in the trial as a "chance to get involved in putting on some boxing gloves and squaring up to it".


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Lawrence Young, a professor of molecular oncology at the University of Warwick - who is not involved in the trial - said it was "one of the most exciting developments in modern cancer therapy".

He added: "Interest in cancer vaccines has been reignited in recent years by a deeper understanding of how the body controls immune responses and by the advent of mRNA vaccines which makes developing a vaccine based on the immune profile of a patient’s own tumour much more straightforward."

There is already hope that the approach can be extended to other cancers such as lung, kidney, and bladder.

BioNTech, whose mRNA Pfizer Covid vaccine has been administered more than any other around the world - 665 million doses to date in the EU alone - are among those in the race to reconfigure the technology towards cancer.

The Herald: The same mRNA technology first used in Covid vaccines is being adapted to personalised cancer therapiesThe same mRNA technology first used in Covid vaccines is being adapted to personalised cancer therapies (Image: Getty)

University Hospitals Birmingham NHS Foundation Trust (UHB) is currently leading a randomised control trial sponsored by BioNTech that will recruit 10,000 patients across the UK to test its colorectal cancer vaccine.

Like the melanoma study, patients with high-risk stage two or three bowel cancer who have already undergone surgery will be given a multiple doses of a personalised vaccine and followed up over three years.

The goal is to measure whether their survival rates exceed those in the "watchful waiting" group - where patients are regularly scanned for signs of recurrence, but do not receive any other intervention.

The first patient to be treated as part of the clinical trial received their jag in April.

It comes just a few months after research in Scotland revealed the impact of HPV vaccination on cervical cancer.

Since the rollout began in 2008, there have been no known cases of the disease in women who were immunised aged 12 to 13.

In the past, cervical cancer peaked among women aged 25 to 39; on current trends it could be all but eliminated within a generation.

In the 20th century, vaccines transformed the threat from infectious diseases. In the 21st century, they might do the same for cancers.