According to the American Cancer Society, skin cancer is the most common of all cancers in the United States. While melanoma accounts for only about 1% of skin cancers, it is expected to cause approximately 8,290 deaths in 2024.

Texas Oncology’s research and clinical trials program, which provides patients with access to breakthroughs in cancer care in the communities where they live, recently added a global clinical trial that leverages mRNA technology to create a vaccine that prevents recurrence in high-risk melanoma patients.

Open to patients with stage II-IV melanoma who have completed surgery, the study seeks to determine if the vaccine, in combination with immunotherapy, delivers better outcomes than immunotherapy alone.

Jeff Yorio, M.D., medical oncologist and hematologist at Texas Oncology–Austin Central and the Central Texas Site Research Leader for Sarah Cannon Research Institute at Texas Oncology, also serves as an investigator for this innovative clinical trial which is currently available at two Texas Oncology locations, Texas Oncology–Austin Central and Texas Oncology–Baylor Charles A. Sammons Cancer Center.

Below, Dr. Yorio answers questions about the potential effectiveness of the vaccine to prevent recurrence of melanoma in patients who have been previously treated with surgery, as well as the importance of clinical trials and what’s being done to improve clinical trial participation among diverse populations.

1) Can you explain mRNA technology and why this could be an innovative breakthrough in cancer care/prevention?

mRNA stands for messenger RNA which is a code used in cells to make specific proteins. With an mRNA vaccine, mRNA is introduced into nearby cells which use that code to make specific proteins that the immune system can recognize as foreign and develop an immune response against the proteins. Once the proteins are made in the cells, the mRNA is destroyed by the cells.

This is potentially useful in cancer treatment because you can essentially train the immune system to recognize and destroy cancer cells. In this trial, we are focusing the immune system on each specific patient's melanoma as the mRNA vaccine is being designed based on the genetic code of that patient's tumor. This is truly personalized immunotherapy!

2) Immunotherapy is a known treatment option for patients with melanoma. Could this mRNA vaccine be used in combination or separate from immunotherapy in the future?

I think the answer is both. Initially, for more advanced cancers, we will use this with current immunotherapy treatments to help make the immune response even better and more specific against the cancer. In the future, I could envision that it could be used on its own, especially with early stages of cancer where you don't need quite as robust of an immune response.

3) When people think of vaccines, they think of the flu or COVID vaccines which prevent disease. How is this vaccine different?

The technology is essentially the same as the COVID mRNA vaccines, however, cancer is much more complex than most viruses. For COVID, you are developing a vaccine for a few broad viral variants and giving them to people as a prevention. For melanoma, they are developing a vaccine for each person that is specific to their actual tumor to boost the ability of the immune system to recognize that person's cancer as the "bad guy."

4) What types of patients are you seeing who have later-stage melanoma? What is one thing you want Texans to know about melanoma?

Melanoma is typically caused by excessive UV exposure throughout someone's life. Unfortunately, if you have a sunburn or excessive sun exposure, even as a kid, this will increase your lifetime risk. Tanning beds increase risk dramatically, and we see a lot of people in their 20s and 30s with melanoma due to tanning bed use. My advice is to enjoy the outdoors with sunscreen, hats, and protective clothing.

5) Can you share why clinical trials are so important? What is being done within clinical trials to help represent diverse populations better?

Clinical trials are so important to help us advance our treatments and end up with better outcomes. We are seeing many people living longer after a cancer diagnosis which would not be possible without clinical trials leading to hundreds of new treatments.

At Texas Oncology, one of our major missions is for our patients to have access to these types of leading edge treatments. In February 2024 alone, there were four new drugs or drug combinations approved for various cancers, and Texas Oncology was involved with the trials for three of them.

As a group that spans the state of Texas, we can reach a diverse population right in the communities where they live so that all types of patients are included in clinical trials.