Could mRNA technology prevent colorectal cancer recurrence?
A team of international researchers is working to test whether mRNA technology could prevent colorectal cancer from recurring.
The standard treatment for many colorectal cancer patients is
surgery, but cancer cells can remain in the body after the tumor is removed. These remaining cancer cells shed DNA into the bloodstream, which is referred to as circulating tumor DNA (ctDNA).
A clinical trial led by Morris and Kopetz is following high-risk patients with stage II or stage III colorectal cancer who test positive for circulating tumor DNA after surgery.
The presence of circulating tumor DNA is checked with a blood test. “If there is ctDNA present, it can mean that a patient is at higher risk for the cancer coming back,” Morris says.
He says that the opposite can also be true: if there is not circulating tumor DNA present, the patient may have a lower risk of recurrence.
Personalizing an mRNA vaccine for mutations that cause cancer
In the Phase II clinical trial, enrolled patients start
chemotherapy after the tumor is surgically removed. Tissue from the tumor is sent off to a specialized lab, where it’s tested to look for genetic mutations that fuel the cancer’s growth.
Morris says anywhere from five to 20 mutations specific to that patient’s tumor can be identified during testing. The mutations are then prioritized by the most common to the least common, and an mRNA vaccine is created based on that ranking. “Each patient on the trial receives a personalized mRNA vaccine based on their individual mutation test results from their tumor,” Morris says.
As with the COVID-19 vaccines, the mRNA instructs the patient’s cells to produce protein fragments based off tumor’s genetic mutations identified during testing. The immune system then searches for other cells with the mutated proteins and clears out any remaining circulating tumor cells.
“We’re hopeful that with the personalized vaccine, we’re priming the immune system to go after the residual tumor cells, clear them out and cure the patient,” says Morris.
A leader in circulating tumor DNA
MD Anderson researchers are hopeful for the future of circulating tumor DNA. “It’s an evolving technology,” says Morris. “It’s new and exciting, and we know it can help us predict which patients are at a high risk of recurrence.”
Morris says this clinical trial is one of many exploring this new approach. “MD Anderson is a world leader in colorectal clinical trials for ctDNA,” he adds. “No matter your stage of disease, we have a new trial potentially for you.”