From COVID-19 to Cancer, Could mRNA Carry the Answer?

If mRNA can trigger an immune response against COVID, what about cancer?

"There's lots of different tricks that cancer cells and tumors use to get around the immune system,’ Dr. Ryan Sullivan, an oncologist at Massachusetts General Hospital tells SurvivorNet. "In fact, every cancer that’s ever been diagnosed has figured out a way around the immune system." Sullivan is a medical oncologist at Massachusetts General Hospital in Boston.

Researchers, including Sullivan, are trying to harness mRNA to orchestrate an immune attack against cancer.

What is mRNA?

mRNA is crucial to carrying out the functions of your genes. Here's how it works. Your genes are made of DNA (deoxyribonucleic acid). Many of your genes carry instructions in their DNA for making a protein. Proteins perform the functions of your cells. Inside the nucleus of your cells, the information in your DNA is transferred into mRNA. The messenger molecule then carries this information from the cell's nucleus to another part of the cell called cytoplasm. In the cytoplasm, the information is read and the appropriate protein is produced. Proteins carry out all the functions of the body.

How Could mRNA Help Fight Cancer?

There are a couple of different ways that mRNA could help your immune system fight cancer.

Dr. Stefanie Avril explains how medicine can harness the immune system to fight ovarian cancer.

Some researchers are developing cancer vaccines using the same mRNA-based technology that the COVID-19 vaccine uses.

Let's look at how the COVID-19 vaccine works. It doesn't contain the corona virus itself. Instead, the vaccine is made up of mRNA that contains the instructions for making the "spike protein" on the surface of the coronavirus. This protein, which the immune system recognizes as an outside invader, triggers the immune system to develop antibodies against it. That way, if the actual coronavirus, with its telltale spike proteins, tries to invade the body of someone who has had this vaccine, the immune system already knows how to tackle it.

Related: Do Statins, a Cholesterol-Lowering Medication, Make a Difference in Cancer Risk & Death?

Now, let's apply that same concept to cancer.

Therapeutic cancer vaccines are meant to help a person who already has cancer. To create a personalized mRNA-based vaccine, scientists analyze tumor DNA and RNA as well as an immune blood type to predict which bits of protein expressed on the surface of the tumor will trigger an immune attack. Next, they create a vaccine made of messenger molecules that contain the instructions for making those very proteins. The idea is that if the proteins on the surface of the tumor alone are not enough to trigger an immune response, perhaps larger quantities of those proteins would help.

Nobel prize winner James Allison explains cancer vaccines.

"These proteins are like flags that get flown on the outside of cells that the immune system can recognize and say 'Oh, we need to kill this cell,'" Sullivan explains.

But that's not the only way science can harness mRNA to fight cancer.

Other mRNA-based treatments, currently in clinical trials, deliver the messengers directly to tumors. The mRNA in these treatments carries instructions for making inflammatory proteins. The idea is that these inflammatory proteins around the tumor will attract the attention of the immune system.

Related: If You Have Cancer It's More Important Than Ever to Get a Flu Shot Amid COVID-19

"It's like throwing chum in the water and hoping that the immune cells, which in this case would be like Jaws, come into the tumor or get more active in the tumor and start attacking," says Sullivan, who leads a couple of clinical trials of mRNA-based cancer therapies.

Judy Perkins tells the story of how immunotherapy cured her metastatic breast cancer.

Trials currently in progress examine how well this works. Early stages of some trials deliver mRNA alone. In later stages of the studies, patients receive the messenger molecules in combination with a checkpoint inhibitor. The thinking is that a checkpoint inhibitor might work better in an immune system that's been activated by mRNA.

These experimental therapies are in phase I clinical trials and still have a long road ahead before they might become standard cancer treatments. "It's still early days," Sullivan says, "but we are heading into intermediate days as we start to get more data on a number of these types of products."

Learn more about SurvivorNet's rigorous medical review process.