Resumo
Objetivo: Identificar os mecanismos e avaliar os impactos clínicos da vacina mRNA-4157 no combate à recidiva do melanoma, explorando as possibilidades terapêuticas desse novo método. Revisão bibliográfica: O melanoma é um dos cânceres de pele mais agressivos e letais, caracterizado por alta taxa de metástase e prognóstico reservado nos estágios avançados. Apesar da eficácia de tratamentos como excisão cirúrgica e imunoterapia nos estágios iniciais, as opções para melanoma metastático ainda apresentam limitações. Nos últimos anos, vacinas terapêuticas têm ganhado destaque por sua segurança e potencial multialvo. A vacina mRNA-4157 utiliza antígenos tumorais para induzir uma resposta imune específica e eficiente, destacando-se como uma abordagem inovadora e economicamente viável. Estudos apontam a crescente relevância dessa estratégia frente à alta incidência e mortalidade do melanoma, que registrou aumento significativo nas últimas décadas. Considerações finais: A vacina mRNA-4157 apresenta-se como uma promissora aliada no tratamento do melanoma, oferecendo avanços significativos em eficácia e segurança. Entretanto, estudos adicionais são necessários para consolidar sua aplicação em diferentes contextos clínicos, especialmente em casos de melanoma metastático. Diante da crescente prevalência da doença, o desenvolvimento de terapias mais efetivas é essencial para melhorar os desfechos clínicos e reduzir a mortalidade associada.
Referências
ADAMIK J, et al. Immuno-metabolic dendritic cell vaccine signatures associate with overall survival in vaccinated melanoma patients. Nature communications, 2023; 14(1): 7211.
ASCIERTO PA, et al. Perspectives in Melanoma: meeting report from the Melanoma Bridge (December 2nd - 4th, 2021, Italy). Journal of translational medicine, 2022; 20(1): 391.
BAFALOUKOS D, et al. Evolution and progress of mRNA vaccines in the treatment of melanoma: Future prospects. Vaccines, 2023; 11: 3.
BHAVE P, et al. Melanoma recurrence patterns and management after adjuvant targeted therapy: a multicentre analysis. British journal of cancer, 2021; 124(3): 574–580.
BIDRAM M, et al. mRNA-Based Cancer Vaccines: A Therapeutic Strategy for the Treatment of Melanoma Patients. MDPI, 2021.
BIRA-KOVÁCS B, et al. Peptide vaccines in melanoma: Chemical approaches towards improved immunotherapeutic efficacy. Pharmaceutics, 2023; 15(2): 452.
BRIDAM M, et al. MRNA-based cancer vaccines: A therapeutic strategy for the treatment of melanoma patients. Vaccines, 2021; 9(10): 1060.
BURRIS HA, et al. A phase I multicenter study to assess the safety, tolerability, and immunogenicity of mRNA-4157 alone in patients with resected solid tumors and in combination with pembrolizumab in patients with unresectable solid tumors. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 2019; 37(15): 2523–2523.
DEDEILIA A, et al Factors affecting recurrence and survival for patients with high-risk stage II melanoma. Annals of surgical oncology, 2024; 31(4): 2713–2726.
FRANZIN R, et al. The use of immune checkpoint inhibitors in oncology and the occurrence of AKI: Where do we stand? Frontiers in immunology, 2020; 11: 574271.
GAINIR JF, et al. T-cell responses to individualized neoantigen therapy mRNA-4157 (V940) alone or in combination with pembrolizumab in the phase 1 KEYNOTE-603 study. Cancer Discovery, 2024; 14:2209-2223.
HUPPERT LA e DAUD AI. Intratumoral therapies and in-situ vaccination for melanoma. Human vaccines & immunotherapeutics, 2022; 18(3): 1890512.
KEUNG EZ e GERSHENWALD JE. Clinicopathological features, staging, and current approaches to treatment in high-risk resectable melanoma. Journal of the National Cancer Institute, 2020; 112 (9): 875–885.
KIM HJ e KIM YH. Molecular frontiers in melanoma: Pathogenesis, diagnosis, and therapeutic advances. International journal of molecular sciences, 2024; 25(5): 2984.
LIU H, et al. Immunotherapy and delivery systems for melanoma. Human vaccines & immunotherapeutics, 2024; 20(1): 2394252.
LOPES L, et al. The influence of checkpoint inhibitors on cancer patient survival. Brazilian Journal of Health Review, 2022; 5(2): 5635-5646.
OTT PA, et al. An immunogenic personal neoantigen vaccine for patients with melanoma. Nature 2017, 547(7662): 217–221.
PATTON EE, et al. Melanoma models for the next generation of therapies. Cancer cell, 2021; 39(5): 610–631.
PING H, et al. Analysis of melanoma tumor antigens and immune subtypes for the development of mRNA vaccine. Investigational new drugs, 2022; 40(6): 1173–1184.
QUINTANILHA T e BECKER R. Vacinas de mRNA: Uma nova era na produção de imunizantes. Revista Perspectiva: Ciência e Saúde, 2024; 8(1).
REZAEI T, et al. Strategies in DNA vaccine for melanoma cancer. Pigment cell & melanoma research, 2021; 34(5): 869–891.
WEBER JS, et al. Individualised neoantigen therapy mRNA-4157 (V940) plus pembrolizumab versus pembrolizumab monotherapy in resected melanoma (KEYNOTE-942): a randomised, phase 2b study. Lancet, 2024; 403(10427): 632-644.
XIE N, et al. Neoantigens: promising targets for cancer therapy. Signal transduction and targeted therapy, 2023; 8(1): 9.
XU Z e FISHER DE. mRNA melanoma vaccine revolution spurred by the COVID-19 pandemic. Frontiers in Immunology, 2023; 14: 1155728.
