By Da Cheung
The American Society of Clinical Oncology (ASCO) annual meeting, which concluded on June 4 in Chicago, highlighted major advances in oncology. Among the most anticipated presentations were early clinical results from two Shanghai institutions, offering a glimpse of where personalized mRNA vaccines for pancreatic cancer may be heading.
Pancreatic cancer is notoriously lethal and is sometimes referred to as the “king of cancers.” About 80% of patients are diagnosed at a late or metastatic stage, missing the window for surgery. As a result, the global five-year survival rate remains around 10% to 13%. Even for the minority of patients eligible for surgery, recurrence after surgery remains common. Chemotherapy remains a mainstay of treatment, but response rates are modest and median overall survival for advanced cases is still less than a year.
Against this backdrop, new data from Shanghai researchers suggest that mRNA technology — best known for its role in COVID-19 vaccines — could become a useful new immunological tool against solid tumors.
Decoding the Shanghai trials
Unlike traditional preventive vaccines, cancer mRNA vaccines are therapeutic vaccines. They work by delivering mRNA that instructs cells to produce tumor antigens, prompting the immune system to recognize and attack existing cancer cells.
At ASCO, a team from Shanghai Jiao Tong University School of Medicine’s Ruijin Hospital presented Phase I data on XP-004, an individualized mRNA vaccine co-developed with Shanghai Xinpu Bio. The trial enrolled 16 post-surgical patients who had undergone R0 resection — complete surgical removal of the tumor with negative margins, meaning no cancer cells were seen at the edge of the removed tissue — but could not tolerate standard chemotherapy.
According to researchers, after a median follow-up of about 10 months, all 16 patients remained relapse-free in the reported cohort. The result was assessed using imaging and minimal residual disease (MRD) testing, which can detect traces of cancer cells left after treatment. The vaccine also triggered an immune response in all 13 evaluable patients.
Fudan University Shanghai Cancer Center also presented early data on RGL-270. The personalized neoantigen mRNA vaccine, developed by Hengrui Pharmaceuticals (600276.SH) subsidiary Ruihongdi Pharmaceutical, was administered alongside the company’s PD-L1 inhibitor, adebrelimab. The company said that in a trial of 16 patients with resectable pancreatic cancer, the combination therapy produced relapse-free survival in all 16 patients and an immune response in all evaluable patients at a median follow-up of 18 months. The safety profile was favorable, with adverse reactions limited mainly to mild fever and injection-site discomfort.
Both studies are early-phase and involved just 16 patients each, so the findings should be viewed as encouraging but preliminary.
Progress in a global race
The results from Chinese developers come as the global pharmaceutical industry races to commercialize mRNA cancer vaccines. Industry giants such as Moderna (MRNA) and BioNTech (BNTX) are leading the field, with both expected to seek their first market approvals between 2027 and 2030. At ASCO, Moderna reported long-term data for its melanoma vaccine, showing a 49% reduction in the risk of recurrence or death over five years when combined with standard immunotherapy.
A key reference point for pancreatic cancer mRNA vaccines is BioNTech’s autogene cevumeran, developed with Memorial Sloan Kettering Cancer Center. While the newly presented Chinese vaccines appeared to show higher initial immune response rates than BioNTech’s 50% figure, a direct comparison remains premature. Both Shanghai trials involved very small cohorts of just 16 patients. The main advantage of BioNTech’s study is its three-year follow-up data, which better informs long-term efficacy.
Despite these caveats, the ASCO presentations underscore broader momentum in pancreatic cancer research. Alongside mRNA vaccines, targeted therapies are also advancing. Revolution Medicines (RVMD) reported Phase III trial data for daraxonrasib, a drug KRAS — a gene that can drive cancer when mutated — that nearly doubled median overall survival for second-line patients from 6.7 to 13.2 months. Evaluate Pharma has estimated that the drug’s peak sales could reach $12 billion.
Looking ahead, Dr. Shen Baiyong of Ruijin Hospital said the potential of mRNA vaccines will depend in part on improving antigen prediction with artificial intelligence and optimizing delivery systems. With more than 20 domestic mRNA tumor vaccines now in clinical trials across China, the convergence of technology and immunology could help improve outcomes for some of the world’s most difficult-to-treat cancers.
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