2026年8月19日,美国生物制药公司莫德纳(Moderna)与默沙东(Merck & Co.)联合宣布:双方共同研发的个体化mRNA癌症疫苗(Intismeran autogene),联合PD-1抑制剂帕博利珠单抗(俗称“K药”),在针对高危黑色素瘤切除术后辅助治疗的临床Ⅲ期试验中取得突破,显著降低高危黑色素瘤患者术后复发和远处转移风险。
On August 19, 2026, the American biopharmaceutical company Moderna and Merck & Co. jointly announced that Intismeran autogene, an individualized mRNA cancer vaccine co-developed by the two parties, in combination with pembrolizumab (commonly known as "K drug"), an anti-PD-1 inhibitor, achieved a breakthrough in the Phase III clinical trial for adjuvant therapy after resection of high-risk melanoma, significantly reducing the risk of postoperative recurrence and distant metastasis in patients with high-risk melanoma.
这是全球首个在随机对照Ⅲ期试验中取得阳性结果的个体化新抗原疗法,也是首个获得阳性Ⅲ期结果的mRNA癌症疗法。
This is the world's first individualized neoantigen therapy to yield positive results in a randomized controlled Phase III trial, and also the first mRNA cancer therapy to achieve positive Phase III results.
值得说明的是,这款疫苗并非健康人打的“预防针”,而是一种治疗性疫苗,适用对象是已经确诊的癌症患者。
It is worth noting that this vaccine is not a "preventive shot" for healthy people, but a therapeutic vaccine intended for patients already diagnosed with cancer.
它的工作原理可以概括为先找到癌细胞身上的独特标记,再给免疫系统制作一张专属通缉令。
Its working principle can be summarized as first finding the unique markers on cancer cells, and then making an exclusive wanted list for the immune system.
具体流程分为四步:首先取样测序,取出患者的肿瘤组织和正常细胞,分别做基因测序;
The specific process is divided into four steps: first, sampling and sequencing—taking the patient's tumor tissue and normal cells and performing genetic sequencing separately;
其次比对找突变,把两组数据做电子比对,找出癌细胞独有的突变;
second, comparing to find mutations—electronically comparing the two sets of data to identify mutations unique to the cancer cells;
然后利用算法挑选靶点,用AI算法从上千个突变中,挑出最能激发免疫反应的“新抗原”(即癌细胞特有的异常蛋白片段);
then selecting targets using algorithms—using AI algorithms to pick out from thousands of mutations the "neoantigens" (that is, abnormal protein fragments specific to cancer cells) most capable of triggering an immune response;
最后定制给药。
finally, customizing and administering the drug.
针对这些新抗原设计患者专属的mRNA序列,制备成疫苗。
Design a patient-specific mRNA sequence targeting these neoantigens and prepare it into a vaccine.
每位患者的疫苗最多可编码34个新抗原,注射后mRNA进入人体细胞,翻译出肿瘤新抗原蛋白,训练T细胞精准识别并攻击带有这些突变的癌细胞。
Each patient's vaccine can encode up to 34 neoantigens; after injection, the mRNA enters human cells and translates into tumor neoantigen proteins, training T cells to precisely recognize and attack cancer cells carrying these mutations.
与传统化疗“无差别击中、杀敌一千自损八百”的模式不同,mRNA癌症疫苗走的是精准追踪路线。
Unlike traditional chemotherapy's mode of "hitting indiscriminately, sacrificing eight hundred of one's own to kill a thousand enemies," the mRNA cancer vaccine follows a precise-tracking route.
它与K药的联用形成双保险——疫苗负责“指认”癌细胞,K药负责“松开”免疫系统的刹车。
Its combination with the K drug forms a double safeguard—the vaccine is responsible for "identifying" the cancer cells, and the K drug is responsible for "releasing" the brakes on the immune system.
莫德纳与默沙东联合开展的Ⅱ期临床试验数据显示,该联合疗法将复发或死亡风险降低了49 %,并将远处转移或死亡风险降低了59 %。
Data from the Phase II clinical trial jointly conducted by Moderna and Merck show that this combination therapy reduced the risk of recurrence or death by 49 %, and reduced the risk of distant metastasis or death by 59 %.
mRNA癌症疫苗率先在黑色素瘤中走到Ⅲ期并取得成功,并非偶然。
That the mRNA cancer vaccine reached Phase III and succeeded first in melanoma is no accident.
黑色素瘤突变多、新抗原多,免疫系统最容易识别。
Melanoma has many mutations and many neoantigens, making it easiest for the immune system to recognize.
历史上PD-1抑制剂的首个适应证也是黑色素瘤,之后一路扩展到肺癌、胃癌、肝癌等二十余种肿瘤。
Historically, the first indication for anti-PD-1 inhibitors was also melanoma, and later it expanded all the way to more than twenty types of tumors such as lung cancer, gastric cancer, and liver cancer.
mRNA疫苗复制同一路径——先在最敏感的癌种验证,再向其他瘤种外推。
mRNA vaccines replicate the same path—first validating in the most sensitive cancer type, then extrapolating to other tumor types.
个体化mRNA癌症疫苗最大的突破在于实现了真正意义上的“一人一方”。
The greatest breakthrough of individualized mRNA cancer vaccines lies in achieving a true "one prescription per person."
与以往检测常见基因突变的“个性化医疗”不同,它针对的是每位患者独有的突变特征。
Different from previous "personalized medicine" that detects common gene mutations, it targets the unique mutation characteristics of each patient.
mRNA技术的平台化特性则使得个性化疫苗的规模化生产成为可能——从肿瘤测序到疫苗制备,整个过程约需4至6周。
The platform-like nature of mRNA technology makes the large-scale production of personalized vaccines possible—from tumor sequencing to vaccine preparation, the entire process takes about 4 to 6 weeks.
然而,挑战同样不容忽视。
However, the challenges must likewise not be overlooked.
首先是成本问题。
First is the cost issue.
个性化定制疫苗的单剂成本预估已超过10万美元,远非普通患者所能承受。
The estimated cost per dose of a personalized custom vaccine has exceeded $100,000, far beyond what ordinary patients can afford.
然后是生产复杂性。
Then comes production complexity.
从肿瘤样本冷链运输、基因测序到GMP级生产质控,多个环节分散且管理极其复杂。
From cold-chain transport of tumor samples and genetic sequencing to GMP-grade production quality control, multiple links are scattered and extremely complex to manage.
此外,新抗原筛选的预测准确性、肿瘤微环境的免疫抑制、长期安全性数据缺失等问题仍需大量研究。
In addition, issues such as the predictive accuracy of neoantigen screening, immune suppression in the tumor microenvironment, and the lack of long-term safety data still require substantial research.
李煜与洪承畴 中英互译
心之所向,生活的滋味常在直觉里体会到 中英互译
徐悲鸿先生留下的水果糖