Moderna's business model was always to be an on-demand vaccine platform, meaning a cost-effective service for ordering a few doses of a fully custom personalized vaccine. Their infrastructure looks more like a just-in-time 3D printer service than like a traditional vaccine development lab. It was a happy accident that the platform was available when we needed to come up with a COVID vaccine rapidly, and that's what made them a household name (and wildly skewed their revenue mix from plan). But this cancer treatment is the sort of thing they had in mind all along.
I object to the inclusion of mRNA based treatments into the category of Vaccine.
According to wikipedia, the mechanism they (the mRNA based treatments) use is:
In contrast, mRNA vaccines introduce a short-lived[58] synthetically created fragment of the RNA sequence of a virus into the individual being vaccinated. These mRNA fragments are taken up by dendritic cells through phagocytosis.[59] The dendritic cells use their internal machinery (ribosomes) to read the mRNA and produce the viral antigens that the mRNA encodes.[4] The body degrades the mRNA fragments within a few days of introduction.[60] Although non-immune cells can potentially also absorb vaccine mRNA, produce antigens, and display the antigens on their surfaces, dendritic cells absorb the mRNA globules much more readily.[61] The mRNA fragments are translated in the cytoplasm and do not affect the body's genomic DNA, located separately in the cell nucleus.[1][62]
So, it's a short lived, self limited gene therapy, not a vaccine. It hijacks the patients own cells to provoke an immune response. If the cells hijacked happen to be in tissue other than the intended injection site, via blood circulation, for example... you can (and sometimes do) have things like heart tissue being attacked by the immune system, with health altering results.
We shouldn't let the category of vaccines include these treatments. It obscures informed consent in a manner that seems to border on deception for better marketing purposes.
But I'll just say there's a reason why the phone app icon on smartphone is of a receiver, when fewer people have even seen one, and how it works is a bit different, despite the goal being the same.
We understand the new by comparisons to the existing.
The Trump administration and RFK Jr. are actively working to prevent mRNA vaccines from reaching the market.
People like Marc Andreessen, Larry Ellison and Elon Musk are actively supporting the administration, including hundreds of millions in donations to MAGA political campaigns in recent months.
Should we hold these people accountable for the damage they're indirectly doing to public health? If not, why?
First I agree RFK jr is the worst possible HHS secretary imaginable. There has been tons of funding pulled for mrna vaccine research for respiratory viruses which is terrible.
That said:
1. Funding hasn't been pulled for mrna vaccines for cancer. rfk has been equivocal about the topic. NCI is stilling rewarding grants for mrna-vaccine cancer trials.
2. Pulling funding is different from blocking vaccines from reaching the market. The new season's covid vaccine is presumably an mrna vaccine. For cancer vaccines, it would be very strange to fund a vaccine just to block it from the market.
Should we hold these people accountable?
What do you mean? The court of public opinion seems to hold them accountable. Are you proposing legal punishments for Marc Andreessen? For what specifically?
He is playing games with vaccine liability rules and recommendations (which can impact insurance coverage). He is trying to undermine the business model.
This is a relevant question. Is it ethical to indirectly kill people for profit? If so, under what circumstances? Phrased like this, it sounds ridiculous, but that must imply that the acts being committed are not understood by the people causing them through the lens I am interpreting them.
>>Should we hold these people accountable for the damage they're indirectly doing to public health?
How much did Moderna and Pfizer profit from the vaccines? I always go back to PG’s 2020 tweet: “Anyone else notice Fauci seems happier? I don’t think it’s just the vaccine.”
https://x.com/paulg/status/1328075680492511232?s=46
Amazingly, when this (IMHO quite good) data leaked, Moderna stock took a huge drop: https://finance.yahoo.com/markets/stocks/article/moderna-sto...
(Seems like people were expecting absolutely incredible, "cure for cancer" results and had already bid up the price a lot in advance.)
Not a huge surprise given the absolute face ripping jump MRNA had when the vaccine was first announced. The ~$20B company jumped 174% overnight, and then climbed another 70% over the last two months, now only dropping 18% on this news.
To illustrate how much they've gone up, this 18% drop is just slightly less than their entire market cap in June (four months ago)
When it clicked that you meant MRNA the ticker symbol, it also just clicked for me that the name Moderna is a play on mRNA. Not sure why I never noticed that before.
Like the FedEx logotype arrow, now I will never unsee it.
I'm way out of my depth on this topic, but my understanding is that studies have shown that several currently approved mRNA vaccines cause a similar reduction in these cancers. Moderna's goal with this trial was to show their tailored vaccine outperformed a COVID vaccine (for example), and my assumption from the stock dip is that smarter people than I were not convinced.
> Moderna's goal with this trial was to show their tailored vaccine outperformed a COVID vaccine (for example), and my assumption from the stock dip is that smarter people than I were not convinced.
The trial result is excellent - anyone ‘not convinced’ was not living in the realm of typical results.
Please note this has about nothing whatsoever to do with COVID. It’s probably best not to comment on technical topics if you have no relevant experience.
This has everything to do with mRNA vaccines effects on cancer reoccurrence. The COVID vaccine just happens to be the most common and therefore most studied.
So the absolute risk of recurrence/death on Keytruda alone was 30%, reduced to 18% with Keytruda plus intismeran. That will definitely make a noticeable difference in this disease if the real world results hold.
I’m grateful you said this. Your comment led me down a path where I discovered it is essentially biologically impossible for his Lenalidomide to have caused stage 4 liver cancer in just a year. It turns out the liver cancer was a totally separate issue brewing silently for years, likely encouraged by a decade of TRT he was on. The severe skin issues he had a few years prior were early warning signs of his liver failing, but they got missed and masked by general dermatitis the myeloma diagnoses.
Realizing the cancer meds weren't to blame actually brings me a ton of closure. I definitely don't want to scare anyone away from life-saving treatment based on my misunderstanding. Thank you.
That isn’t to say there aren’t terrible tradeoffs that have to be faced in the course of cancer treatment, and much of medicine. Pharmaceuticals seem to beget pharmaceuticals.
that's great though that you got closure. also remember that hindsight is 20/20 and it's hard to really link some vague symptoms to a disaster until it's too late
This is so lovely to read. Medicine is hard. Cancer is harder. I wish we were better as a society at understanding that care doesn’t end with the patient per se.
I lost a friend who died from complications caused by chemotherapy. That's a true statement. It's also true that she would most likely have died at least a decade earlier, maybe two decades, had she not done chemotherapy. (She was on her 3rd or 4th relapse.)
I don't mind the above wording at all, because there's another thing that happens: people seem to have this impression that if you get cancer, follow the recommended treatment, and are in remission... that you're "done", and you "won". It isn't like that. First, the treatments have serious side effects, both short and long term. Second, cancer is never gone from your life, even if it never comes back. That doesn't mean you should not do the recommended and available treatments. Your odds of survival are almost always much much higher if you do, and imo is the right thing to do for the vast majority of people. But go into it with your eyes open. You're past the point where you get to have a conventional happy ending. You'll need to figure out how to be ok with the ending that you can still have. (Which may be a happy one! But not in the way that you imagined when you were younger.)
I lost my dad to cancer because of surgical complications. All of this stuff is risky, and not treating the cancer is a valid choice that some people make. But anybody who reads an anecdote by a quasi-anonymous non-expert had better not base their care plan on that.
> but held off reporting details until the data could be presented at an upcoming scientific conference
If you hold the key to saving a million people's lives, yet you decide to let those million people die so you can take the stage at a prestigious conference, are you a good person?
Curing disease is literally a race, with people dying every minute of every day. In any other situation, labs would be running night and weekend shifts and not a second would be lost.
The data reporting timeline has nothing to do with the approval and deployment timeline.
It takes a profoundly naive person to think an organization full of people who have literally dedicated their careers to actually solving these problems are focused on the prestigious conferences.
These people signed up for decades and decades of work on a problem that would result in (statistically speaking) guaranteed failure.
For future reference, the preparation for reporting trial data and submission to regulatory agencies typically happens in parallel. Both activities take time and the company is highly motivated for both to happen as quickly as possible.
In practice, data for new cancer treatments is usually published 6-12 months before approval. There are definitely exceptions, especially where the drug is already approved and the data is supporting a new use, but that is not the norm for new drugs.
There are other factors too e.g. it can take time to make commercial drug supply available. In this specific case how Merck/Moderna will scale the boutique manufacturing process for a much larger number of patients while maintaining the speed they need for the treatment to work is a major question.
Again, the company is extremely motivated to do all of this as fast as possible. In addition to the points raised elsewhere in this chain.
Moderna's business model was always to be an on-demand vaccine platform, meaning a cost-effective service for ordering a few doses of a fully custom personalized vaccine. Their infrastructure looks more like a just-in-time 3D printer service than like a traditional vaccine development lab. It was a happy accident that the platform was available when we needed to come up with a COVID vaccine rapidly, and that's what made them a household name (and wildly skewed their revenue mix from plan). But this cancer treatment is the sort of thing they had in mind all along.
I object to the inclusion of mRNA based treatments into the category of Vaccine.
According to wikipedia, the mechanism they (the mRNA based treatments) use is:
So, it's a short lived, self limited gene therapy, not a vaccine. It hijacks the patients own cells to provoke an immune response. If the cells hijacked happen to be in tissue other than the intended injection site, via blood circulation, for example... you can (and sometimes do) have things like heart tissue being attacked by the immune system, with health altering results.We shouldn't let the category of vaccines include these treatments. It obscures informed consent in a manner that seems to border on deception for better marketing purposes.
True and I agree.
But I'll just say there's a reason why the phone app icon on smartphone is of a receiver, when fewer people have even seen one, and how it works is a bit different, despite the goal being the same.
We understand the new by comparisons to the existing.
The Trump administration and RFK Jr. are actively working to prevent mRNA vaccines from reaching the market.
People like Marc Andreessen, Larry Ellison and Elon Musk are actively supporting the administration, including hundreds of millions in donations to MAGA political campaigns in recent months.
Should we hold these people accountable for the damage they're indirectly doing to public health? If not, why?
First I agree RFK jr is the worst possible HHS secretary imaginable. There has been tons of funding pulled for mrna vaccine research for respiratory viruses which is terrible.
That said:
1. Funding hasn't been pulled for mrna vaccines for cancer. rfk has been equivocal about the topic. NCI is stilling rewarding grants for mrna-vaccine cancer trials.
2. Pulling funding is different from blocking vaccines from reaching the market. The new season's covid vaccine is presumably an mrna vaccine. For cancer vaccines, it would be very strange to fund a vaccine just to block it from the market.
Should we hold these people accountable?
What do you mean? The court of public opinion seems to hold them accountable. Are you proposing legal punishments for Marc Andreessen? For what specifically?
He is playing games with vaccine liability rules and recommendations (which can impact insurance coverage). He is trying to undermine the business model.
>The Trump administration and RFK Jr. are actively working to prevent mRNA vaccines from reaching the market.
Why though? Would they get paid by "crakpots" more than they could get paid by Big pharma !?
Apparently everyone knows Trump is only interested in him and friends making money. So how do you rationalize your claim?
> Would they get paid by "crakpots" more than they could get paid by Big pharma !?
Yes. A whole bunch of the prominent "MAHA" folks sell/promote supplements, peptides, miracle cures.
https://en.wikipedia.org/wiki/Children's_Health_Defense
https://www.cspi.org/press-release/peptides-fda-urged-overru...
https://www.washingtonpost.com/health/2024/12/03/dr-oz-influ...
There's a shitload of money in alternative medicine, and you can get away with more.
It isn't a cynical scam to make money. They are genuinely stupid.
This is a relevant question. Is it ethical to indirectly kill people for profit? If so, under what circumstances? Phrased like this, it sounds ridiculous, but that must imply that the acts being committed are not understood by the people causing them through the lens I am interpreting them.
> This is a relevant question
Important? Yes. Relevant? No.
FYI the Trump administration was definitely not against vaccines: https://web.archive.org/web/20201216233803/https://www.hhs.g...
...nor Trump himself: https://www.newsweek.com/trump-says-he-saved-100-million-liv...
What's it like waking up after being asleep for 6 years?
Trump was the guy to do the "two weeks" lockdowns during COVID.
Would you say the Trump administration still now supports that?
Except for the part where he named an anti-vaxer as the Secretary of Health, which oversees the CDC
It's not 2020, dude.
.
>>Should we hold these people accountable for the damage they're indirectly doing to public health?
How much did Moderna and Pfizer profit from the vaccines? I always go back to PG’s 2020 tweet: “Anyone else notice Fauci seems happier? I don’t think it’s just the vaccine.” https://x.com/paulg/status/1328075680492511232?s=46
Amazingly, when this (IMHO quite good) data leaked, Moderna stock took a huge drop: https://finance.yahoo.com/markets/stocks/article/moderna-sto... (Seems like people were expecting absolutely incredible, "cure for cancer" results and had already bid up the price a lot in advance.)
Not a huge surprise given the absolute face ripping jump MRNA had when the vaccine was first announced. The ~$20B company jumped 174% overnight, and then climbed another 70% over the last two months, now only dropping 18% on this news.
To illustrate how much they've gone up, this 18% drop is just slightly less than their entire market cap in June (four months ago)
The usual “buy the rumour, sell the news” then?
When it clicked that you meant MRNA the ticker symbol, it also just clicked for me that the name Moderna is a play on mRNA. Not sure why I never noticed that before.
Like the FedEx logotype arrow, now I will never unsee it.
Seems like absolutely huge news, and hopefully getting it approved means it can be developed even more...
I'm way out of my depth on this topic, but my understanding is that studies have shown that several currently approved mRNA vaccines cause a similar reduction in these cancers. Moderna's goal with this trial was to show their tailored vaccine outperformed a COVID vaccine (for example), and my assumption from the stock dip is that smarter people than I were not convinced.
https://www.nature.com/articles/s41586-025-09655-y
> Moderna's goal with this trial was to show their tailored vaccine outperformed a COVID vaccine (for example), and my assumption from the stock dip is that smarter people than I were not convinced.
The trial result is excellent - anyone ‘not convinced’ was not living in the realm of typical results.
Please note this has about nothing whatsoever to do with COVID. It’s probably best not to comment on technical topics if you have no relevant experience.
This has everything to do with mRNA vaccines effects on cancer reoccurrence. The COVID vaccine just happens to be the most common and therefore most studied.
Related, if you are curious: this is what BioNTech is currently working on.
https://www.biontech.com/int/en/home/pipeline-and-products/p...
So the absolute risk of recurrence/death on Keytruda alone was 30%, reduced to 18% with Keytruda plus intismeran. That will definitely make a noticeable difference in this disease if the real world results hold.
It's a huge break through. Keytruda as a neoadjuvant (before surgery, in addition to after) has recently been showing gains as well, with a similar reduction. https://dailynews.ascopubs.org/do/neoadjuvant-therapy-trials...
The question now is what do you get with both treatments together?
* after 2 years
I hope this gets through quickly. I have some friends in treatment now and lost my dad to cancer because of cancer medication.
Note that the trial was for “stage IIB–IV melanoma that had been surgically removed prior to entering the trial.”
> lost my dad to cancer because of cancer medication
Please don’t phrase it like this. Loss is hard. But desperate people have skipped treatment because they misread something online.
I’m grateful you said this. Your comment led me down a path where I discovered it is essentially biologically impossible for his Lenalidomide to have caused stage 4 liver cancer in just a year. It turns out the liver cancer was a totally separate issue brewing silently for years, likely encouraged by a decade of TRT he was on. The severe skin issues he had a few years prior were early warning signs of his liver failing, but they got missed and masked by general dermatitis the myeloma diagnoses. Realizing the cancer meds weren't to blame actually brings me a ton of closure. I definitely don't want to scare anyone away from life-saving treatment based on my misunderstanding. Thank you.
That isn’t to say there aren’t terrible tradeoffs that have to be faced in the course of cancer treatment, and much of medicine. Pharmaceuticals seem to beget pharmaceuticals.
only in HN!
that's great though that you got closure. also remember that hindsight is 20/20 and it's hard to really link some vague symptoms to a disaster until it's too late
This is so lovely to read. Medicine is hard. Cancer is harder. I wish we were better as a society at understanding that care doesn’t end with the patient per se.
I wish we were better at preventing cancer, vs general populace having written it off to a reverse lottery-win.
I wish we were better at having the hard conversations beforehand,
(regarding metabolic health, immune health, what those even mean, why they apply).
I lost a friend who died from complications caused by chemotherapy. That's a true statement. It's also true that she would most likely have died at least a decade earlier, maybe two decades, had she not done chemotherapy. (She was on her 3rd or 4th relapse.)
I don't mind the above wording at all, because there's another thing that happens: people seem to have this impression that if you get cancer, follow the recommended treatment, and are in remission... that you're "done", and you "won". It isn't like that. First, the treatments have serious side effects, both short and long term. Second, cancer is never gone from your life, even if it never comes back. That doesn't mean you should not do the recommended and available treatments. Your odds of survival are almost always much much higher if you do, and imo is the right thing to do for the vast majority of people. But go into it with your eyes open. You're past the point where you get to have a conventional happy ending. You'll need to figure out how to be ok with the ending that you can still have. (Which may be a happy one! But not in the way that you imagined when you were younger.)
I lost my dad to cancer because of surgical complications. All of this stuff is risky, and not treating the cancer is a valid choice that some people make. But anybody who reads an anecdote by a quasi-anonymous non-expert had better not base their care plan on that.
have you heard of this interesting treatment?
https://youtu.be/VGvuEc_tLQY?si=S2aYc67QamB-bkOr
> but held off reporting details until the data could be presented at an upcoming scientific conference
If you hold the key to saving a million people's lives, yet you decide to let those million people die so you can take the stage at a prestigious conference, are you a good person?
Curing disease is literally a race, with people dying every minute of every day. In any other situation, labs would be running night and weekend shifts and not a second would be lost.
The data reporting timeline has nothing to do with the approval and deployment timeline.
It takes a profoundly naive person to think an organization full of people who have literally dedicated their careers to actually solving these problems are focused on the prestigious conferences.
These people signed up for decades and decades of work on a problem that would result in (statistically speaking) guaranteed failure.
For future reference, the preparation for reporting trial data and submission to regulatory agencies typically happens in parallel. Both activities take time and the company is highly motivated for both to happen as quickly as possible.
In practice, data for new cancer treatments is usually published 6-12 months before approval. There are definitely exceptions, especially where the drug is already approved and the data is supporting a new use, but that is not the norm for new drugs.
There are other factors too e.g. it can take time to make commercial drug supply available. In this specific case how Merck/Moderna will scale the boutique manufacturing process for a much larger number of patients while maintaining the speed they need for the treatment to work is a major question.
Again, the company is extremely motivated to do all of this as fast as possible. In addition to the points raised elsewhere in this chain.