With the current US administration giving Moderna's mRNA-based vaccines for infectious diseases the cold shoulder, the biotech is hoping its experimental cancer vaccine might receive a warmer welcome. On Sunday, Moderna shared a sneak peek of data from a Phase I/II trial of mRNA-4359 it plans to present at the European Society for Medical Oncology (ESMO) conference later this week. The candidate is an immune-evasion targeted cancer antigen therapy (CAT) that encodes epitopes of PD-L1 and IDO1. mRNA-4359 is designed to prompt T-cells to directly kill tumour cells expressing the two antigens, and to deplete immunosuppressive cells that protect the tumour. According to Moderna, this dual-pronged approach is intended to tilt the tumour microenvironment into an "immune-permissive state." "Where other checkpoint inhibitors restore non-specific T-cell activity, mRNA-4359 encodes two critical immune escape pathways to help generate new, target-directed T-cells," said Kyle Holen, Moderna's head of development, therapeutics and oncology, in a company release. "This could enable broader and more durable immune responses for patients who have not had success with prior lines of therapy."In the mid-stage study, Moderna is evaluating 400-µg and 1000-µg doses of the cancer vaccine every three weeks alongside Merck & Co.'s PD-1 inhibitor Keytruda (pembrolizumab) in patients with melanoma who are checkpoint inhibitor-resistant/refractory (CPI-R/R) who had at least one prior CPI. Across all 29 evaluable patients, treatment with mRNA-4359 led to an objective response rate (ORR) of 24% and disease control rate (DCR) of 60%. However, of nine patients with PD-L1–positive tumours, six responded to treatment, for an ORR of 67%. "After failing to respond to first-line immunotherapy, existing options for PD-L1–positive patients are limited, underscoring a clear need for effective, tolerable therapies," said lead author David Pinato who will be presenting the abstract at ESMO on Oct. 17. "mRNA-4359 has the potential to rebalance the tumour microenvironment to overcome this immunotherapy resistance."Moderna added that median duration of response (DOR) to mRNA-4359 has not yet been reached. The candidate had a "consistently manageable safety profile," with no new immune-related adverse events. The experimental therapy is also being studied as a monotherapy, and in combination with Keytruda, in a Phase I/II trial of patients with advanced melanoma and non–small-cell lung cancer.For more details on Moderna's cancer pipeline, see Vital Signs: Moderna turns to oncology as its basket runs out of eggs.