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Moderna, the $5 Billion Startup, has now started dosing patients with an mRNA-based personalized cancer vaccine that resembles another one being developed by BioNTech.

RNA interference therapeutics are based on a natural process by which RNA sequences can block the expression of DNA into protein. The RNAi molecule binds to specific messenger RNA molecules that code a certain protein and directs it to the RNA-induced silencing complex(RISC), which cleaves the molecule and therefore the protein cannot be produced.

In case of the drug being designed by Moderna, next generation sequencing to identify cancer mutations, called neoepitopes is being used. The company then predicts which neoepitopes will elicit the strongest immune response against the tumor.

In the trial announces a few months ago, this therapy will be tested in up to 90 patients divided into two different study parts. Part A will recruit patients whose tumor has been removed by surgery and are free of cancer, whereas part B will test mRNA-4157 in combination with the checkpoint inhibitor Keytruda (pembrolizumab) in cancer patients whose tumors cannot be removed by surgery.

Like Moderna, BioNTech is also planning on combining mRNA cancer vaccines with checkpoint inhibitors. The rationale behind it is that while the mRNA vaccine guides the immune system against cancer cells, the checkpoint inhibitors remove the brakes of the immune system to make the response stronger. While Moderna is partnered with MSD to use Keytruda, BioNTech is preparing to use Tecentriq (atezolizumab), from its partner Genentech, in future trials.

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