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Cancer Vaccine Plus Keytruda Lower Recurrence in Melanoma

A personalized mRNA cancer vaccine with immunotherapy lengthened survival without recurrence and distant metastasis compared with immunotherapy alone in people with melanoma, according to results from a phase III clinical trial announced by Merck and Moderna, the manufacturers of the vaccine. The trial included 1,137 people with stage IIB to IV melanoma who underwent surgery, Time reported. Patients were randomly assigned to receive either about a year of Keytruda (pembrolizumab) plus nine doses of the vaccine, intismeran autogene, or Keytruda alone after surgery. The combination improved both recurrence-free and distant metastasis-free survival compared with Keytruda alone, according to a press release. The results have not yet been published in a peer-reviewed journal, and Merck and Moderna did not release specific rates on these outcomes but said the findings will be presented at a future medical conference. In the meantime, researchers will continue the trial to evaluate other outcomes, including overall survival. The results build upon findings from an earlier trial presented June 1 at the 2026 American Society of Clinical Oncology Annual Meeting, which showed the vaccine plus Keytruda led to a 49% lower risk for recurrence or death and a 59% lower risk for distant metastasis or death compared with Keytruda alone. “I think this is really an important achievement,” Jedd Wolchok, a medical oncologist at Meyer Cancer Center at Weill Cornell Medicine in New York City who was not involved in the trial, said in an article on STAT. “It tells us what might have been considered science fiction 15 or 20 years ago—that we can produce a personalized vaccine based on sequencing from a tumor from a pathology specimen—could be used to delay progression of melanoma.” Intismeran autogene uses a patient’s unique tumor DNA to create mRNA sequences that target up to 34 mutations. When administered, these sequences train the immune system to recognize and destroy specific cancer cells. Researchers combined the vaccine with Keytruda, an approved immunotherapy, in this trial, but they are also looking into testing the vaccine on its own, Time reported.

Active Surveillance Use in Prostate Cancer Increased Over Two Decades

For slow-growing prostate cancers, doctors may closely monitor the disease through regular testing, MRIs and biopsies, holding off on invasive treatment unless the disease shows signs of progression, an approach called active surveillance. Its use within the Veterans Affairs (VA) Healthcare System has more than tripled between 2005 and 2024 among veterans with low- and favorable intermediate-risk prostate cancer, according to a study published in JAMA. The study analyzed 73,042 people diagnosed with prostate cancer from 2005 to 2024, MedPage Today reported. Some 38,000 veterans chose active surveillance as their initial strategy. Active surveillance among people with low-risk disease increased from 27% in 2005 to 93% in 2024, while use among those with favorable intermediate-risk disease grew from 14% to 61%. Older age and recent diagnosis were associated with a greater likelihood of selecting active surveillance. Conversely, Black race, Hispanic ethnicity, a higher number of positive biopsy samples and socioeconomic disadvantages were associated with lower adoption rates. These results stem from the VA’s integrated health care system, and the authors said that adherence to certain components of monitoring within community practices may make active surveillance more feasible, MedPage Today reported. Active surveillance can be personalized to each patient based on their risk factors, Grace Lee, a resident physician at UCSF Helen Diller Family Comprehensive Cancer Center in San Francisco and co-author of the study, told MedPage Today. Prostate-specific antigen tests can be collected at intervals of six months or longer, and biopsies and MRI can be no more frequent than once a year. “Given this, it is very feasible to manage patients under active surveillance even with limited health care resources,” she said.

Researchers, Patients Advocate for Cancer Drug Dose Optimization

A cadre of patients, researchers and oncologists are challenging standard dosages for major immunotherapy drugs like Keytruda (pembrolizumab) and Opdivo (nivolumab), KFF Health News reported. Standard oncology protocols base the recommended dose on maximum tolerated levels seen in clinical trials, but unlike traditional chemotherapy, immunotherapy reaches maximum effectiveness at lower doses. International trials and real-world data show reduced doses or shorter treatment schedules can maintain an effect on cancer while potentially reducing severe side effects and health care costs. In 2021, the Food and Drug Administration launched Project Optimus to encourage drugmakers to explore regimens optimized for both efficacy and tolerability before approval. Still, financial incentives heavily favor high doses. Pharmaceutical companies, hospitals and oncology practices profit from standard prescriptions. Because drugmakers lack financial incentive to fund dose-reduction studies after a medication has been approved for use, independent researchers and patient advocates lead the push for these trials. “We want to maintain efficacy. But we also want patients to have excellent quality of life,” Julie Gralow, executive vice president and chief medical officer of the American Society of Clinical Oncology, told KFF Health News. “It is our job to make sure we’re not compromising quality of life with higher doses that are unnecessary,” especially for patients with advanced cancers.