Moderna's Cancer Vaccine May Cut Deaths In Half | The Brainstorm 146

**Sam** (0:00)
Agents are learning the same lessons that humans have, which is, it's not about raw intelligence. Sometimes it's about grit.

**Brett** (0:06)
Sometime in the future, we could look back and be like, I can't believe you were taking basically the equivalent of like aspirin for every cancer. Like you were taking something that was just a random thing you're throwing at a very customized disease that your own body had generated. And so it does seem like this is kind of a pathway towards customized cancer treatments for everybody.

**Sam** (0:24)
Welcome to The Brainstorm. Today, we are talking cancer vaccines from Merck and Moderna. And Brett has finally subscribed and has Grok Bot paying for itself already. So, Brett, let's dive in a non-AI topic for a change here. But just as life changing and as big an opportunity maybe, Merck and Moderna, what was announced with the cancer vaccine? Why is it notable?
Where do we go from here?

**Brett** (0:55)
Yeah. So, I mean, it's a cancer. I think of a vaccine as something you take before you get a disease. This is a vaccine, but it's a vaccine that you take after you get the disease. The reason it's called a vaccine is because if you've gotten a cancer, and they do surgery on the cancer to take it out, then they can take a sample of that cancer and they can compare it to a sample of your own blood and they can say, well, what are the RNAs being expressed in this cancer? And can we guess which ones are then going to be visible on the outside of a cell?
And so then the patient who's had this cancer resected then gets a custom designed RNA treatment that causes those things on the outside of the cell to be expressed inside the body, which causes the patient's immune system to be activated against those neoantigens, they're called, so that when the cancer comes back, the immune system is already charged up and ready to go and to attack those specific cells. So it is a vaccine in that you are basically charging up your immune system to go after a specific disease, but in this case, it's the specific custom cancer that your body has generated. And so over the past week, they indicated that in melanoma, their phase 3 trial had come out, Moderna's phase 3 trial had come out very positive.
And so that's both exciting for aggressive melanoma patients, but it's also exciting because they have a number of these trials against different cancer types on the offer. And they are all using basically the same technique. It's not a drug in that it's a drug that you buy off the shelf. It's a drug that's custom designed for each patient's cancer. So it means that one of the ones in trial is for stage one aggressive lung cancer, where you've done a surgery on it. At stage one, it was localized to the lung, but then you can kind of provide a custom treatment for this patient. And so it promises to potentially mean that every cancer over time is actually treated with a custom treatment by patients, assuming they can scale up the manufacturer of these therapies.

**Sam** (3:20)
All right. So let's start with a few things you just said. Phase three, what does that mean? How long then after a positive result from phase three to it being available to people? And custom, custom sounds expensive.
So what is it on the cost side of things?

**Brett** (3:39)
Yeah. Generally, a phase three trial takes a long time. Here, they've actually gotten the results out of the phase three. So they're going to present the full data sometime this fall. And then you should expect that commercialization could happen relatively quickly after that. You have to go through a licensing step, but it could be, I don't know, six or 12 months. I'm not sure what the estimates are particularly specific to this Moderna drug, but from there, it's kind of like a slam dunk process, assuming it commercially looks good. On the expensiveness, yes, these are developing a custom drug for a specific patient is hundreds of thousands of dollars type expense, maybe $200,000, $300,000 right now at current scale.
You can imagine that there are ways that you want to scale up the manufacturing, so you can take in lots of patient samples, keep them segregated, grow the particulars treatments for all of the patients, and then ship them back. But as long as it remains at that sort of price point, these treatments will be reserved for the most severe cases, not because they wouldn't be useful in earlier stage. You know, cancers are cancers that might not prove as higher risk of mortality, but because of that expense.