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Messenger RNA vaccines for cancer immunotherapy: progress promotes promise
Amanda L. Huff, … , Elizabeth M. Jaffee, Neeha Zaidi
Amanda L. Huff, … , Elizabeth M. Jaffee, Neeha Zaidi
Published March 15, 2022
Citation Information: J Clin Invest. 2022;132(6):e156211. https://doi.org/10.1172/JCI156211.
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Review

Messenger RNA vaccines for cancer immunotherapy: progress promotes promise

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Abstract

The COVID-19 pandemic has elevated mRNA vaccines to global recognition due to their unprecedented success rate in protecting against a deadly virus. This international success is underscored by the remarkable versatility, favorable immunogenicity, and overall safety of the mRNA platform in diverse populations. Although mRNA vaccines have been studied in preclinical models and patients with cancer for almost three decades, development has been slow. The recent technological advances responsible for the COVID-19 vaccines have potential implications for successfully adapting this vaccine platform for cancer therapeutics. Here we discuss the lessons learned along with the chemical, biologic, and immunologic adaptations needed to optimize mRNA technology to successfully treat cancers.

Authors

Amanda L. Huff, Elizabeth M. Jaffee, Neeha Zaidi

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Figure 1

Modifications of mRNA vaccines for enhanced antitumor immunity.

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Modifications of mRNA vaccines for enhanced antitumor immunity.
Several ...
Several strategies have been used to chemically modify mRNA constructs to optimally balance antigen expression with innate immune recognition of the mRNA construct itself. (A) Manipulations that enhance antigen expression include modification in the 5′ cap through anti-reverse cap analogs, methylation of start nucleotides, and decapping-resistant analogs; modification in untranslated regions through the removal of long stem-loop-like structures with high GC content, insertion of an internal ribosomal entry site within the 5′-UTR, and inclusion of a Kozak sequence upstream of the start codon; modification in the open reading frame (ORF) through codon optimization based on target cell tRNA abundance; and modification of the poly(A) tail by incorporation of ATP analogs and click-labeling with fluorescent dyes. The ideal polyA length within human cells is approximately 120 bases. Use of nucleotide analogs, sequence complexity, GC content, and length modifications can reduce detection by innate sensors such as TLR7/8 or TLR3 or cytoplasmic sensors such as RIG-I, MDA5, OAS, NOD2, and PKR. Purification of in vitro–transcribed RNAs by HPLC, FPLC, or cellulose-based methods can further remove contaminating dsRNA products that would engage these sensors. (B) While these alterations result in greater transgene expression and less immunogenicity to the mRNA construct, the optimal combination of modifications and balance of the two to yield a therapeutic advantage is still an open question as it relates to optimization of cancer vaccines.

Copyright © 2022 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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