00:01In this particular trial, it was melanoma patients who had what we call very high risk
00:08resectable melanoma, stage two, right up to stage four. They had their melanoma completely removed
00:16by surgery. But the problem with melanoma is you can do a great surgical resection, you can remove
00:23all the melanoma we can see. However, the nasty thing about melanoma and the many other cancers
00:29is they can come back after you've had good surgical clearance because the cancer cells
00:36get into the bloodstream early on, almost before you even notice the first lump. So what we did in
00:43this trial is we took those patients who'd had surgical resection of all their melanoma and we
00:49randomized them either to receive our standard immunotherapy, pembrolizumab in this case or
00:56ketruda versus the same drug, hembrolizumab, ketruda with a personalized mRNA vaccine made just for that
01:09individual patient's tumor. This is a world first. It's the first trial to show a benefit. The full
01:18results will be presented in October at the European Society of Medical Oncology and will be published
01:25at that time so you can see exactly the size of that benefit. But this is real landmark moon landing
01:34a change in approach to cancer. Cancer cells? Yeah. Can you talk broadly about those benefits
01:42before it's published? No, we can't at this stage. We're still cleaning up the data and analyzing it.
01:49It will be presented. It's embargoed. It's a late-breaking abstract. We're still actually going
01:55through for legal reasons. We must announce that this is positive trial. But what it really says is
02:03the mRNA technology, COVID, actually lent from oncology cancer. This technology, we've been working
02:12on this for a long time. And then it pivoted to COVID. And now we're back on cancer. And this
02:21is
02:21the final type of trial to show it really works. We're hoping that this will impact other cancers.
02:26In fact, every single drug we have developed in melanoma has then been used a lot of other cancers. So
02:35immunotherapy happened first in melanoma, then lung cancer, kidney cancer, bladder cancer,
02:40head and neck, et cetera, et cetera. It's now the most ubiquitously used drug. Same thing will
02:46probably happen within this. We don't know. But this is the first landmark study to show you can
02:52take someone's tumor. You can see what's unique about their cancer, different to anyone else's cancer,
02:59even if it's the same type. You make a vaccine against that cancer because the immune system thinks
03:05it's a friend, but the vaccine helps your immune system understand that it's an enemy.
03:11So we power boost the immunotherapy we use with this personalised approach.
03:16It's brilliant.
03:17Someone listening might be thinking, well, how do you actually personalise it? How do you work
03:22out what that cancer is? Can you briefly explain that? Because I believe it's about
03:26the molecular configuration of that cancer.
03:30It is. All of us have a genetic code in each of our cells. Cancer cells have just a very
03:36abnormal
03:36genetic code. It's mutated. We take the cancer cell. We take your normal cells. We see what's unique
03:43about your cancer cell that's not in your normal cell. We have a name for that. They're called
03:48neoantigens. They're unique. They're individualised to that cancer. And then we make a vaccine based on
03:55that genetic code. So we sequence the genetic code of the cancer and your normal cells, find out what's
04:01different. And they're unique. No one else shares those. That little code is not shared by anyone else.
04:09And then we make a vaccine that has all the code that's very unique. We inject it into the patient
04:16so that the immune system learns that that's odd. That is not my friend. Anything that possesses
04:23that code must be dealt with and killed. And that's how it works in a nutshell.
04:29So this is stage three. We know that that is the last end of clinical trial, stage three. Where does
04:35it go next? And what sort of timeframe are you looking at?
04:39So it's what we call a phase three trial. And now it gets published. It gets presented to
04:47authorities around the world. And then authorities. So for example, in Australia, it would be the TGA
04:53is our first port of call. The second is the PBAC, the pharmaceutical benefits. And that gets
04:59considered by that committee and recommended to the government as to whether this would be
05:05supported by taxpayers. So in Australia, we're very lucky. We've got a wonderful centralised medical
05:10system and all things are considered. The evidence is considered. And that committee decides whether
05:18this is worthwhile for us taxpayers to fund these drugs for all Australians. And so that system...
05:25Yes. So, Georgina, this drug ostensibly, if it went through that process and was successful,
05:30would be for melanoma patients. But where do you see that drug going? Which next cancer might it be
05:36most effective with? So this is a specific technology. So at the moment, there are many
05:43trials looking at this technology in lots of different cancers. This includes lung cancer,
05:50kidney cancers, a lot of other cancers, pancreatic cancer, which is one of the hardest to treat cancers.
05:58So there is no end to where you can try this. What's really interesting is once you've established
06:08the technology, it's very quick. All you need to know what's different in this tumour that's not
06:13in the normal tissue. But you can start to look at even other different hooks to make a vaccine
06:20against, a therapeutic, what we call a drug treatment type vaccine. It's not a vaccine that
06:25prevents the cancer. This is a vaccine or what we call a personalised type of treatment for people
06:32who have active cancer. So very different to what we think of when we think measles, mumps,
06:39rubella, a very different approach. So look, the trials are ongoing in lots of different cancers.
06:46But to have the proof of principle taken from what we call phase one trials, so first in humans,
06:52right up to phase three in melanoma, bodes very well for other cancers. Melanoma really is the
06:59poster child for these novel approaches and immunotherapies and really does set the bar
07:04and other cancers follow. Professor Georgina Long, it's been really great speaking with you.
07:09Your excitement is very clear. Thank you again. Thank you.
07:16You
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