Can Personalized Neoantigens Raise the T Cell Bar?

Primary Malignant Melanoma of the Urethra: A Rare Finding

Primary urinary tract metastatic melanoma is an extremely rare cancer involving the urinary tract. In the majority of melanomas, skin melanocytes can become damaged by ultraviolet radiation and cause melanoma. However, in rare cases, melanocytes in mucosal tissue can develop into melanoma, which can be challenging to diagnose and treat. This case report describes managing and treating a patient with an extremely rare primary cancer finding. We describe the case of a patient who was diagnosed with primary metastatic melanoma of the urinary tract following an extensive and detailed diagnostic period of 2.5 months. After review by an interdisciplinary tumor board and a shared decision-making process with the patient, he agreed to immunotherapy with ipilimumab and nivolumab. The patient survived nearly five months after the initiation of treatment. The cause of death was challenging to determine due to it being unwitnessed; however, it is suspected to be cardiovascular-related, owing to a history of severe cardiovascular disease and an acute stress event prior to death.

Messenger RNA vaccines for cancer immunotherapy: progress promotes promise

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.

Turning tumors from cold to inflamed to improve immunotherapy response

Immune checkpoint inhibitors have revolutionized the treatment landscape for a number of cancers over the last few decades. Nevertheless, a majority of patients still do not benefit from these treatments. Such patient-specific lack of response can be predicted, in part, from the immune phenotypes present in the tumor microenvironment. We provide a perspective on options to reprogram the tumors and their microenvironment to increase the therapeutic efficacy of immunotherapies and expand their efficacy against cold tumors. Additionally, we review data from current preclinical and clinical trials aimed at testing the different therapeutic options in monotherapy or preferably in combination with checkpoint inhibitors.