Inside Moderna’s Personalized Cancer Vaccine

a16z General Partner Jorge Conde sits down with Moderna CEO Stéphane Bancel to discuss a major milestone for mRNA technology: positive Phase 3 results from Moderna and Merck’s individualized treatment for melanoma, after more than a decade of work on personalized cancer vaccines. Stéphane explains how the treatment works by sequencing an individual patient’s tumor and healthy cells, identifying the mutations most relevant to their cancer, and encoding up to 34 of them into an mRNA designed specifically for that patient. Rather than simply unleashing the immune system, the goal is to teach it exactly what to recognize and attack. They also unpack the engineering challenge of manufacturing a different medicine for every patient, how Moderna has brought the process down to roughly 42 days from biopsy to treatment, and what it would take to manufacture personalized medicines at scale. Finally, Stéphane looks beyond melanoma to lung, kidney, bladder, pancreatic, and gastric cancers, as well as Moderna’s longer-term work applying mRNA to rare genetic and autoimmune diseases.