Two decades ago, a dear friend called me in a trembling voice. Was there hope for his young nephew, whose cancer had spread to the brain? Sadly, “no”, I said. But today, for such patients, there are options that were unimaginable back then.

Recently, researchers at the European Society For Medical Oncology presented the latest chapter results from a randomised controlled trial of a bespoke cancer vaccine for patients with high-risk melanoma. The trial involved 1,137 patients whose melanoma had been surgically removed but remained at high recurrence risk. They received either pembrolizumab, an established immunotherapy, or pembrolizumab combined with an experimental mRNA vaccine, designed to help the immune system recognise and attack targets unique to the patient’s tumour.

At two years, 82.2% of those who received the combination were alive without their cancer returning, compared with 70% of those given pembrolizumab alone – a difference of about 12 percentage points. The combination also reduced the relative risk of distant metastasis or death by 38%.

These results raise the prospect that personalised vaccines could become an important addition to cancer treatment. Whether they will deliver similar benefits in other cancers remains to be established.

Overall survival data are not yet mature, so we don’t know whether the combination helps people live longer. Fever, injection-site pain and fatigue were common with the vaccine combination. Rates of severe treatment-related adverse events were similar between the groups; quality-of-life data is not yet........

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