The Current - Could mRNA vaccines cure cancer?

Episode Date: April 23, 2026

Six years ago, Donna Gustafson was diagnosed with pancreatic cancer one of the deadliest cancers. Today, she's cancer-free. She’'s one of 16 patients in an early clinical trial testing a personalized mRNA cancer vaccine  designed to train the immune system to recognize and fight cancer.We hear from Donna and from the doctor leading the research, Dr. Vinod Balachandran, about what these early — but encouraging — results could mean. And we speak to Dr. Ramy Saleh, Associate Professor at McGill University, on how similar research is taking shape in Canada.

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is a CBC podcast. Hello, I'm Matt Galloway, and this is the current podcast. In 2019, Donna Gustafson was visiting her daughter in Australia when a trip to the hospital changed everything. It was there that she was told she had pancreatic cancer. Pancreatic cancer is one of the deadliest forms of the disease, fewer than 13 percent of patients live longer than five years. Well, now six years later, Donna is now cancer-free.

She is one of 16 people who took part in an early clinical trial testing a personalized mRNA cancer vaccine. The idea is to use the genetic makeup of a patient's own tumor to train the immune system to recognize and fight the cancer. This trial is being conducted by researchers at Memorial Sloan Kettering Cancer Center in New York, and we'll hear from the doctor leading that study in a moment. But first, Don Augustifson joins us now. Good morning. Good morning. How are you doing? Cancer-free is an amazing thing to be able to say. Amazing, amazing thing. totally cancer-free with no physical or dietary restrictions, no limitations, no further treatment. I get checked once a year.

It's fabulous. Go back to that moment. You're on this trip. You're visiting your daughter in Australia. You end up in the emergency department. What do you remember about that day? We really thought that I was dehydrated from the long plane flight. And we felt the easiest way to get fluids would go to an emergency room.

and they would give me an IV and I would be fine. We went to the emergency room and they ran some tests and they said, no, you are not dehydrated. You have pancreatic cancer. They said it straight up like that. Straight up, definite diagnosis. And I was shocked because I said, how do you know there was no biopsy? Why are you so sure? And the doctor explained to me that the position of the tumor, the borders of the tumor,

of the tumor were total indications. And I remember saying to her, pancreatic cancer has a very low rate of survival. And she said, yes, it does. And I mean, that was the facts, and that's where we stood. And so what was your plan then? Okay, well, first the plan was

to get home as quickly as possible because I was very far away. So we got on the next plane we could get out. And while we were in flight, I have three daughters, three amazing women, who are true warriors. And by the time I landed, they had done all the research they could find on pancreatic cancers and treatments and options and different hospitals and doctors. And then they called everybody they knew who was in the medical field and called in every favor. And they got me an appointment with Dr. Eileen O'Reilly of Memorial Sloan Kettering, and that led me to the trial.

This trial started, it was the day before you were supposed to start chemotherapy, right? Mm-hmm. What did they tell you about, you said that this was a no-brainer to take this trial and to be part of this MRI vaccine trial, but what did they tell you about what the possibilities were? Well, first of all, we had done enough research to know that statistically the odds were. against me. When they had offered it to me, I thought it was, I was so in awe with the science to have a tumor that was personalized just for, to have the tumor and personalized the vaccine just for me was amazing. And they offered me hope. This was something that was maybe better

than the odds I was looking at. Now, there was a point. pause because once you have surgery and you recover, they very much want you to start chemotherapy as quickly as you can. And I had to delay this because I had to take the vaccine first. So there was a leap of faith there that I wasn't, if the vaccine didn't work, I wasn't wasting precious time by not going into the chemo treatment. But you felt it was worth it? Oh, absolutely. And MSK was amazing. The Dr. B's fact. fantastic. They explained everything to me. To me, it was a no-brainer. It offered me hope, and I was willing to grab it. Can you just explain, we're going to speak with a doctor in just a

moment, but just explain how this works. They, they, I said in the introduction, that they essentially use the genetic makeup of the tumor to train your immune system to fight this cancer. Yes, yes, yes. Is that through a series of vaccines, or how does that work? Yes. Okay, you have a series of nine vaccines. I had eight treatments of the vaccine, then I had 11 chemotherapy treatments, and they follow up at the very end with the ninth vaccine treatment. The greatest thing is not only do I feel 100%, that's what saved me, but the side effects of the vaccine treatment are so much less. They are milder, much more manageable. And we all know that chemo is very difficult to take. And so when they tell you, we think this is working, what was that like? Well, you know,

we didn't know. And after treatment, every three months you get checked to see if there's any return of the disease. So you wait three months, it's clear. And then you wait another three months, and it's clear. And then you do that for two years. And then after two years, you can go six months. And then once you reach five years, you could go a year at a time before being screened. So, yes, every time it was like not returning, not returning, it was unbelievable. It was so amazing. So thankful, so blessed. I'm going to let you go, but I saw a photo of you. You were in Sicily last year celebrating your 50th wedding anniversary.

Yes, yes. And you're smiling and you get your arms out and you're in the side of a volcano and you look as happy as you could possibly be. Yes, where I'm in Edna. What do you think the message is to others about what you have gone through? Again, this is an early trial and there's a lot of road left ahead for people to try to figure out more about this trial. but what's the message that you're left with? Hope. There is so much hope out there,

and things are developing so quickly right now in this field. There is hope. It is not a death sentence. Like everyone thinks pancreatic cancer, you hear that term, and you think there's nothing after that, but there is. And I'm living proof that it works,

and you can survive and be totally healthy. I wish you the best of health, Donna. it's great to talk to you. Thank you. Thank you. Take care. And you, Donna Gustafson, is a participant in the personalized MRNA cancer vaccine trial. She was in Del Rey, Florida. Dr. Vinoid Balachandran is the trial's principal investigator and director of the Olean Center for Cancer Vaccines at Memorial Sloan Kettering Cancer Center in New York, where Donna was treated. Dr. Balachandran, good morning to you. Good morning. We know that the survival rate for pancreatic cancer is, as Donna said, very low. How does this vaccine change that possibly? So the story behind how we got to this vaccine is, as you mentioned,

approximately 90% of pancreatic cancer patients will die with the current treatments. But not all do, and a rare 10% of patients in fact survive long term. Why? Unknown. So about a decade ago, we became interested to learn how they were doing this so perhaps we could replicate this in other patients. And what we learned was that these rare survivors generate very strong immune responses against genetic errors in their cancer. And so we sought off to isolate these genetic errors so that maybe we could deliver it to other patients in the form of a vaccine, teach others to recognize their cancers in a manner that these patients were doing naturally. And what we found was these errors were individual components of each person's cancer, so the vaccine would have to be

individualized. And so in 2017, actually, we thought the best technology to make a custom cancer vaccine was to use RNA technology. And that was what led to this trial that we started in 2019. This is a small phase one trial, just 16 participants. But what have you seen coming? out of it that gives you, well, just how would you describe it? So pancreatic cancer, as you may know, is one of the most challenging cancers in oncology. And specifically for the newest wave of oncology drugs, the immune therapies, pancreatic cancer has been the toughest to treat because none of the current immune therapy. These are drugs that use patients' own immune systems to fight.

their cancer, the current class of drugs essentially do not work at all in pancreatic cancer. So there has been a perception, perhaps, that such drugs, immune therapies would never be possible in pancreatic cancer. And pancreatic cancer also reflects the about 80% of human cancers where these first class of immune therapies do not work. So the finding that we can use a personalized RNA vaccine to generate not only an immune response against pancreatic cancer, but an immune response that is very potent and durable, I think is very exciting because it suggests that if we could crack this in pancreatic cancer, this could perhaps provide a blueprint to develop other immune therapies for many, many more cancers. And this is very exciting. Tell me more about that,

because you have said that vaccines for cancer have long been sought after, but they are one of the most significant challenges in modern medicine. Why is that? So vaccines for cancer are a little bit different than how we typically think of as a conventional vaccine for a pathogen, such as a virus or bacteria, where for those vaccines, infectious disease vaccines, these, what you're doing is you're teaching healthy individuals to recognize a virus or a bacteria to prevent future disease from that entity. And secondly, our immune systems are hardwired to recognize viruses and bacteria as foreign.

So in essence, you're teaching the immune system to do something that it already wants to do. Now, cancers, unlike a virus or a bacteria, they're in fact part of our own bodies, their self. And our immune systems are, in fact, hardwired to not recognize our own bodies as foreign. So to teach the immune system to recognize an individual person's cancer requires very specific teaching of the immune system to recognize specific components of the cancer that are different. than the other normal tissues. And this is a fundamental scientific challenge that has been investigated now for many decades by laboratories and scientists around the world.

But if you can crack this, and again, this is early, but if you can crack this for pancreatic cancer, is your sense that this approach and this technology, the technology of an MRI vaccine, may be applicable to other cancers? Yes, we think so. Pancreatic cancer is not only the most oncologically challenging, meaning essentially all waves of drugs that we have historically used for pancreatic cancer are not very effective. And this is why, even in 26, with our best treatments, we say that close to 90% of patients will die within five years of diagnosis and treatment. So that remains a very, very deep challenge. So not only is it the most oncologically challenging, it is also from an immunological perspective. It is a cancer where one has thought that this would perhaps be the last place that you could develop an immune therapy for because it is too tough. So if we can beat the toughest, teach the immune system to recognize the

most challenging of cancers, then perhaps this can pave the way to recognize many human cancers. And I think this is a very exciting moment for the field for us. Tell me about phase two of this research and what you hope that will lead to. Yeah. So in this phase one trial, our primary question was, can we make these vaccines? Are they safe? Can we deliver it to patients on time? And do, do they generate a very strong immune response? And the answer to all of those questions have been yes. But we still have some important questions to answer, namely, are these vaccines able to

perform better than standard treatments? Or when we combine them with standard treatments, could they prevent cancers from returning after surgery? And perhaps could they also allow patients to live longer? And this requires what we call a randomized trial where patients either receive the experimental treatment plus standard treatments or they receive standard treatments alone. And this trial is now well underway globally, North America, Europe, and Asia. Just before I let you go, Donna Gustafson said, she's living proof of the word hope in some ways.

And that's the word that she would apply to this. What is the word that you would apply to what this research is telling you and telling us? I think the word that I would use to describe this entire moment has been determination. Patients and their families really go through, they overcome challenges that for us are really impossible to fathom. There are so many challenges that they have to overcome as they fight their cancer. And they really demonstrate exceptional determination and grit and strength and fight. So to be part of their team to fight this disease alongside them, I think is really a privilege and inspiration for all of us. And the determination of researchers like yourself as well to keep on this to try to figure out answers to these questions, right?

Absolutely. Team effort. This really requires concerted, coordinated effort from all members of the team, patients, families, scientists, clinicians, researchers. And I think it really shows us, and in this particular scenario, I would also like to mention our biopharma partners also. It really was a great team effort. And I think all of us are really determined to be. this disease and I really do feel that we will see progress, meaningful progress in our lifetime for pancreatic cancer. Dr. Bellachandran, great to speak with you. Thank you very much. Thank you. Dr. Vinov Balchandran is director of the Olaan Center for Cancer Vaccines at Memorial Sloan Kettering Cancer Center in New York. Our My Beauty Destination event is on at Jean-Cutou. It's the perfect opportunity to discover what's new, earn moi points, and take advantage of savings to spring into the new season. Because from this Friday to Sunday only, you'll get a $15 Jean-Coutou gift card for every $75 you spend on cosmetics.

Plus, until Wednesday, get 20% off selected Carine-Jean-Jonka anti-aging skincare products. Head in store or online to take advantage of these offers. Certain conditions apply. Details at jeancoutu.com. Hi, Donovan Woods here. Hey, hey, it's me, Tom Power. We're here to tell you about our brand new podcast. It's called The Big Five.

So Donovan, what is the Big Five? Yeah, exactly. What is the Big Five? That's what the Big Five is all about. Every week, Tom and I will sit down with a special guest and dive into new topics debating things like, what are the Big Five farm animals, the Big Five types of hat, the Big Five guys named Paul. Martin, Revere, Mezcal, McCartney, John Paul, the debate is settled by a listener from somewhere across the country. It's like a game show. It is a game show. The Big Five, available now wherever you get your podcast. Dr. Rami Saleh is an associate professor at McGill University where he leads a cancer research unit working with MRNA vaccines. Dr. Sally, good morning to you. Good morning.

This feels like good news. What is your reaction to this story? Absolutely. I truly believe we're living in a golden era of cancer treatments, especially with what's been going on over the last few years and the MRA vaccines that we're discovering. And you're seeing this right in your own laboratory and your research unit.

Tell me about the work that you're doing, particularly it's with bladder cancer, right? Yeah, so at the McGill University Health Center, we actually treated the first patients with lung cancer worldwide. with MRNA vaccines. And also we had the privilege to treat the first patient with bladder cancer in Canada with MRI vaccines. So the field is really exploding into many diseases as we speak.

During the pandemic, we talked a lot about the promise of MRNA vaccines. How do you see that promise? Unfortunately, the pandemic was a disaster to humanity, but we did learn something out of it. we learned about a new technology and using it on the worst disease that humanity ever encountered, which is cancer. I think we're at the tip of the iceberg. We started to understand how the vaccines work. Now I think we are in the stage of trying to see which cancer will respond to what kind of vaccine.

And this is the research that's being done at the moment. Where does that promise live with these vaccines? What is it that they can do that we have not been able to do thus far in terms of tackling something like cancer? I think one of the worst things to do is a patient going through an entire surgery, chemotherapy or other kinds of treatments, and then find out a year or two later that the cancer came back. I think that's the worst news you can give to a patient, especially after a very hard battle with cancer.

I think vaccines will definitely play a role in what we call the adjuvant setting where we make sure that the cancer never comes back again. So it's mostly as a guarantee or increase the chance. of a cure that will be pivotal in cancer treatments. These are early stage treatment right now and just at the experimental stages. How do you balance the sense of optimism and hope that people have with the pragmatism that is essential because it's early days? Yeah, this is a great question.

I mean, some trials are in phase one, but, you know, the trials that we have in Canada are already in the phase two, end of phase two. So we're hoping to get those results by, I would say, another year or so. So we're not really that far away from really knowing and defining which cancer will respond to the vaccines. So I'm hoping really in the next 18 months we'll definitely start to get very advanced results in research and start seeing them more and more in clinic in the next five years or so. You know, we don't talk a lot about cost of care, health care, in this country for a number of reasons. And perhaps we should talk more about it. But when it

comes to something like this, if this is personalized, individualized treatment, do we have a sense as to how much it would cost to create and administer that sort of care? Yeah, I like this question. I think we should start asking that question more and more in our healthcare system should start considering those costs. We should be more proactive than reactive. The cancer vaccines are very complex to produce, as my colleague at Sloan Kettering was mentioning. They will definitely have a very steep cost. This is not in the thousands of dollars. This is definitely in the six digits. I think what would be important for Canada to stay ahead of the curve, start planning. Do we have enough labs to produce those vaccines and start figuring out the operational aspect? The faster we

figure out that part, I think the lower the cost. What is the role of our public healthcare system then in helping to push this forward? Because a lot of the research is being done, as you know, by private pharmaceutical companies. They have the war chest to be able to push something like this forward and obviously have a vested interest if the vaccines are successful. But is there a role that the public health care system and the government should play in this? If it is as promising as you're suggesting? Yeah, absolutely, Matt.

I think you remember in COVID when it hit, we started realizing we don't have enough infrastructure, you know, how to produce masks or basic things during the COVID wave. I think what we should do is not to be, reactive. We should as of now think as a public health care system, do we have enough biotechnological manufacturing plants for MRNA vaccines? Do we have enough of the equipment spread around our country is huge? Our biggest, I would say, enemy is our geography. And I think if as of now the public health care system maps out the different parts to produce those things

and start early negotiating with pharma companies or forming alliances, but also the great news is in our public health care system. There's a lot of academic centers, British Columbia and Alberta and Ontario and Quebec, where those centers are producing their own RNA vaccines to be tested. So we should invest in those also to see which cancer vaccine is going to work. Are we uniquely positioned in this country? In the United States, you have the health secretary, RFK Jr., who canceled, what, $500 million in mRNA vaccine development last year. He has been stirring up public distrust. in this technology, are we uniquely positioned here to try to take advantage of something like that? This is the best time to be proud to being a Canadian, to be honest with you. We have, in my opinion,

despite all the challenges, one of the best healthcare system. You know, as a cancer patient, the last thing you want to worry is costs and access of drugs. We don't have that. Our patients only focus on getting treated. The cancer patients in Canada are very invested in going on research trials, you know, at the end of the day, you want the best chances to survive. This is about life or death. And the Canadian people try as much as possible to embark on those trials. So I'm really not worried about that. I have to let you go.

But just personally, what does it like to be involved in something like this that will change lives down the line? You know the potential of this. If you can answer some of those questions and the people, generations from now may benefit from this. What does that like? Honestly, I love my job. I think it's awesome. I call it the bird's eye view. Doing phase one and phase two, clinical trials shows me what's coming next over the next five years.

And I can tell you, there's amazing technologies that are already happening in Canada that definitely are going to change the course of cancer. I think the word cure and increased survival is going to be more and more common without the dismal news of you might die, you know, 90% at five years. So I'm really hoping we're going to turn the corner in the next five years. I think a lot of us are tired of dismal news. This is a great news story. Early days, but with real potential to your point. And the bird's eye view is an important one. Dr. Saleh, thank you very much.

It's my pleasure. Thank you for having me. Dr. Rami Saleh is an associate professor at McGill University. He leads a cancer research unit working with MRNA vaccines. You've been listening to the current podcast. My name is Matt Galloway. Thanks for listening. I'll talk to you soon.

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