After a melanoma diagnosis, mRNA cancer vaccine delivered a patient hope — and a path forward

When drugmakers Merck and Moderna announced promising results in August from a late-stage trial of adding an mRNA cancer vaccine to immunotherapy, it was heralded as potentially powerful new way of fighting tumors. But the data don’t show what such a treatment can mean for an individual patient. At the STAT Summit in Boston on Thursday, a patient in the clinical trial for the treatment, intismeran autogene, told his story virtually. Gary Keblish, a schoolteacher, was diagnosed with melanoma and felt lucky to be in the trial for intismeran and to be in the treatment arm. We’re including his prepared remarks, including references to the children’s television show “The Magic School Bus” and its teacher, Ms. Frizzle. My name is Gary Keblish. I am a public school teacher. I guide students on their individual pathways through secondary school and beyond. If their idea is to graduate high school, then I am here to help achieve a successful result. “To the bus!” as Ms. Frizzle would say. I am here today to uncover my pathway to a successful outcome after a high-risk melanoma diagnosis in 2019. Mine was a bit of a roller coaster ride, an emotional and physical adventure. My emotional bandwidth started out broad and steadily narrowed as neuropathy issues grew and then widened again as they resolved. I walked into my dermatologist’s office not exactly holding my head high — I had been remiss. It had been a couple of years since my last visit, and I felt ashamed. Two excisions later, and I was worried. But a referral to a surgical oncologist left me feeling hopeful. “This time, they’ll get it all,” I thought. A subsequent referral to an oncologist had me questioning, “What’s all this about?” Gary KeblishCourtesy Gary Keblish After my initial meeting with Jeffrey Weber, deputy director of the Perlmutter Cancer Center at NYU Langone and co-leader of its Clinical Melanoma Program, I was trepidatious. Would I, or wouldn’t I? Should I, or shouldn’t I? Relief and excitement soon followed. I was lucky; my name was drawn from the hat to be a participant in a clinical trial for a combination of the immunotherapy drug Keytruda and the mRNA cancer vaccine developed by Merck and Moderna. “To the bus!” I found myself thinking. Undergoing mRNA cancer vaccine and immunotherapy treatment is like a ride on “The Magic School Bus.” It’s an adventure full of emotions and physical changes. “Seatbelts, everyone!” I am supported in life by happy, healthy, nurturing family and friends. The contingent of medical professionals and support staff, serving during the Covid-19 pandemic no less, proved to be no different, and to them I bow down! Ongoing visits with Dr. Weber and his colleagues provided me with the guidance and support needed on my journey to renewed health. Together, they set a clear path and encouraged me to maintain focus on the proverbial light at the end of the tunnel. I always knew that I would come out the other end. What I didn’t anticipate, however, was the physical and mental tension that comes with neuropathy. Tincture of time to the rescue; eventually, I wasn’t discouraged from sitting down for fear of having to get up. But I had to make a conscious decision to be happy again, because neuropathy daily affected my outlook. It taught me to feel less. It rendered me less physically active than I might have been, and it clouded my judgement. Fortunately, both Dr. Weber and my family were able to read between the lines and push me in the right direction. Oof! That must not have been easy. At the end of every episode of “The Magic School Bus,” all the students returned safe to the classroom, even after navigating intestines, nostrils, and Mars. So did I. I’m back in the classroom teaching. In truth, I never had to leave, and it has been six years since my tumor was removed. I’m thrilled that I got the treatment! Keep doing what you do best and let the excellent adventures continue. To the bus, everyone!