Moderna's betting big on personalized vaccines to treat cancer. Its CEO lays out his vision for how it could transform healthcare.

• Personalized cancer vaccines could provide a new way to fight early cancer cases.
• The COVID-19 vaccine developer Moderna just announced positive results for a skin-cancer vaccine.

A lack of confidence has never been an issue for Moderna and its CEO.

An unwavering belief in messenger RNA, or mRNA, the genetic technology at the core of its technology platform, helped Moderna develop a coronavirus vaccine in record time in 2020. Now, Moderna CEO Stéphane Bancel is outlining another audacious goal: upending how cancer is treated, including the idea of finding and treating cancer in seemingly healthy people at their annual physicals.

On Tuesday, the Cambridge, Massachusetts-based biotech said a midstage study in skin cancer succeeded, as its vaccine reduced the likelihood that people would die from the cancer returning. The $77 billion biotech saw its stock price jump 20% Tuesday after the results were announced.

In an interview, Bancel shared his vision on how these personalized cancer vaccines could transform cancer care. Similar to how Bancel talked about the need to spend billions on manufacturing capacity or how Moderna planned to price its COVID-19 vaccine in the early months of 2020, he is now talking about the future for these cancer programs well before they are commercially approved.

Moderna will launch more cancer-vaccine studies in 2023

In addition to launching a flurry of late-stage studies for its cancer vaccine in 2023, Bancel said his team is also interested in taking advantage of the emerging field of blood-cancer tests called liquid biopsies.

Companies like Illumina's Grail, Exact Sciences, and Freenome are now developing these cancer-screening tests, which could be a $50 billion-plus market, according to analysts at the investment bank SVB Securities.

"Maybe, potentially, as liquid biopsy improves as a technology, you could see a world, maybe in a few years, where you do your blood work for your physical, a liquid biopsy is run on your blood, it sees an early sign of cancer, we make a cancer vaccine for you, and you get the vaccine," Bancel said.

The goal would be to kill cancer in its infancy, before it even grows into a tumor that can be seen by typical imaging techniques like PET scans. Based off the blood work, Moderna would design vaccines that target the genetic mutations in cancerous cells that stand out from healthy cells. Like the COVID-19 vaccine, these shots use mRNA to get inside immune cells and instruct those cells to produce particular proteins that help fight that person's cancer.

Bancel didn't specify exactly how Moderna could work with liquid biopsies, such as partnering with diagnostic companies.

Bancel says mRNA could be 'a big change in cancer care'

If this works out — a big if that will likely take years to play out — liquid biopsies and cancer vaccines could change the way cancer is detected and treated. The blood tests could find cancer before it grows too much, and mRNA vaccines could squash it.

Bancel acknowledges a lot of work still has to be done to realize that vision. The blood tests still face questions about their usefulness in the real world, particularly their accuracy in detecting cancer. And the skin-cancer results for Moderna's vaccine are preliminary, as the data has yet to be published in a journal or presented at a medical conference. Moderna will likely have to run a larger study to confirm that result as well before seeking approval.

Still, Bancel said he will invest aggressively in cancer research with Moderna's $17 billion balance sheet. He compared the potential impact on cancer to the checkpoint inhibitors, a class of best-selling immunotherapies that have revolutionized treatment of many cancer types like skin, lung, and head and neck.

"We have to explore, we have to demonstrate, but when you think about where this could lead to, this could lead to immunotherapy 2.0," Bancel said. "A big change in cancer care, as big or bigger than the checkpoints were to cancer treatment."