mRNA vaccine targeting KRAS-mutated cancers

Safety and Efficacy of KRAS Vaccine in the Treatment of KRAS-mutant Malignancies

We will try an mRNA vaccine that targets KRAS mutations in adults with KRAS-mutated solid tumors, given alone or with the immunotherapy drug toripalimab and/or standard chemotherapy.

Quick facts

• Phase: PHASE1
• Study type: Interventional
• Enrollment: 20 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Sichuan University (other)
• Drugs / interventions: prednisone, immunotherapy
• Locations: 1 site (Chengdu, Sichuan)
• Trial ID: NCT07004244 on ClinicalTrials.gov

What this trial studies

This is a Phase 1 trial testing the safety and preliminary efficacy of an mRNA vaccine designed to target KRAS-mutant tumors, with some participants also receiving the PD-1 antibody toripalimab and/or pemetrexed plus carboplatin. The trial enrolls adults with KRAS-mutated solid tumors who have measurable disease and good performance status (ECOG 0-1), and includes a cohort of newly diagnosed, resectable KRAS-mutant lung adenocarcinoma (specific KRAS variants listed). Primary objectives focus on safety and tolerability with secondary objectives including early signs of anti-tumor activity. Treatments are administered at West China Hospital, Sichuan University, with standard phase 1 monitoring for adverse events and tumor response by RECIST 1.1.

Who should consider this trial

Good fit: Adults (≥18 years) with solid tumors confirmed to carry KRAS mutations, measurable disease, ECOG 0-1, and adequate organ and marrow function—including a cohort for resectable KRAS G12C/G12D/G12V/G13D lung adenocarcinoma or patients who have exhausted or are ineligible for standard therapy.

Not a fit: Patients without KRAS mutations, those with other active malignancies, untreated primary central nervous system disease, poor performance status, or mutations not covered by the vaccine are less likely to benefit from this trial.

Why it matters

Potential benefit: If successful, the vaccine could stimulate immune attacks on KRAS-mutant cancer cells and provide a new precision treatment option for patients with KRAS-driven tumors.

How similar studies have performed: While targeted small-molecule drugs against specific KRAS mutations (e.g., G12C inhibitors) have shown clinical benefit, KRAS-directed mRNA vaccines are a novel approach with only early-stage clinical data available so far.

Eligibility criteria

Key Inclusion Criteria:

* Male or female participants ≥18 years of age.
* Participants with solid tumors confirmed to carry KRAS mutations.
* At least one measurable lesion according to RECIST 1.1 criteria.
* ECOG physical condition score: 0-1 point.
* Adequate organ and bone marrow function.
* Ability to understand and voluntarily provide written informed consent before trial participation.

Cohort-specific Inclusion Criteria:

Cohort 1:

* Failure of prior standard therapy, intolerance to standard therapy, ineligibility for standard therapy, or absence of a standard treatment regimen.
* Life expectancy ≥3 months.

Cohort 2:

* Newly diagnosed, treatment-naïve lung adenocarcinoma confirmed by pathology (histology/cytology).
* Resectable disease classified as stage IB-IIIA per AJCC 9th edition criteria.
* KRAS G12C/G12D/G12V/G13D mutation-positive by genomic testing.

Exclusion Criteria:

* Patients with a history of other malignancies.
* Presence of primary central nervous system (CNS) tumors, active CNS metastatic tumors, or carcinomatous meningitis, either historically or identified during screening.
* Uncontrolled moderate to massive serous cavity effusion.
* Confirmed presence of other classic gene variants.
* Known cardiac clinical symptoms or diseases that are poorly controlled.
* Unstable thrombotic events (e.g., deep vein thrombosis, arterial thrombosis, pulmonary embolism) requiring therapeutic intervention within 6 months prior to screening.
* Any active autoimmune disease or a history of autoimmune disease.
* Uncontrolled clinical disorders, psychiatric illnesses, or other significant diseases as assessed by the investigator that may interfere with informed consent, compromise interpretation of trial results, pose risks to participants, or otherwise hinder the achievement of trial objectives.
* History of interstitial pneumonia or suspected interstitial pneumonia; or pulmonary abnormalities that may interfere with the detection or management of suspected drug-related pulmonary toxicity during the trial.
* Hypersensitivity to the investigational drug (including any excipients).
* Patients who received anti-tumor therapy within 4 weeks prior to the first dose, or those with unresolved adverse reactions (except alopecia) from prior anti-tumor therapy (NCI CTCAE \> grade 1).
* Systemic use of corticosteroids (\>10 mg/day prednisone or equivalent) or other immunosuppressants within 14 days prior to the first dose.
* Participants who received drugs of the same class within 6 months prior to the first dose.
* Prior organ transplantation or allogeneic hematopoietic stem cell transplantation.
* Active hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), or syphilis infection.
* Active tuberculosis (TB) or a history of active TB; or severe acute/chronic infections requiring systemic treatment.
* Pregnant or lactating women.
* Any other factors deemed by the investigator to render the participant unsuitable for trial participation.

Where this trial is running

Chengdu, Sichuan

• West China Hospital, Sichuan University — Chengdu, Sichuan, China (RECRUITING)

Conditions: Malignant Tumors, KRAS-mutated malignancies, mRNA vaccines, treatment, safety, efficacy