Cancerwise

Tony Hout first noticed a sore on the top of his ear after he got a bad sunburn while watching his son play soccer in the summer of 2023. It kept scabbing over and bleeding. “I thought it was just taking a long time to heal,” he recalls.

Fast-forward to March 2024: his ear became swollen, red and painful during a family lake trip. A visit to urgent care led him to a dermatologist, who biopsied the sore and a spot on his chest. Both came back positive for stage 2 melanoma, the most aggressive type of skin cancer.

The dermatologist sent Tony to UT MD Anderson. He and his wife, Kim, lived near Houston at the time, so they knew of UT MD Anderson’s reputation.

Surgery revealed his melanoma had spread 

At UT MD Anderson, Tony met with surgical oncologist Ashley Holder, M.D.

During surgery, surgeons found melanoma in a lymph node in his neck. UT MD Anderson changed his diagnosis to stage 3C melanoma.

“Learning that the melanoma had spread changed the way I thought about my future,” Tony says. He wanted to understand his treatment options and what they meant for him and his family.

Research nurse Sydney Nguyen told him about a Phase 3 clinical trial led by melanoma specialist and researcher Hussein Tawbi, M.D., Ph.D., at UT MD Anderson. The trial was testing a personalized messenger RNA (mRNA) cancer vaccine that would be made using tissue removed during Tony’s surgery.

How a personalized melanoma vaccine works 

To make a personalized vaccine, researchers would analyze the tumor removed during surgery to identify genetic changes that make it different from normal cells. These mutations can produce abnormal proteins called neoantigens. Researchers would use this information to create a personalized mRNA vaccine for Tony that would train his immune system to recognize the tumor cells.

For people with stage 3C melanoma, the risk of melanoma returning can be more than 50%. Immunotherapy can cut that risk nearly in half, and researchers hope a personalized vaccine given with pembrolizumab, an immunotherapy drug that helps the immune system target cancer cells, can reduce the risk even further.

Joining the melanoma vaccine clinical trial 

Tony’s family read the study materials and talked through the decision. Some of his children were skeptical about vaccines, and he had questions, too.

“We’re talking about joining something that’s really cutting-edge,” he remembers thinking.

After weighing their options, Tony and his family chose to move forward with the clinical trial, hopeful that the personalized cancer vaccine could offer him more time.

The trial was double-blind, which meant that Tony didn't know whether he was receiving the investigational vaccine or a placebo. He did know that he was experiencing significant side effects after his injections.

The fatigue hit within hours. After his Friday injections, he sometimes couldn’t get out of bed until Tuesday.

Around his sixth injection, doctors found squamous cell carcinoma on his hand. He had Mohs surgery to remove the cancer; the surgeons used tissue from under his arm to repair his hand.

Just two days later, he received another trial injection in his other arm. Recovering from hand surgery while managing the vaccine’s side effects made that week especially hard. He wondered if he could make it through the remaining injections. But he kept going and completed them.