雅思阅读 53: The Personalised mRNA Cancer Vaccine（个性化mRNA癌症疫苗）

改编自 CNN / Merck & Moderna 官方公告（2026年8月）。雅思阅读 Section 3 难度，约 1050 词。 素材来源：https://lite.cnn.com/2026/08/19/health/moderna-merck-mrna-melanoma-vaccine

Reading Passage

A. Messenger RNA, the molecule that became famous during the COVID-19 pandemic, was never meant to live or die by a single viral disease. Researchers had been tinkering with it for decades before 2020, precisely because it promised something almost no other drug could offer: a set of instructions that any human cell could be made to read. In a conventional vaccine, a weakened germ or a purified protein is injected to provoke immunity. With mRNA, the body itself becomes the factory. A strand of synthetic RNA tells a muscle cell to manufacture a fragment of a pathogen, briefly, and then the cell degrades the message. The immune system, presented with that unfamiliar fragment, learns to recognise it. When the pharmaceutical company Moderna and its long-time partner Merck began applying the same logic to cancer, they were betting that the immune system could be taught to recognise something far more elusive than a virus — the specific, private mutations that distinguish one patient's tumour from everyone else's. That bet, once regarded as speculative, has now paid off in a late-stage clinical trial that oncologists are calling a landmark.

B. A personalised cancer vaccine is not manufactured in bulk and stored on a shelf. It is, rather, a custom product that begins with a biopsy. Surgeons remove a patient's tumour, which is then sequenced to identify the genetic errors — the mutations — that have turned ordinary cells cancerous. Most of these errors are silent, but a handful produce abnormal protein fragments, known as neoantigens, that appear on the cancer cell's surface and nowhere else in the body. Algorithms compare these neoantigens against the patient's own immune type, encoded by molecules called HLA proteins, and pick the handful most likely to trigger a strong T-cell response. From that list, chemists synthesise a strand of mRNA carrying the instructions for those chosen fragments. The resulting vaccine, called intismeran autogene or mRNA-4157, is therefore unique to one person; a dose made for one patient is worthless to any other. The elegance of the approach is that it attacks tumours by their very nature — their mutated, self-alienating identity — rather than by a broad chemical poison that harms healthy cells along the way.

C. The clinical evidence supporting this strategy accumulated slowly at first, then decisively. In a Phase 2b trial known as KEYNOTE-942, patients whose high-risk melanoma had been surgically removed were given either Merck's immunotherapy drug pembrolizumab, sold as Keytruda, or the same immunotherapy plus the personalised mRNA vaccine. At five years of follow-up, the combination had reduced the risk of recurrence or death by 49 percent and the risk of distant metastasis or death by 62 percent compared with Keytruda alone. Those encouraging figures set the stage for the larger Phase 3 trial, called INTerpath-001, which enrolled 1,137 patients with completely resected stage IIB, IIC, III or IV melanoma. In August 2026 the companies announced that the interim analysis had met both its primary endpoint — recurrence-free survival — and its key secondary endpoint of distant-metastasis-free survival, on top of standard PD-1 blockade. Georgina Long, the trial's principal investigator, described it as the first late-stage study to show that a treatment built on the unique mutational fingerprint of a patient's own tumour could reduce the danger of the disease returning.

D. For all the excitement, the path from a successful trial to a widely available treatment is littered with practical obstacles. Manufacturing the vaccine is slow: each dose must be sequenced, designed, synthesised and tested individually, a process that historically took months, and months are a luxury a cancer patient may not have. The cost of such bespoke production, if not scaled, could place the therapy far beyond reach in health systems outside the wealthiest countries. Neoantigen prediction itself is imperfect; algorithms rank which mutations will most reliably attract T cells, but they still guess, and a guessed target may fail to provoke a response at all. Regulators, meanwhile, have never approved a drug that is remade for every patient, and the U.S. Food and Drug Administration's earlier refusal to approve a similar promising melanoma treatment is a reminder that statistical hope in a trial does not automatically translate into a marketable medicine. The combination with Keytruda is also double-edged: while the immunotherapy releases the natural brakes on T cells, the added mRNA vaccine primes them, and the combined effect on the immune system can produce toxic side effects that neither drug causes alone.

E. Even if every one of these hurdles is cleared, the melanoma trial is best understood as a proof of principle rather than an endpoint. The same partners have already initiated Phase 3 studies of the mRNA approach in non-small-cell lung cancer and squamous-cell skin carcinoma, and dozens of smaller programmes are testing it against ovarian, pancreatic and colorectal tumours. The broader vision is a shift in how cancer is treated: from one-size-fits-all chemotherapy and surgery to a rapid-response, individually designed intervention that teaches the body's own defences to recognise the enemy. Whether that vision becomes routine care depends on whether the manufacturing pipeline can be made faster and cheaper, and whether the predictive algorithms can be trained to pick reliable neoantigens with fewer misses. If they can, the late-stage melanoma results announced in 2026 may be remembered not as a single drug approval, but as the moment mRNA stopped being a pandemic technology and became a platform for treating a disease that, for most of medical history, was fought only after it had already spread. The cost question will not disappear quietly. Health systems will have to decide whether a therapy that takes months to build for one patient is worth its price tag when cheaper, if cruder, alternatives already exist, and whether the manufacturing pipeline can be scaled to reach patients in middle-income countries rather than only those in Boston, Berlin or Sydney. Yet the underlying scientific point is hard to dismiss: for the first time, a drug has been designed from the unique mutational fingerprint of one tumour rather than from the averages of millions. The next decade will determine whether that bespoke approach remains a luxury or becomes, like the mRNA vaccines that preceded it, a routine part of medicine.

Questions 1-4

Choose the correct heading for paragraphs B, C, D and E from the list of headings below.

List of Headings i. How a personalised vaccine is designed from a tumour ii. The clinical evidence for the combination therapy iii. Why manufacturing remains a practical obstacle iv. Beyond melanoma: a broader treatment vision v. A history of messenger RNA research vi. The economics of hospital administration vii. How COVID-19 vaccines were stored

1. Paragraph B: ____
2. Paragraph C: ____
3. Paragraph D: ____
4. Paragraph E: ____

Questions 5-8

Choose the correct letter, A, B, C or D.

5. Why is intismeran described as unique to each patient? A. It is derived from a different animal species for every patient. B. It is built from the specific mutations found in that patient's tumour. C. It is manufactured in a different country for each patient. D. It contains a standardised dose of a universal protein.

6. What did the five-year follow-up of KEYNOTE-942 show? A. The vaccine had no effect on survival. B. The combination reduced recurrence or death by 49 percent. C. Keytruda alone was superior to the combination. D. All patients were cured of their melanoma.

7. Why is the mRNA vaccine given together with Keytruda? A. Keytruda preserves the vaccine from decay. B. The vaccine primes T cells while Keytruda releases their natural brakes. C. Keytruda reduces the cost of the mRNA dose. D. The combination avoids any side effects entirely.

8. According to the writer, what remains a significant practical difficulty? A. The vaccine cannot be stored at room temperature. B. Manufacturing each dose individually is slow and potentially costly. C. Tumours cannot currently be sequenced at all. D. Patients refuse personalised treatment.

Questions 9-13

Do the following statements agree with the claims of the writer?

Write:

• TRUE if the statement agrees with the information
• FALSE if the statement contradicts the information
• NOT GIVEN if there is no information on this

9. The mRNA vaccine dose made for one patient is effective for any other patient with the same cancer.
10. The Phase 3 INTerpath-001 trial enrolled more than a thousand patients.
11. The intismeran treatment had already received full FDA approval at the time of the announcement.
12. The manufacturers intend to test the same mRNA approach in lung cancer patients.
13. The personalised vaccine is currently cheaper than conventional chemotherapy.

Questions 14-15

Complete the summary below using NO MORE THAN TWO WORDS from the passage.

After a tumour is removed and sequenced, algorithms select abnormal surface fragments called (14) __________, and the synthetic mRNA is delivered alongside Merck's immunotherapy known as (15) __________.

答案与解析

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