ctDNA can in theory be used to sequence the cancer.
I don’t think that’s a good idea. It’s not the same and would be hard to separate from other cfDNA.
Moderna has just put an individualized cancer vaccine into a phase III Do you think that trial is a bad idea?
What Moderna is doing is sequencing cancer cells and healthy cells, and using some algorithm to guess what mRNA vaccine would work. I think they’re not quite there yet: the hazard ratio with a checkpoint inhibitor isn’t much better than the checkpoint inhibitor alone, and I always discount the reported performance in small trials a bit. (And looking at the stock price, Wall Street seems to agree.) Note also that it’s specifically for certain types of melanoma, and comes after several failed cancer mRNA vaccine trials. That limitation to melanoma types indicates to me that their algorithm and its personalization are probably rather limited.
It’s not that I’m opposed to Moderna doing their trial per se, but I am a bit concerned that their patents could ultimately result in a net reduction in progress.
That’s very true.
That’s not what I said: I said it’s not harder and seems better. I’m aware of the chemistry involved and stand by that. Contrary to your implication, oligonucleotide synthesis also requires protecting groups.