This is still an evolving area so hopefully some of my followers who know more will chime in Scientifically, it is very cool. Tumors, being made of mutated cells, can make unique proteins not present in the healthy cells. Unique proteins offer a suitable target for the immune system to attack. This is the basis for the immune system to kill bacteria and viruses, since they have many unique proteins not present in the human body. Instead of waiting for the body to “figure this out” we can use modern biotech to sequence the genetic code and create an mRNA vaccine that will perfectly match the unique cancer protein and ~hopefully~ trigger a unique immune response to your cancer. But … it is not perfect and not everyone will mount an immune response, and also … we can never be 100% sure there is not some other similar protein elsewhere in the body that might also be a target of the vaccine … from which will come side effects. And the sad truth is, historically, this approach has not been as effective as we would have expected. In the past, cancer vaccines have not always been as cooperative as we would like. Kind of underwhelming actually. So …like every new / experimental medicine … you will have uncertain benefits and uncertain side effects. And the best way to sort all that out would be to run clinical trials … except … how do you run a clinical trial for an “N of 1 vaccine” ?? There are ... challenges. The regulatory machine is grappling with this right now. Because it is simultaneously a bespoke treatment, and an experimental therapy at the same time. For sure, insurance companies are not going to want to pay for what amounts to a fairly expensive treatment with unclear benefit. Worst part is, even if the approach works for one person, you can’t extrapolate that to a different vaccine for a different cancer in a different person. It will always be “N of 1” Meanwhile the cancer community, especially the richer ones among them, are rightfully impatient waiting for the state to sort it out. I completely sympathize with them. “Right to try” and all that. On one front, I am absolutely supportive of patients trying things out with their own money and their own bodies, especially if they have a terminal / incurable disease. And provided there is proper consent. Our people should not have to travel to far abroad to get access to this. But I am not willing to say insurance or medicare should pay for experimental and unproven therapies. To end on a happy note - the recent Moderna study, combining modern immune therapy (pembrolizumab) plus a bespoke melanoma vaccine did have a positive result, which gives hope for the technique. They were able to pull off a clinical trial using bespoke vaccines, setting the model for trials to come. However, melanoma has always been recognized as an immunologically vulnerable cancer, and whether this approach will work broadly across the full range of tumors remains to be seen Put me down as a cautious optimist. Like every new cancer treatment, we will carve off a slice vulnerable to a novel effective therapy, but it will not be a panacea and we will have plenty more work to do when other cancers refuse to cooperate.