“Despite the promise, scientists say the next phase of mRNA innovation will be slower and more challenging than the COVID-19 sprint.“
The Next Frontier: Can mRNA Tackle Cancer And HIV?
When the world first heard of mRNA vaccines in 2020, they seemed almost magical — a pandemic fix born from decades of quiet experimentation.
Five years later, mRNA technology is evolving from a crisis tool to a cornerstone of modern medicine.
Now, research teams worldwide are asking a bold question: If mRNA can stop COVID-19, can it also combat cancer, HIV, and rare genetic disorders?
From Pandemic Breakthrough To Medical Platform
mRNA — short for messenger RNA — teaches human cells to make specific proteins that trigger immune responses or correct faulty biological processes.
Because it’s programmable, it allows scientists to design new vaccines or therapeutics in weeks rather than years.
According to Nature Reviews Drug Discovery, over 230 mRNA-based drugs and vaccines are currently in active development globally, targeting a range of conditions, from seasonal flu to enzyme deficiencies.
Four areas are leading the charge: infectious disease, cancer, HIV, and rare genetic disorders.
“Cancer, HIV, and rare diseases could be mRNA’s true test — not COVID.”
The Next Big Test: Influenza And RSV
After COVID-19, the next big proving ground for mRNA is influenza — a virus that mutates every year, forcing scientists to guess which strain will dominate.
Moderna’s mRNA-1010, a seasonal flu vaccine, just delivered strong phase 3 results in adults aged 50 and older.
Reported in June 2025, the vaccine demonstrated a 26.6% higher efficacy compared to a leading licensed shot — a first for any mRNA flu candidate. The company now plans to file for regulatory approval later this year.
Meanwhile, mRNA-1345, Moderna’s RSV vaccine, has shown durable protection in older adults for over eight months, according to The Lancet Infectious Diseases.
With RSV hospitalisations rising worldwide, this could signal a major shift in how we prevent respiratory illnesses.
HIV: Inching Toward The Impossible
No virus has outsmarted scientists quite like HIV. It mutates rapidly, hides within cells, and thwarts traditional vaccine designs. But mRNA could offer a new angle.
This year, Moderna and the International AIDS Vaccine Initiative (IAVI) announced early results from a trial aimed at eliciting broadly neutralising antibodies — rare immune responses capable of tackling multiple HIV strains.
The results, although early, demonstrated that mRNA can safely deliver complex immunogens that guide the immune system in the desired direction.
Dr Mark Feinberg, IAVI’s CEO, described it as “a critical first step” in developing a true HIV vaccine.
Still, experts caution that success will likely require multi-dose regimens and years of optimisation.
Cancer Vaccines: Personal Medicine Gets Personal
Perhaps the most ambitious use of mRNA is in personalised cancer vaccines — tailored shots that teach the immune system to recognise and attack a patient’s own tumour cells.
In 2024–2025, studies published in Nature and Science reported promising data from trials combining mRNA cancer vaccines with immunotherapy drugs.
Moderna and BioNTech both unveiled early results showing reduced recurrence rates in patients with melanoma and pancreatic cancer.
These vaccines are custom-built: tumour DNA is sequenced, key mutations are identified, and an mRNA sequence is printed to code for those tumour markers. The vaccine then “shows” them to the immune system, training T-cells to attack.
However, cost, logistics, and regulation remain steep challenges. Each vaccine must be made-to-order, requiring new manufacturing and delivery pipelines.
Rare Diseases: Treating The Untreatable
Beyond infectious and immune diseases lies a quieter revolution: mRNA as therapy.
Instead of making antibodies or triggering immune responses, therapeutic mRNA can replace missing or defective proteins — the root cause of many rare genetic diseases.
In 2024, Moderna’s mRNA-3705 for methylmalonic acidemia became one of the first gene-replacement mRNA therapies to enter the FDA’s START program for rare diseases.
Early data indicate that the platform can express functional enzymes in patients who otherwise lack them — a milestone that could unlock treatments for conditions such as cystic fibrosis, glycogen storage disease, or phenylketonuria (PKU).
What’s Holding mRNA Back?
Despite the promise, scientists say the next phase of mRNA innovation will be slower and more challenging than the COVID-19 sprint.
- Durability: mRNA vaccines may lose effectiveness more quickly than traditional ones, particularly against upper respiratory infections.
- Delivery: Delivering mRNA into tissues beyond muscle — such as the lungs or liver — remains technically challenging.
- Manufacturing: Personalised cancer vaccines and therapies for rare diseases require flexible, local production, not mass production in factories.
- Politics And Funding: U.S. federal budget reviews in 2025 have already delayed several mRNA research programs, underscoring how shifts in funding can slow scientific progress.
Still, the scientific consensus is clear: mRNA is here to stay — but it will evolve in fits and starts, not leaps.
What To Watch Next
- Regulatory approvals for flu (mRNA-1010) and RSV (mRNA-1345): Both could redefine seasonal vaccine schedules.
- HIV bnAb trials: Success here would be a watershed for immunology.
- Neoantigen vaccine + immunotherapy combos: The holy grail for personalised cancer care.
- Rare disease programs in FDA START: These could mark the first mRNA therapeutics approved for enzyme disorders.
The Big Picture
mRNA is no longer a pandemic hero story — it’s a platform reshaping how we think about vaccines, immunotherapy, and genetic medicine.
Each clinical success brings it closer to mainstream healthcare. Yet for now, progress will depend on whether global health systems, regulators, and innovators can move as fast — and as boldly — as the science.
“mRNA isn’t just about vaccines anymore — it’s about rewriting what’s treatable.”
