a16z General Partner Jorge Conde sits down with Moderna CEO Stéphane Bancel to discuss a major milestone for mRNA technology: positive Phase 3 results from Moderna and Merck’s individualized treatment for melanoma, after more than a decade of work on personalized cancer vaccines. Stéphane explains how the treatment works by sequencing an individual patient’s tumor and healthy cells, identifying the mutations most relevant to their cancer, and encoding up to 34 of them into an mRNA designed specifically for that patient. Rather than simply unleashing the immune system, the goal is to teach it exactly what to recognize and attack. They also unpack the engineering challenge of manufacturing a different medicine for every patient, how Moderna has brought the process down to roughly 42 days from biopsy to treatment, and what it would take to manufacture personalized medicines at scale. Finally, Stéphane looks beyond melanoma to lung, kidney, bladder, pancreatic, and gastric cancers, as well as Moderna’s longer-term work applying mRNA to rare genetic and autoimmune diseases. Timestamps: 00:00 - Intro 00:59 - How Moderna Went From COVID to Cancer 02:48 - The Phase 3 News: mRNA Cancer Vaccine + Keytruda in Melanoma 05:46 - What Is Keytruda & Why Isn't It Enough Alone? 09:23 - Preventing the Return of Cancer: What "Vaccine" Really Means Here 11:16 - Why 20 Years and 1,000 Trials Failed Before mRNA Worked 15:09 - Inside the Algorithm: How Moderna Picks the 34 Neoantigens 18:48 - The Operational Lift of Making a Vaccine for Every Patient 20:16 - Vein to Vein: How Fast Can You Deliver a Personalized Vaccine? 24:33 - Manufacturing at Scale & the COGS Question 27:08 - How Do You Regulate a Medicine That's Different Every Time? 29:37 - Beyond Melanoma: Which Cancers Are Next? 35:58 - The Full Arc: From COVID to Cancer to Autoimmune Disease Resources: Follow Stéphane Bancel on LinkedIn: https://www.linkedin.com/in/st%C3%A9phane-bancel-8185251/ Follow Jorge Conde on X: https://x.com/JorgeCondeBio Stay Updated: If you enjoyed this episode, be sure to like, subscribe, and share with your friends! Find a16z on X: https://twitter.com/a16z Find a16z on LinkedIn: https://www.linkedin.com/company/a16z Listen to the a16z Show on Spotify: https://open.spotify.com/show/5bC65RDvs3oxnLyqqvkUYX Listen to the a16z Show on Apple Podcasts: https://podcasts.apple.com/us/podcast/a16z-podcast/id842818711 Follow our host: https://x.com/eriktorenberg Please note that the content here is for informational purposes only; should NOT be taken as legal, business, tax, or investment advice or be used to evaluate any investment or security; and is not directed at any investors or potential investors in any a16z fund. a16z and its affiliates may maintain investments in the companies discussed. For more details please see http://a16z.com/disclosures.