# Personalized mRNA vaccine: figure sources and representation notes
Reviewed 13 September 2026. Independent educational example; no sponsor commission or endorsement.

## Figure 1: Mechanism
Eight conceptual panels connect target selection, mRNA delivery, translation, antigen processing and MHC presentation, T-cell priming, PD-1 blockade, recognition and a possible cellular response. Intismeran autogene (V940/mRNA-4157) remains investigational. The formulation, geometry, trajectories, membrane crossings, cell layout and timing are illustrative. Not every delivered RNA particle escapes its endosome; recognition does not imply every target is eliminated. Costimulation and CD4 help are not fully drawn.

Experimental structures used in the interactive film: [7PHR](https://www.rcsb.org/structure/7PHR), [8JDM](https://www.rcsb.org/structure/8JDM), [5GGS](https://www.rcsb.org/structure/5GGS). The gp100 recognition complex is a representative structure, not a measured V940 patient-specific antigen. The PD-1 visual uses a Fab fragment, not an intact antibody.

## Figure 2: Clinical evidence
KEYNOTE-942 is randomized open-label Phase 2b (157 patients, resected high-risk stage III/IV melanoma). Median five-year recurrence-free survival HR 0.510 (95% CI 0.294–0.887), combination versus pembrolizumab alone. RFS concerns recurrence, new primary melanoma or death in this Phase 2b definition. The figure shows a reported hazard ratio and confidence interval, not a reconstructed survival curve or absolute risk estimate.

INTerpath-001 is randomized double-blind Phase 3 (1,137 patients, resected stage IIB–IV melanoma). Its August topline reported RFS and DMFS endpoints met; numerical effects were not disclosed in that release. OS follow-up continues. Trial-specific populations and analyses must not be pooled. Pembrolizumab has serious immune-mediated risks; see full prescribing information.

- [KEYNOTE-942 sponsor update, 20 January 2026](https://www.merck.com/news/moderna-merck-announce-5-year-data-for-intismeran-autogene-in-combination-with-keytruda-pembrolizumab-demonstrated-sustained-improvement-in-the-primary-endpoint-of-recurrence-free-survival-i/)
- [INTerpath-001 sponsor update, 19 August 2026](https://www.merck.com/news/merck-and-moderna-announce-phase-3-interpath-001-trial-of-intismeran-autogene-plus-keytruda-met-endpoints-of-recurrence-free-survival-rfs-and-distant-metastasis-free-survival-dmfs-in-patient/)
- [KEYNOTE-942 registry](https://clinicaltrials.gov/study/NCT03897881)
- [INTerpath-001 registry](https://clinicaltrials.gov/study/NCT05933577)
- [KEYTRUDA prescribing information](https://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_pi.pdf)