多娜·古斯塔夫森（左）和丈夫埃德·古斯塔夫森。七年前，多娜接种了首剂mRNA癌症疫苗，用于治疗胰腺癌。
Donna Gustafson (left) and her husband, Ed Gustafson. Donna had her first mRNA cancer vaccine seven years ago to treat her pancreatic cancer.
Yuki Noguchi/NPR 多娜·古斯塔夫森正在活出一名癌症患者的梦想。
Yuki Noguchi/NPR Donna Gustafson is living a cancer patient's fantasy.
今年72岁的退休会计师多娜徒步、旅行、举重，并与结婚50年的丈夫埃德交换深情的目光。所有这些时刻都发生在她毫无二期胰腺癌迹象的情况下——这种癌症本应在数年前夺走她的生命。
At 72, the retired accountant hikes, travels, lifts weights, and exchanges adoring glances with Ed, the husband she married 50 years ago. All these moments are happening while she shows zero evidence of the Stage II pancreatic cancer that was supposed to kill her years ago.
“我拥有100%的生活质量；我已恢复到病前的状态，”古斯塔夫森说。
"I have had 100% quality of life; I am back to where I was prior," Gustafson says.
“她比那更好，”丈夫插话道。“她更风趣，身体状况是这辈子最好的时候——毫无疑问。”七年前，古斯塔夫森成为全球首位接种旨在治疗胰腺癌的mRNA疫苗的受试者。胰腺癌是一种高度致命的疾病，每年约有7万名美国人被确诊。针对该病鲜有有效疗法，但古斯塔夫森接种的是个性化版本，利用她的肿瘤样本制造，旨在重编程她的免疫细胞——实质上是训练它们识别癌细胞上独特的突变蛋白并将其杀灭。
"She's better than that," her husband interjects. "She's sassier, and she's in the best shape of her life — there's no question about that." Seven years ago, Gustafson became the world's first recipient of an mRNA vaccine designed to treat pancreatic cancer, a highly lethal disease diagnosed in about 70,000 Americans every year. There are few effective treatments for the disease, but Gustafson's was a personalized version, created using samples of her tumor, aiming to reprogram her immune cells — training them, essentially, to recognize distinctive mutant proteins on cancerous cells and kill them.
mRNA疫苗迎来高光时刻 今年对利用mRNA的癌症疫苗而言是重要的一年，特别是在默克和莫德纳两家药企上月公布mRNA疫苗治疗皮肤癌的首个大型成功试验结果后，显示复发和死亡风险在两年内降低了42%。
mRNA vaccines having a moment It's been a big year for cancer vaccines using mRNA especially after drugmakers Merck and Moderna released results last month from the first major successful trial of mRNA vaccines for skin cancer, showing a 42% reduction in recurrence and death over two years.
结合mRNA、基因组学和人工智能的多种技术帮助研制出了这些疫苗，目前也在针对肺癌、肾癌、膀胱癌和脑癌进行测试。但研究人员尚不清楚为何一些试验失败，而另一些却出现了古斯塔夫森这样令人瞠目结舌的成果。
A combination of technologies using mRNA, genomics and AI, helped create these vaccines, which are also being tested on lung, kidney, bladder and brain cancers. But researchers don't yet understand why some trials have failed, while others show eye-popping results in the form of people like Gustafson.
古斯塔夫森的时间分配在新泽西州和佛罗里达州，她表示，自己并不害怕第一个测试这种针对胰腺癌的概念。她将自己能够找到并加入这项试验归功于她三个成年的女儿。“这是个不用动脑筋的决定，”她说，“我知道从统计学上讲，我存活的几率很低，我非常高兴能获得某种希望。”古斯塔夫森接受了九剂疫苗，并进行了手术和化疗。她是一项包含16名胰腺癌患者的小型临床试验的参与者。该疫苗对半数患者有效，这八人中有七人至今仍在世。
Gustafson, who splits her time between New Jersey and Florida, says she wasn't scared to be first to test this concept against pancreatic cancer. She credits her three grown daughters for finding and getting her into the trial. "It was a no brainer," she says. "I knew that statistically, the odds of my survival were low, and I was very happy to be offered some type of hope." Gustafson received nine doses of the vaccine, along with surgery and chemotherapy. She was part of a small clinical trial involving 16 pancreatic cancer patients. The vaccine worked on half of the patients, and seven of those eight are still alive today.
对于使用这些疫苗的患者来说，治疗也是一个更容易的选择。埃德·古斯塔夫森（Ed Gustafson）不寒而栗地表示，这根本无法与化疗相比，化疗需要数小时的输液，并伴随着对他妻子来说“野蛮”的后遗症。
For patients on these vaccines, treatment is also an easier option. It does not compare to chemotherapy, which requires hours of infusion and comes with after-effects that were "barbaric" for his wife, Ed Gustafson says with a shudder.
相比之下，多娜·古斯塔夫森（Donna Gustafson）说，注射这些针剂毫无感觉。“我没有任何症状，也没有副作用——甚至到了我实际上开始担心它可能没有起作用的地步。”但它确实起作用了。而且非常迅速。
By contrast: The shots felt like nothing, Donna Gustafson says. "I had no symptoms, no side effects — to the point where I was actually worried that maybe it was not helping." But it was. Very swiftly.
外科医生兼科学家维诺德·巴拉钱德兰（Vinod Balachandran）在纽约市的纪念斯隆·凯特琳癌症中心主持了这项试验。他研究中使用的疫苗是在一个宽敞的实验室里制造的，里面有成排的冰柜、办公桌、离心机和细胞仪。患者对治疗的反应在该实验室中进行测量。在那里工作的肿瘤学家和数学家致力于解码胰腺癌，然后逆向工程对抗它所需的mRNA。
Surgeon and scientist Vinod Balachandran ran the trial at Memorial Sloan Kettering Cancer Center in New York City. The vaccine used in his research is made in an expansive lab made up of hallways of freezers, desks, centrifuges and cytometers. Patients' responses to the treatment are measured in the lab. The oncologists and mathematicians who work there are dedicated to decoding pancreatic cancer, then reverse engineering the mRNA necessary to fight it.
巴拉钱德兰解释说，一名研究分析师在电脑上调出一张图表，上面显示了数十条重叠的绿色线条——每一条都代表免疫细胞繁殖的次数。
A research analyst pulls up a graph on her computer, showing dozens of superimposed green lines — each representing the number of times an immune cell reproduces, Balachandran explains.
看着代表唐娜·古斯塔夫森（Donna Gustafson）免疫细胞计数的图表，巴拉昌德兰（Balachandran）指出这些线条是如何急剧上升，然后保持在高位并趋于平缓的——“增加了1万倍”——这反映出她的免疫系统是如何大量生产攻击癌症的细胞，并在她接受最后一针之后的多年里持续这种状态。“这只是告诉我们，这种反应会持续下去，”巴拉昌德兰说。
Looking at the graph representing Donna Gustafson's immune cell count, Balachandran notes how the lines shoot up, then remain high and flat — "a 10,000-fold increase" — reflecting how her immune system mass produced cancer-attacking cells and sustained it, for years beyond her last shot. "It just tells us that this response lasts," Balachandran says.
巴拉昌德兰表示，正是这种在半数患者中出现的强大且持久的免疫反应，让他对mRNA疫苗的可能性大开眼界。“好吧，如果你能在最难治的癌症中产生如此强烈的免疫反应，这是否同样可以为广泛的人类癌症开发出癌症疫苗呢？”他说。
Balachandran says it was the strength and durability of such responses in half of the patients that, for him, blew open the possibility of mRNA vaccines. "Well, if you could generate such a strong immune response in the toughest of cancers, could this similarly develop cancer vaccines for a broad array of human cancers?," he says.
充满希望的未来 这种技术现在正处于一个拐点——对于患者、医生、研究人员和投资者而言皆是如此。例如，美国国家癌症研究所（National Cancer Institute）正与私营公司合作，以加速更多mRNA癌症疫苗的研发。巴拉昌德兰和斯隆·凯特林纪念癌症中心（Sloan Kettering）也是其中的一部分，并计划在现场扩大为患者生产个性化疫苗的规模。
Promising future This technology is now at an inflection point — with patients, doctors, researchers and investors. The National Cancer Institute for example, is working on a partnership with private companies to fast-track research and development of more mRNA cancer vaccines. Balachandran and Sloan Kettering are part of that, with plans to expand production of personalized vaccines for patients on site.
唐娜·古斯塔夫森表示，在过去的七年里，她和丈夫感到无比幸运。
Donna Gustafson says she and her husband have felt overwhelmingly lucky over the past seven years.
“我看到另外两个孙辈出生并长大，与家人度过了许多个生日、节日和圣诞节，”她说。
"I saw two more grandchildren be born and grow, many birthdays, holidays and Christmases with my family," she says.
她和丈夫一起制定并完成了心愿单上的许多项内容：跳伞、登顶，庆祝他们的金婚纪念日，并期待着更多的日子到来。
With her husband, she's created and ticked off many items off her bucket list: skydiving, summiting, celebrating their 50th anniversary with the expectation of many more to come.
“我们做了那么多事情——我们可能做了更多，”埃德·古斯塔夫森（Ed Gustafson）说，随后他的妻子接过了他的话，“……如果我们没有经历过这一切的话。”“我们现在更懂得活在当下，”埃德·古斯塔夫森看着妻子说。
"We've done so many things — we probably have done so much more," Ed Gustafson says, before his wife picks up his sentence, "...if we had not had this experience." "We live so much more for the day now," Ed Gustafson says, looking at his wife.