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DR-18 mRNA is an mRNA-based gene therapy encoding a modified version of interleukin-18 (IL-18) known as decoy-resistant IL-18 (DR-18). Standard IL-18 activity is often neutralized by the high-affinity endogenous decoy receptor IL-18 binding protein (IL-18BP), which is frequently upregulated in the tumor microenvironment. DR-18 is engineered to maintain its bioactivity and binding to the IL-18 receptor while being unable to bind to IL-18BP, thereby bypassing this immune inhibitory mechanism. In preclinical studies, intratumoral administration of DR-18 mRNA, particularly in combination with IL-12 mRNA, has demonstrated potent synergistic effects in inducing interferon-gamma (IFNγ) release and enhancing the activity of CD8+ T cells and cDC1 dendritic cells, leading to improved local and systemic antitumor immunity.
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