Researchers from Canada and the United Kingdom have reported improved survival of patients with stage IIIB non-small cell lung cancer (NSCLC) after treatment with a cancer vaccine, according to a study published in the Journal of Clinical Oncology .

Lung cancer remains the leading cause of cancer-related deaths in the US. NSCLC is the most common type of lung cancer, accounting for approximately 75-80% of all lung cancers. It is named for the type of cell in which the cancer originated. Standard treatment for NSCLC largely depends upon the stage or extent of spread of the cancer and may include surgery, chemotherapy, radiation therapy, and/or targeted therapy. Cancer vaccines are one type of targeted therapy being evaluated for the treatment of several types of cancer, including NSCLC.

Previous studies of vaccine therapy for patients with cancer have been disappointing, and there are no approved vaccines for patients with solid tumors such as lung cancer. Researchers in the current study, however, were hopeful that vaccination against a substance called MUC1, which is widely and abnormally expressed in NSCLC, could produce an anticancer response and improve survival. The goal of vaccine was to produce an immune response that would cause the body to reject tissues that express MUC1.

To evaluate the effect of this vaccine (called L-BLP25), researchers in Canada and the United Kingdom conducted a phase II clinical trial. The study enrolled 171 patients with stage IIIB or IV NSCLC who responded or had stable disease after first-line treatment. Patients were randomly assigned to receive either the vaccine or best supportive care. Overall, there was a four-month improvement in median survival among patients treated with the vaccine, with the greatest suggestion of a benefit among patients with stage IIIB disease and no pleural effusion. The vaccine was well tolerated by patients; adverse effects were generally mild and included skin rashes and flu-like symptoms.

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The researchers conclude that although the L-BLP25 vaccine does not appear to benefit patients with stage IV NSCLC, it may improve survival among patients with stage IIIB NSCLC. Further clinical trials will be conducted among patients with stage III NSCLC. Patients with NSCLC may wish to talk with their doctor about the risks and benefits of participating in a clinical trial further evaluating this or other promising therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.

Reference: Butts CA, Marshall E, Murray NR, et al. Randomized phase IIB trial of BLP25 liposome vaccine in stage IIIB and IV non-small cell lung cancer. Journal of Clinical Oncology. 2005;23:6674-6681.

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