A new vaccine may produce antibodies that help prevent the progression of malignant melanoma and prolong survival, say researchers in a report in the January 2000 issue of the Journal of Clinical Oncology. This vaccine, called an anti-idiotype antibody (TriGem), will be studied further in clinical trials that compare this new therapy to other more commonly used treatments against malignant melanoma, a type of cancer of the skin.
Vaccines are an important subject of study for cancer treatment because they may offer effectiveness against disease, without the serious side effects associated with many chemotherapy drugs. Vaccines work by helping the immune system to defend the body against infection and other forms of intrusion. A cancer vaccine serves to mimic an antigen found on cancer cells, causing the immune system to attack these cells. The strategy used in developing the TriGem vaccine against melanoma was to develop an antibody to a cancer antigen, and then develop an antibody (called an anti-idiotype antibody) to that original antibody. The anti-idiotype antibody in the TriGem vaccine mimics a melanoma antigen, called the GD2 antigen.
Researchers administered the TriGem vaccine, along with an agent called QS-21 to enhance the effect of the vaccine, to 47 patients with advanced malignant melanoma. All patient received the vaccine once per week for 4 weeks, then once monthly until the cancer showed progression. One patient, whose disease had spread to multiple sites in the body, had a complete response of more than 24 months to the vaccine. Twelve patients were stable (the cancer had not spread) for more than 14 to 37 months. Side effects were minimal and included swelling at the site of injection, mild fever, and chills. Laboratory tests showed that the immune system does respond to the vaccine, developing antibody responses to the GD2 antigen in the majority of patients.
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These findings suggest that the TriGem vaccine may have a role in preventing disease progression and in increasing survival time for patients with advanced malignant melanoma. Future studies will be conducted to compare the effectiveness of the vaccine with other treatments and to determine its effectiveness in combination with chemotherapy.
Journal of Clinical Oncology, Vol 18, No 2, pp 376-384, 2000
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