According to results recently published in the Journal of Clinical Oncology, therapy involving a patient’s own immune cells appears promising in the treatment of advanced melanoma that has stopped responding to standard therapies.

Melanoma is a type of skin cancer that often starts in the form of a mole. Although melanoma is very curable in its earliest stages prior to its spread, advanced-stage melanoma is considered difficult to cure. Metastatic melanoma refers to cancer that has spread to several and/or distant sites in the body, with long-term survival rates remaining dismal. Refractory melanoma refers to melanoma that has stopped responding to standard therapies.

Melanoma is one type of cancer that has demonstrated anti-cancer responses to immune therapy, or therapy that stimulates the immune system to attack the cancer. Researchers have been evaluating ways in which to improve upon immune therapy in the treatment of melanoma. Interleukin-2 (IL-2) is an agent that stimulates immune cells and is normally produced in the body. IL-2 is often used as part of a treatment regimen for melanoma.

Researchers from the National Cancer Institute recently conducted a clinical trial to evaluate a novel approach of immune therapy in patients with metastatic melanoma, referred to as “adoptive cell transfer therapy”. This trial involved 35 patients whose cancer was progressing and had stopped responding to standard therapies. Patients had received multiple prior therapies. Adoptive cell transfer therapy involves the removal of some of the patient’s cancer cells, as well as some of the patient’s T-cells (a specific type of immune cell), which were mixed together in a laboratory. Researchers isolated specific parts of the cancer cells that would stimulate the T-cells to recognize them as “foreign” and initiate an immune attack against the cancer cells specific to the patient. The T-cells were multiplied extensively and then re-infused into the patient. Patients then received IL-2 to continue the stimulation of T-cell growth within their body. Prior to infusion of the T-cells, patients were first treated with chemotherapy consisting of Fludara® (fludarabine) and cyclophosphamide (Cytoxan®) to reduce the level of immune cells in their body that were not providing an adequate immune response against the cancer.

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Overall, anti-cancer responses were achieved in 51% of patients. An additional 23% of patients experienced minor anti-cancer responses or “mixed” responses, in which some of the sites of cancer demonstrated regression, while others did not. The duration of anti-cancer responses lasted between 2 months and over 2 years, with 9% of patients still experiencing a response at the time of this publication. This treatment was generally well tolerated.

The researchers concluded that adoptive cell transfer therapy appears to be a promising treatment approach in patients with progressing metastatic melanoma who do not respond to standard therapies. This treatment approach is still in clinical trials and researchers are evaluating ways in which to improve upon these treatment outcomes. Patients with advanced melanoma who have received extensive prior therapy may wish to speak with their physician regarding the risks and benefits of participating in a clinical trial further evaluating adoptive cell transfer therapy, or other types of therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (cancer.gov) and www.cancerconsultants.com.

Reference: Mark E. Dudley, John R. Wunderlich, James C. Yang. Adoptive Cell Transfer Therapy Following Non-Myeloablative but Lymphodepleting Chemotherapy for the Treatment of Patients With Refractory Metastatic Melanoma. Journal of Clinical Oncology. 2005; 23: 2346-2357.

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