According to a recent article published in the Journal of Clinical Oncology, injections of irradiated autologous melanoma cells appear to improve anti-cancer responses and may improve survival in some patients with metastatic melanoma.

Melanoma is an aggressive type of cancer that originates in the skin. It typically begins in the form of a mole and when diagnosed and treated early, is curable with surgery. However, melanoma that has spread to distant or several sites in the body is difficult to treat with standard procedures, as it often does not respond to chemotherapy and/or radiation therapy and long-term survival remains dismal for this group of patients. Biologic therapy or immunotherapy, treatment that stimulates the immune system to help fight the cancer, has offered promise as therapy against melanoma and researchers are investigating several regimens of treatment involving different types of biologic therapy with or without chemotherapy.

Patients with advanced melanoma may undergo surgery to remove all detectable cancer in the body. Unfortunately, undetectable cancer cells often remain following surgery and are responsible for cancer recurrences. Researchers are developing and evaluating different types of therapy in an attempt to kill any remaining cancer cells following surgery (adjuvant therapy) in the hopes of offering a reduction in cancer recurrences and an improvement in long-term survival.

One type of therapeutic approach being evaluated for melanoma is the use of vaccines comprised of a patient’s own melanoma cells (autologous). Cancer cells contain different antigens (proteins with or without carbohydrates) on their surface than healthy cells. For reasons not entirely understood, the immune system does not seem to distinguish the antigens on cancer cells growing in the body from antigens on healthy cells. However, the same antigens taken from cancer cells that are injected back into the body appear to stimulate the immune system to mount an attack against remaining cancer cells in the body displaying the specific antigens. These vaccines are comprised of antigens taken from surgical specimens of the cancer that are irradiated so that they are not able to replicate. In addition, through laboratory processes, these vaccines may also contain a component that secretes substances to further stimulate the immune system to fight the cancer.

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Researchers from Massachusetts recently conducted a clinical trial to evaluate the effectiveness of an autologous vaccine in the treatment of metastatic melanoma. These vaccines contained irradiated autologous melanoma cells that were engineered to secrete granulocyte macrophage colony stimulating factor (GM-CSF), a substance normally produced by the body to stimulate the initiation of an immune attack. This trial involved 32 patients with metastatic melanoma; 6 of whom had rapid progression of cancer and were withdrawn from the trial early. Eight patients experienced an anti-cancer response or disease stabilization following treatment with the vaccine. At a minimum of 3 years following treatment, 10 patients were alive and 4 had no detectable cancer following further surgery. The average duration of survival was 15 months, and nearly 30% of patients were alive at 3 years following therapy. Side effects were mainly mild local injection site reactions.

The researchers concluded that autologous irradiated vaccines that are engineered to secrete GM-CSF may provide immune stimulation against melanoma in patients with metastatic melanoma and result in improved survival in some patients. The authors note that combination therapy utilizing vaccines and chemotherapy and/or other biologic therapy may augment treatment benefit even further. Patients with melanoma may wish to speak with their physician about the risks and benefits of participating in a clinical trial further evaluating vaccines or other promising therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (cancer.gov) and www.cancerconsultants.com. Personalized clinical trial searches are also performed on behalf of patients at cancerconsultants.com

Reference: Soiffer R, Hodi FS, Haluska F, et al. Vaccination with Irradiatied, Autologous Melanoma Cells Engineered to Secrete Granulocyte-Macrophage-Colony-Stimulating Factor by Adenoviral-Mediated Gene Transfer Augments Antitumor Immunity in Patients with Metastatic Melanoma.

Journal of Clinical Oncology. 2003;21:3343-3350

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