According to an article recently published in the Journal of the National Cancer Institute, idiotype vaccines may improve cancer-free survival among patients with non-Hodgkin’s lymphoma whose immune systems respond to the vaccine.
Non-Hodgkin’s lymphoma (NHL) is a form of cancer that begins in the cells of the lymph system. The lymph system includes the spleen, thymus, tonsils, bone marrow, lymph nodes, and circulating immune cells. The main cells in the lymph system are lymphocytes, of which there are two types: B- and T-cells. Each cell type has a specific function in helping the body fight infection.
NHL is characterized by the excessive accumulation of atypical (cancerous) lymphocytes. These lymphocytes can crowd the lymph system and suppress the formation and function of other immune and blood cells. NHL is categorized by the type of lymphocyte it involves and by the rate at which the cancer grows.
Follicular lymphoma is considered a low-grade or indolent lymphoma, which means that it is a slow-growing subset of NHL. Advanced follicular NHL is considered incurable with standard treatment approaches. Researchers thus continue to evaluate ways to improve survival for these patients.
Idiotype vaccines are vaccines that stimulate the immune system to fight cancer cells. Idiotype proteins are proteins specific to cancer cells. Researchers isolate these proteins from a patient’s cancer cells to produce a vaccine that stimulates the immune system to fight the cancer cells displaying these proteins.
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Researchers from Spain recently conducted a clinical trial to evaluate the effectiveness of an idiotype vaccine for the treatment of follicular NHL. This trial included 33 patients who experienced a cancer recurrence; they had been treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. Patients who achieved a complete disappearance of cancer (30) following CHOP were then treated with the vaccine. In one patient, researchers were not able to isolate the idiotype proteins to manufacture a vaccine. The results from the 29 patients who were treated with the vaccine are as follows:
- 80% of patients’ immune systems responded to the vaccine.
- None of the patients who experienced an immune response experienced a cancer recurrence while undergoing vaccination.
- The median duration of complete disappearances of cancer has not yet been reached, but exceeds 33 months.
- Of the five patients who did not respond to the vaccine, the duration of time that their cancer was not detectable following their second round of therapy was actually shorter than that of their initial therapy.
The researchers concluded that idiotype vaccines made from components of a patient’s own cancer cells appear to significantly prolong cancer-free survival among patients whose immune systems respond to the vaccine.
Patients with follicular lymphoma may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating vaccines or other novel therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.
Reference: Inoges S, Rodriguez-Calvillo M, Zabalegui N, et al. Clinical Benefit Associated with Idiotypic Vaccination in Patients with Follicular Lymphoma. Journal of the National Cancer Institute. 2006; 98: 1292-1301.
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