Vaccine Improves Progression-Free Survival in Kidney Cancer
According to a recent article published in The Lancet, a vaccine using a patient’s own cancer cells delays time to cancer progression and improves progression-free survival in patients with kidney cancer.
The kidneys are a pair of bean shaped organs located on each side of the spine. The kidneys filter the blood and eliminate waste in the urine through a complex system of filtration tubules. All of the blood in the body passes through the kidneys approximately 20 times an hour. Renal cell cancer (RCC) is an uncommon form of cancer that is most often characterized by the presence of cancer cells in the lining of the filtration tubules of the kidney. Patients who have RCC that is at least 2.5 centimeters in diameter but has not spread from the kidney are often treated with a partial or radical nephrectomy, which is the surgical removal of either the portion of the kidney in which the cancer exists (partial) or the entire kidney (radical). Unfortunately, a large portion of patients experiences a recurrence and progression of their cancer following a nephrectomy. RCC is a type of cancer that tends to respond to immune or biologic therapy, in which the immune system is stimulated to help fight cancer, and research involving biologic therapy has been ongoing in an attempt to reduce the risk of cancer progression or recurrence following surgery for patients with RCC that has not spread beyond the kidney.
Researchers from Germany recently conducted a clinical trial to evaluate the use of a vaccine following a radical nephrectomy in patients with RCC. This trial included 379 patients who had RCC that was at least 2.5 centimeters in diameter, but had not spread outside the kidney. Approximately half of the patients were treated with the vaccine following surgery, and the other half of patients received no further therapy following surgery (control group). The vaccine was comprised of cells from the patient’s cancer. The cells were collected during surgery, rendered inactive, and made into a vaccine. Cancer cells have different antigens (protein and/or carbohydrate sequences) than normal cells in the body. Normally, antigens that differ from those of cells in the body stimulate an immune response. However, cancer cells seem to evade an immune attack when they are within the tumor through several speculated mechanisms. Research has indicated that antigens from cancer cells can trigger an immune response when taken from the tumor and injected elsewhere in the body. Several different vaccines involving the manipulation of a patient’s own cancer cells are currently in clinical trials for various cancers.
At approximately 5 years following therapy, progression-free survival was 77.4% for patients treated with the vaccine, compared to 68% for the control group. At approximately 70 months following therapy, progression-free survival was 72% for patients treated with the vaccine, and 59.3% for the control group. Side effects from the vaccine were uncommon and not severe.
The researchers concluded that treatment with the vaccine comprised of a patient’s own cancer cells following surgery significantly improves progression-free survival compared to surgery alone in patients with RCC that is confined to the kidney, and is very well tolerated. They also stated that patients with RCC confined to the kidney that is 2.5 centimeters or greater in diameter who undergo a radical nephrectomy will be considered candidates for the vaccine at their practicing institutions.
Reference: Jocham D, Richter A, Hoffmann L, et al. Adjuvant autologous renal tumour cell vaccine and risk of tumour progression in patients with renal-cell carcinoma after radical nephrectomy: phase III, randomized controlled trial.
The Lancet. 2004; 363:594-599.