Follicular lymphoma: vaccine increases disease-free survival


A lymphoma vaccine uniquely tailored for each patient extends disease-free survival by 14 months, with signs of an even better response for patients with a specific biological marker, researchers at The University of Texas MD Anderson Cancer Center reported in the Journal of Clinical Oncology.

The multi-center study is the first successful phase III trial of a lymphoma vaccine and one of the first of a personalized cancer therapy agent. Initial results were presented in part at the Plenary Session of the American Society of Clinical Oncology ( ASCO ) Annual Meeting in 2009.

To make the vaccine, unique proteins from each patient's tumor are isolated and combined with a delivery agent and a growth factor. This mixture then is injected back into the patient. Earlier studies showed this approach induces anti-tumor immune responses with few side effects in most lymphoma patients.

According to the National Cancer Institute ( NCI ), non-Hodgkin's lymphoma is one of the most common cancers in the United States. More than 74,000 people were diagnosed with the disease in 2010. Follicular lymphoma accounts for 22 percent of non-Hodgkin lymphomas worldwide.

Survival of follicular lymphoma patients has improved with newer types of chemotherapy, but advanced-stage disease still is considered incurable.

The 234 patients in this trial first were treated with a chemotherapy combination known as PACE. Of these patients, 117 went into complete remission or had a complete response for at least six months, and they received either the vaccine or a placebo. During a median follow-up period of 55.6 months, median time to relapse for the 76 vaccinated patients was 44.2 months, compared with 30.6 months for the 41 who received placebo.

However, an unplanned subgroup analysis showed that patients with a certain biological marker had an even more profound response, extending disease-free survival time from 28.7 months to 52.9 months. While those results need to be confirmed in randomized studies, they suggest the potential for further targeting the vaccine.

These findings may be applicable to other types of cancers, as well as a broader range of lymphoma patients. In addition, Kwak said a next-generation lymphoma vaccine his team has been working on should enter clinical testing sometime within the next year.

Source: University of Texas MD Anderson Cancer Center, 2011

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