With the exception of the so-called cervical cancer vaccine, no shots have been approved specifically to prevent malignant tumors. But cervical cancer, which is caused by the sexually transmitted human papillomavirus (HPV), isn't the only tumor linked to a virus; another is cytomegalovirus (CMV), a usually harmless form of herpes that's the target of a possible therapeutic cancer vaccine for brain tumor patients.
As Scientific American reports this month, CMV has been found in the most common type of brain tumor, glioblastoma multiforme (GBM) — the cancer Massachusetts Democratic Sen. Edward Kennedy is battling. Duke University is recruiting 20 patients with these types of tumors for a combined phase 1/2 clinical trial (an early stage of testing that checks the safety and usefulness of a product) of an experimental vaccine treatment for these patients. It's also testing a similar version in another trial.
Duane Mitchell, the Duke University neuro-oncologist heading up the GBM vaccine treatment trials, is optimistic about them, telling Scientific American that creating a shot that goes after CMV "may be a radically new way to consider treating these tumors."
Pharma giant Novartis, meanwhile, is working on a CMV vaccine that would prevent infection with the virus. The company, headquartered in Basel, Switzerland, announced late last month that it expected to begin a phase 2 trial (which tests efficacy) of a preventive CMV vaccine this year. While CMV isn’t dangerous to most people, it infects 30,000 newborns in the U.S. annually, causing severe disability such as vision or hearing loss, seizures and cognitive problems in 8,000, according to the Centers for Disease Control and Prevention (CDC). It can also be deadly in people with weakened immune systems, such as AIDS patients.
Still, there are challenges. One researcher who tested a preventive CMV vaccine, University of Pennsylvania emeritus professor Stanley Plotkin, came up short when he found that it seemed to produce an immune response without actually preventing infection. "Is antibody sufficient, or do you need cellular immune responses? Or, are cellular immune responses sufficient and you don't need antibody? Those are unresolved issues," Plotkin told The Scientist in 2006, "that have somewhat hindered CMV vaccine development."
CMV: A virus in search of a vaccine
Interesting Excerpt
Dog treated for brain tumors: Experimental test a trial for humans
If it works for ‘Batman’ and other dogs, it promises effective treatment, say Minneapolis researchers
Star Tribune (Minneapolis)
Thursday, August 21, 2008
MINNEAPOLIS — Batman has always been a hero to Anna and Eric Baker. Not the comic book variety, but a furry, 38-pound, bat-eared one who patiently lets their toddler climb all over him.
Now, if all goes well, he may also become a hero for the thousands of people — and tens of thousands of dogs — who each year have brain tumors diagnosed that are equally fatal in both.
Batman, a Shepard mix, is having surgery to remove a brain tumor, August 5, 2008, at the University of Minnesota’s Veterinary Medical Center. It’s the same kind of tumor that is common in people. Cancer researchers will use his surgery for an experimental advanced treatment.
A new method to battle cancer
Tumor's amino acids train white blood cells to fight back
Clinical trial at UCLA
The DCVax clinical trial at UCLA's Jonsson Comprehensive Cancer Center remains open to patients who have glioblastoma brain cancer. For information, call 310-267-2621 or visit http://www.cancer.ucla.edu.
Photo by Joseph A. Garcia
Lupe Carrillo, shown with his wife, Carmen, has been receiving personalized treatment to battle his brain cancer. A tumor was removed last summer.
Photo by Joseph A. Garcia
Lupe Carrillo, front left, has had support from his wife, Carmen, and their three sons, in rear from left, Lupe Jr., Christopher and Adrian, while battling brain cancer.
The brain tumor that threatened to kill Lupe Carrillo is now being used to help him survive.
The 61-year-old Oxnard man, diagnosed with a cancer that carries a 98 percent fatality rate, is being treated with an experimental vaccine made of his own white blood cells and amino acids from the tumor.
Like a search-and-rescue dog trained to follow a scent, the amino acids are used in a UCLA clinical trial to teach Carrillo's immune system to recognize and fight cells from his specific cancer.
UCSF Brain Tumor Vaccine Trial Shows Promising Results
A vaccine for treating a glioma, a recurrent cancer of the central nervous system that occurs primarily in the brain, has shown promise in preliminary data from a clinical trial at the University of California, San Francisco.
Findings from a group of 12 study patients showed that vitespen vaccination (trademarked as Oncophage) was effective in stimulating the patient’s immune system to attack the tumor cells, a function that is known medically as tumor-specific immune response. All the patients had recurrent, high-grade glioma, and all showed the immune response. The vaccine is made from the patient’s own tumor.
The clinical trial was conducted by the UCSF Brain Tumor Research Center. Results were presented April 16 at the 75th annual meeting of the American Association of Neurological Surgeons in Washington, DC.
“In this trial, we have observed a correlation between immune response as a result of Oncophage vaccination and potential clinical benefit,” said Andrew T. Parsa, MD, PhD, assistant professor in the Department of Neurological Surgery at UCSF and recipient of the 2007 Young Investigator Award at AANS. “We are encouraged by the prolonged improvement in overall survival rates, although this phase 1/2 study is not designed to primarily evaluate efficacy. The patients in this trial represent the most challenging patient population to treat.”
Of the 12 patients being treated, eight can currently be evaluated for overall survival, while four are still receiving treatment. Seven out of the eight patients have exceeded the historical median benchmark of 6.5 months survival from time of recurrence. The investigators will continue to follow the patients for overall survival. Based on these results, a larger, multi-center phase 2 study is planned for late 2007.
Derived from each individual’s tumor, vitespen contains the “fingerprint” of the patient’s particular cancer and is designed to reprogram the body’s immune system to target only cancer cells bearing this fingerprint. The vaccine is intended to leave healthy tissue unaffected and limit the debilitating side effects typically associated with traditional cancer treatments such as chemotherapy and radiation therapy. Vitespen has been granted fast-track and orphan drug designations from the Food and Drug Administration for both metastatic melanoma (skin cancer) and renal cell carcinoma (kidney cancer).
Reviewing the presentation at AANS, Henry Brem, MD, director of neurosurgery at the Johns Hopkins Medical Institutions, noted, “This is an encouraging study of a therapeutic cancer vaccine that targets multiple tumor antigens, supported by rigorous immuno-monitoring. A larger phase 2 trial is certainly warranted to evaluate efficacy.” Brem is a developer of the first approved local therapy for glioma.
The UCSF clinical trial is a phase1/2 study designed to establish the feasibility, safety and preliminary efficacy of vaccination in patients with recurrent, high-grade glioma. The trial involves two groups of six patients, both of whom receive a minimum of four injections. The first group receives biweekly vaccinations and the second receives weekly vaccinations. Patients are monitored for immune response before, during and after treatment.
The UCSF investigators will continue to follow patients for progression-free survival and overall survival. According to investigators, no adverse events or toxicity identified were considered attributable to the vaccine.
Cheryl Canagelo, a 52-year-old woman from Oakley, Calif., came to UCSF for a second opinion after undergoing radiation and chemotherapy elsewhere for treatment of a glioma. At UCSF she learned that part of the tumor was still present, and she enrolled in the vitespen vaccine trial.
Once the chemotherapy was out of her system, Parsa performed surgery, just four days before Christmas. He removed all but a very small amount of tumor that was near an area that could affect her speech. The removed tissue was sent to Antigenics, the Massachusetts biotech company that produces the vaccine from the patient’s tumor tissue. Altogether, Canagelo has now received seven injections of vaccine.
“My most recent MRI showed that there is no tumor,” Canagelo said. “I haven’t had any side effects from the treatment, and I’m getting stronger every day. I would urge patients to seek out second opinions and investigate clinical trials. I can tell you I am so glad I did.”
“Our goal is to change the management of recurrent glioma from a life threatening disease into a chronic disease with extended survival and improved quality of life for patients,” Parsa said. “Although our survival data are encouraging, a larger phase 2 study will be required to determine the benefit of vitespen for patients with recurrent glioma. The consistent, tumor specific immune response seen in these patients suggests that in the right patient population, the vaccine could have a significant impact.”
The clinical trial was funded by the American Brain Tumor Association and the National Cancer Institute’s Specialized Program of Research Excellence.
UCSF is a leading university that advances health worldwide by conducting advanced biomedical research, educating graduate students in the life sciences and health professions, and providing complex patient care.
ABC News: Vaccine Helps Man Survive Deadly Cancer
Ryan DeGrand Was Given Less Than Two Years to Live Before He Tried an Experimental Cancer Vaccine:
Developing an effective cancer vaccine has been a frustratingly elusive goal in medicine. Now researchers at Duke University Medical Center believe they might have one, harnessing the most effective and efficient of all disease fighters: the body's own immune system. Watch the story on "World News Tonight" at 6:30 p.m. ET. It appears to have helped Ryan DeGrand. DeGrand was living the American dream. Married with two children, he runs a successful golf equipment company in St. Louis,...
Cross hairs on a cancer
An experimental vaccine is now in multi-center, late-stage trials for treatment of glioblastoma, the most common brain cancer in adults. If the therapy lives up to its promise, it could potentially be used for other cancers as well.
