Word: follicular
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...cancer vaccine is not like the measles shot you get as a kid. Instead of inoculating a healthy person against a foreign body like a virus, cancer vaccines use parts of tumors to help the patients' immune systems recognize diseased cells. Follicular lymphoma, a generally slow-moving cancer of the immune system that affects roughly 5,000 Spaniards each year, presents an especially enticing target for vaccine researchers because its cells all carry a protein, called an idiotype, that distinguishes them from their healthy counterparts. Mixing the idiotype with other substances that trigger immunological responses, "the vaccine presents a tumor...
...Follicular lymphoma cannot currently be cured, but with chemotherapy and other treatments, a patient can usually achieve remission. The cancer almost always returns, however, and each subsequent remission tends to be shorter than the previous one. In 2001, Bendandi began vaccine therapy on 25 patients who had achieved a second remission with chemotherapy. The vaccine did not have any effect on five of the subjects, but the other 20 who did respond received a total of 10 vaccinations over 26 months. "Partway through the study, one of my patients - a hairdresser - came to me and said, 'I know the treatment...
...vaccine for follicular lymphoma is not new. Stanford University's Ron Levy pioneered the effort more than 25 years ago, demonstrating that anti-idiotype antibodies could be produced in a laboratory and used to create a vaccine for humans that would trigger an immune response. In 1999 Kwak, then working at the National Institutes of Health (nih), modified the vaccine in a way that makes it easier for the immune system to recognize. His results were striking: the vaccine eliminated the residual tumor cells left after chemotherapy in 15 of his 20 patients. Now Bendandi, who worked with Kwak...
...everyone is convinced by that logic. Dr. Robert Schwartz, an editor at the New England Journal of Medicine, says, "Using patients as their own control is a bit shaky, especially for follicular lymphoma." A Phase III randomized trial, more difficult but still possible to conduct even with customized vaccines remains, he says, "the gold standard for proof of efficacy." Dr. Kwak, who is conducting his own Phase III trial of a vaccine for the American pharmaceutical company Biovest, believes his former trainee's results support the case for a therapeutic lymphoma vaccine, but is skeptical about his methods. "Dr. Bendandi...
...just one patient relapsed while receiving the vaccine, it would have been over. I would have needed a new job," he jokes. But the Italian-born physician is still working. In a few weeks he starts his new study, which is designed to test the vaccine's effectiveness in follicular lymphoma patients with an especially poor prognosis. Bendandi plans to administer the vaccine to participants until they relapse or die from a cause other than lymphoma. "This time," he says, "I'm going after a cure...