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Personalized Vaccine in Trial Raises Hope for Advanced Ovarian Cancer Patients

A personalised cancer vaccine in pilot trial for ovarian cancer, aimed primarily at determining safety and feasibility, has now shown clear signs of being effective. About half of the vaccinated patients showed signs of anti-tumor T-cell responses, and those “responders” tended to live much longer without tumor progression than those who didn’t respond. One patient, after two years of vaccinations, was disease-free for another five years without further treatment.

This vaccine appears to be safe for patients, and elicits a broad anti-tumor immunity—we think it warrants further testing in larger clinical trials,” said study lead author Janos L. Tanyi, MD, an assistant professor of obstetrics and gynecology at Penn Medicine.

Researchers at the Perelman School of Medicine and the Abramson Cancer Center, at the University of Pennsylvania, developed the vaccine using dendritic cells (DCs) derived from each patient’s own peripheral blood mononuclear cells. These dendritic cells were then exposed to the patient’s tumor cells, activated with interferon gamma, and injected into the patient’s lymph nodes.

In the trial, all 25 patients received a series of such injections, either alone or in combination with chemotherapy drugs. None of the vaccinated patients reported

severe side-effects, and patients who received the vaccine along with two chemotherapy drugs had a two-year survival rate of 78 percent—compared with just 44 percent for patients in a control cohort receiving only chemotherapy. Tanyi tells the Los Angeles Times that the vaccine appears to be “so safe it’s unbelievable.”

CT scans of two tumor lesions (yellow arrows) in the pelvis of a patient enrolled in the study. The tumors became smaller during the vaccination treatment (right) compared with before vaccination (left). (J.L. Tanyi et al / Science Translational Medicine)

Results showed that vaccine-reactive T cells were readily detectable in on-vaccination peripheral blood mononuclear cells (PBMCs), but were significantly lower or undetectable in prevaccination PBMCs (P=0.001). Patients whose postimmunization T cells recognized autologous tumor cells or DC-presented tumor antigen, demonstrated significantly longer progression-free survival (PFS) on immunotherapy than those whose T cells did not respond to either.

A personalized ovarian cancer vaccine is likely years away from widespread use in patients. Scientists will likely have to find a way to make larger supplies of vaccine with a limited supply of tumor cells, Tanyi said. Meanwhile, researchers are already finding new ways to enhance the vaccine’s effectiveness, he added.

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