Therapeutic cancer vaccine significantly prolongs disease-free survival for follicular lymphoma
An eight-year randomized, controlled phase III clinical
study has shown that a patient-specific therapeutic vaccine, BiovaxID, significantly
prolongs disease-free survival in follicular non-Hodgkin's lymphoma.
The study, which is being featured in ASCO's plenary
session, found that patients who received the vaccine experienced a median disease-free
survival of approximately 44 months compared to approximately 30 months for those
who received a control vaccine - an increase of 47 percent.
BiovaxID is individually manufactured from a tissue biopsy
obtained from a patient's own tumor. The vaccine targets an idiotype expressed
by cancerous B cells in follicular lymphoma and spares normal, healthy B cells
that do not express the tumor idiotype.
The final vaccine is administered as a subcutaneous injection
along with granulocyte-monocyte colony stimulating factor (GM-CSF) and keyhole
limpet hemocyanin (KLH), which together enhance the potency of the immune response
induced by BiovaxID. A previous phase II study demonstrated that patients receiving
the BiovaxID vaccine develop a highly specific immune response against tumor cells.
"With this vaccine, we've now moved into an era where
we can safely use a patient's immune system to effectively fight follicular lymphoma
and enhance the response to conventional chemotherapy," said Stephen J. Schuster,
M.D., associate professor at the University of Pennsylvania School of Medicine
and the study's lead author. "Because this vaccine uniquely recruits the patient's
immune system to seek and destroy only tumor B cells, this approach may be applicable
to the treatment of other B-cell lymphomas."
The study achieved its primary endpoint of prolonging
disease-free survival in patients vaccinated with BiovaxID after achieving a complete
response to chemotherapy. In the study, 177 patients with follicular lymphoma
who had achieved a complete response to PACE (prednisone, doxorubicin, cyclophosphamide
and etoposide) chemotherapy were randomized to the BiovaxID vaccine arm (vaccine
plus KLH/GM-CSF) or to the control arm (KLH/GM-CSF alone). Investigators analyzed
the cohort of 117 patients who, as per study protocol requirements, maintained
a complete response to chemotherapy for at least six months and received active
(76 patients) or control (41 patients) vaccine. After a median follow-up of 4.71
years (56.6 months, range: 12.6 - 89.3 months), the median disease-free survival
in the BiovaxID arm was 44.2 months compared with 30.6 months in the control arm,
which is a statistically significant difference.
BiovaxID demonstrated a favorable safety profile and
was very well tolerated by patients. Further studies are planned to examine the
role of BiovaxID in patients with other B-cell lymphomas and as maintenance therapy
in patients with follicular lymphoma.
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