Cancer Consultants (KC) 09-Apr-08
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Oncophage® Vaccine May Have Activity in Renal Cell Carcinoma....
Researchers from MD Anderson Cancer Center have reported that Oncophage® (vitespin, HSPPC-95) given with Proleukin® (interleukin-2) has activity in a minority of patients with metastatic renal cell carcinoma. The details of this study appeared in an early online publication in the British Journal of Cancer on March 25, 2008.1
Oncophage is a cancer vaccine that is based on heat shock protein (HPS), which is a naturally occurring substance that binds all peptides it comes in contact with. HPS is also capable of activating antigen presenting cells, indirectly presenting antigens and “chaperoning” peptides during antigen presentation.
Researchers at Antigenetics have developed a procedure that produces individual peptides that serve as tumor-specific or tumor-associated antigens by mixing individual tumor cells with HSP. When re-injected into the patient from whom the cancer was obtained, specific immune responses are observed. This means that the vaccine contains all of the many tumor antigens present in the cancer.
Antigenics has developed a commercial system where tumors can be sent to the laboratory and a potentially commercially viable vaccine is returned to the physician. Early studies in patients with metastatic melanoma and pancreatic cancer have shown clinical responses.
Renal cell cancer is one of the few cancers that respond to immunotherapy. Approximately 10–15% of patients with renal cell cancer respond to immune therapies such as Proleukin, interferon-alfa, and non-marrow ablative stem cell transplants. A few patients are apparently cured with these approaches. One study from Germany also suggested activity for an autologous vaccine.
The current study evaluated Oncophage in 84 patients with Stage IV metastatic renal cell carcinoma who had nephrectomy. Vaccine was administered four weeks after surgery. Patients who had progressive disease received Proleukin in addition to vaccination. There were 60 patients evaluable for response and two had a complete response, two a partial response, and seven had stable disease.
Two patients who progressed on vaccine alone had disease stabilization. These authors concluded that the majority of patients did not benefit from Oncophage but suggested that the vaccine be combined with other immunoregulatory agents.
Comments: Oncophage therapy is associated with a relatively low but definite response rate in metastatic renal cell carcinoma that is typical for all immune therapies studied in this disease. Oncophage might be more effective in a truly adjuvant setting of minimal residual disease and in combination with other agents such as Proleukin and interferon alfa.
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