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Non-Hodgkin's lymphoma support

 

Vaccines for lymphoma



 

Vaccine's for Non-Hodgkin's Lymphoma

These are a very promising science, but one that is still in the clinical trial stages. Just like the name suggests, vaccines are an attempt to prevent relapses. Most of the vaccine trials are focusing on the indolent varieties of NHL at this time.  Vaccine therapies have experienced several major setbacks with the failed results of the two biggest vaccine treatments. Both the Genitope and Favrille clinical trials failed in their primary endpoints in their trials, and both companies are now bankrupt and out of business.

The BiovaxID vaccine from Biovest had a major breakthrough in 2010. Their Phase III results showed that the vaccine that is directed against the IgM idiotype on tumour is very effective, whereas the vaccine directed against the IgG idiotype was not effective. What was amazing about this discovery is that the previous Favrille and Genitope vaccines were directed against IgG. This opened the door to highly specific vaccines that are thought to work. The BiovaxID vaccine has approval or pending approval in the United States, Canada and the European union. Read their ASH 2010 abstract below.  

Vaccination with IgM but Not IgG Idiotype Prolongs Remission Duration In Follicular Lymphoma Patients

An updated review which patients will benefit from this vaccine and those who will not benefit.

Identifying Patients With Follicular Lymphoma Who Are Likely to Benefit From an Idiotype Vaccine

Sadly another update in 2014 seems to show that MyVax may not offer any benefit after all.

Active Idiotypic Vaccination Versus Control Immunotherapy for Follicular Lymphoma


There are still other vaccine treatments in clinical trials or in laboratory studies. Here is some information about some of them.

Idiotype: You will see the term "idiotype" used often in cancer vaccine research. Idiotype refers to the unique set of antigens that are expressed on the surface of each patients cancer cells. If  you can isolate those specific antigens then you can use them to manufacture a vaccine against them, just like we can manufacture vaccines against specific viruses.

One of the challenges of the personalized vaccines like BiovaxID is that each vaccine must be specifically made for each patient. The manufacturing process takes about 6 months or more and some patients relapse before that time. It is also extremely costly. The solution to this is to find a specific target that is expressed on everyone's lymphoma cells so that a generic vaccine can be made. Progress in this direction has been made. Here is one of the first studies that finds a suitable target.

TCL1: a shared tumor-associated antigen for immunotherapy against B-cell lymphomas 

Here is a peer review of the above study which is in relatively simple terms so that most people can grasp what they are discussing.

Toward an off-the-shelf vaccine for B-cell malignancies

In Situ Vaccination

In this ongoing study, they first radiate a tumour site to kill the cancer. Then they inject an immune stimulant directly into the tumour.  There is no custom vaccine to make so treatment can be started immediately, without any chemotherapy. This could be the next big breakthrough in vaccine therapy . In the first study there were significant responses.

In Situ Vaccination With a TLR9 Agonist Induces Systemic Lymphoma Regression: A Phase I/II Study

The results from that first study were so promising they have published an update. The results are below. Due to these results they are initiating a trial for previously untreated patients.

in Situ Vaccination for Patients with Previously Untreated Follicular Lymphoma:  Analysis of Immune Responses

In a later study they found that targeting the Toll Like Receptor (TLR) 3 instead of TLR3 as in the above two studies, produced markedly better results.

New Vaccine Formulation Effective in Low-Grade Lymphoma

Click here for information about enrolling in the new clinical trial

Genetically modified T-cell vaccine

Below is a description of this line of research from one of the researchers at the Fred Hutchinson Cancer Center. The quote is from 2004 but the research is more up to date.


We are conducting phase I trial for patients with relapsed follicular NHL using "killer" T-cells that have been genetically modified to recognize the CD20 marker on lymphoma cells. We extract a patient's T-cells from the blood, insert a gene into the T-cells in the laboratory so that they recognize CD20, grow the cells to large numbers in the lab, and then reinfuse these genetically modified cells back into the patient. We have treated 2 patients so far and hope that T-cell immune therapy against lymphoma will be better than the current antibody based therapies. We are conducting studies targeting other lymphoma markers and using T-cell immunotherapy for other types of lymphoma.

Here are some links about the above trial.

Plant produced idiotype vaccines for fNHL

In this line of research they are using plants to produce the vaccines much faster than they can in the laboratory.  Here is a link to a recent study on this topic.

Dendritic cell vaccines

Dendritic cells are cells that process antigen material and present it to other immune cells, thus initiating an immune response. Read more about dendritic cells at Wikipedia.

Vaccines prepared in one day

One of the difficulties of the Favrille and Genitope vaccines was that they were time consuming and expensive to produce. Each vaccine took about six months to prepare. The following study attempts to address this issue. This vaccine can be made in a single day and it still uses a patient specific vaccine.

Additional information about lymphoma vaccines

The following two articles are from the the Journal Blood, and the journal Bloodline. Both are authoritative resources for anything haematology related.

 


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