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Treating Lymphoma: Will a Customized Vaccine Work?

Cutting Edge Research

Testing Vaccines for Non-Hodgkin's Lymphoma

Summary & Participants

Vaccines for cancer are no longer futuristic medicine. See how people with non-Hodgkin's lymphoma are on the cutting edge of research.

Medically Reviewed On: June 11, 2008

Webcast Transcript

RONALD LEVY, MD: We have some people getting the vaccine that's made from their own tumor, and some people getting something that looks and feels like the vaccine but doesn't contain the ingredients from their own tumor. And we're comparing these two groups to each other. We're trying to prove that it actually keeps the lymphoma from coming back and keeps people living longer.

ANNOUNCER: Patients are still being recruited for these trials, but only certain patients are eligible.

DAVID FISHER, MD: The current trials are looking at patients with newly diagnosed follicular lymphoma. We're looking at patients who are newly diagnosed, so that they haven't been sort of beaten up with the chemotherapy and they have a good immune system.

RONALD LEVY, MD: We also like to have the tumor down to the minimum, so the tumor is not damaging the immune system.

ANNOUNCER: Two Phase II trials are looking at combining two immunotherapies, an antibody, called Rituxan, with the idiotype vaccine. This is an option for patients who don't respond as well as they might to the chemotherapy, who relapse, or even as their first treatment.

RONALD LEVY, MD: For the people who have what we call an inadequate response to chemotherapy (their tumors shrink not enough or they shrink not long enough and come back again) -- give all those patients Rituxan as a second treatment to get their tumors to shrink, and then to give them the vaccine.

ANNOUNCER: For patients in the Phase III trials, treatment follows a standard plan with an important addition.

DAVID FISHER, MD: We do require a biopsy of fresh tissue either a surgical biopsy or a needle biopsy. We do go through chemotherapy after that and the chemotherapy is standard and routine and it's the same you'd receive even if you weren't on the trial.

RONALD LEVY, MD: We allow a period of recovery from the chemotherapy for the immune system to recover before we start the vaccine.

DAVID FISHER, MD: The vaccinations are given as a shot under the skin like a diabetic gives himself insulin and it's been very well tolerated.

In addition, patients take a drug called GM-CSF as a shot under the skin for four days after each vaccination. This helps stimulate the immune response.

ANNOUNCER: The side effects from the vaccine itself are minimal.

DAVID FISHER, MD: You can sometimes get some redness, some swelling around the sites of the injections. Some people have had some flu-like symptoms, sort of muscle aches, low-grade fevers. Otherwise, they've been well tolerated.

Once the vaccinations are done, we follow patients, which is the standard of what we would do with patients who were receiving chemotherapy watch for any signs of recurrent disease, but without any further therapies.

ANNOUNCER: Yet taking part in the trial doesn't mean abandoning other therapies if the disease returns.

DAVID FISHER, MD: The question is: Does receiving the vaccine close any doors down the line? And it doesn't. So once the disease does show evidence of coming back, if it does, patients can receive any other therapy that they would if they hadn't received the vaccine.

ANNOUNCER: There are also exciting possibilities about combining the vaccine with other therapies and using it on a more wide spread basis.

RONALD LEVY, MD: We would love to be able to combine an active vaccine with a monoclonal antibody treatment, such as Rituxan or other monoclonal antibodies that are being developed. We'd love to try it in other kinds of B-cell lymphomas and T-cell lymphomas. There's no reason this couldn't also be used with aggressive lymphomas or what we call intermediate-grade lymphomas. There's no reason it couldn't be used after bone-marrow transplantation. There's no reason it couldn't be used as the first treatment, instead of chemotherapy.

ANNOUNCER: The development of this vaccine may have far reaching implications and the trials to test it are the first step in making these customized vaccines a reality for all patients.

DAVID FISHER, MD: We know, with chemotherapy, that people tend to have their disease come back. So why not try something that may turn the tables and keep the disease away longer or perhaps eradicate it and what could be better than a drug that's designed to attack my specific lymphoma, my own protein on the surface of the cell? Hopefully, this will pay -- will pay off in the future. Time will tell.

ANNOUNCER: For more information on the Clinical Trials of Idiotype Vaccine in Non-Hodgkin's Lymphoma, visit the Lymphoma Research Foundation website at www.Lymphoma.org.

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