Tailor-made vaccines
Paul Nghiem, MD, PhD, examines a mole on Jim McKenna's shoulder.
With research on the problem intensifying and more melanoma patients coming to Dana-Farber for treatment, the Institute's Medical Oncology Department this spring launched a program to help focus oncologists' efforts to turn scientific findings into new therapies for melanoma — particularly in its advanced stages — and for CTCL. Fisher heads the program, and Stephen Hodi, MD, serves as its clinical director.
Hoping to improve the outlook for patients with advanced melanoma, Hodi has been testing therapeutic vaccines designed to spur the body's natural defenses against it.
"These investigations are likely to fundamentally change our thinking about melanoma."
—Thomas Kupper, MD
These vaccines are tailored to each patient — in fact, they're made from his or her own melanoma cells. Surgeons take a sample of tumor cells from the patient, and those are infected with viruses that carry a gene for making GM-CSF, a natural chemical that prompts a strong immune response. Hodi notes that when the cells were returned to patients in a clinical trial, they stimulated an immune reaction in about two-thirds of them, and a few patients have survived without relapsing for as long as five years.
Building on these results, he has begun a new trial to test a method for boosting the numbers and potency of cancer-killing immune cells stirred up by the vaccine. Another study is assessing a vaccine combined with an antibody to make it stronger — not only in melanoma patients, but in those battling cancers of the ovary, lung, and blood.
Ultimately, Hodi predicts, the key to controlling advanced melanoma won't be a single approach. "It's likely that we'll use vaccines to augment the immune system," he says, "along with targeted drugs that shut down overactive growth signals in tumors and stop them in their tracks."
