This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hsueh, E. C. Articles by Morton, D. L. Search for Related Content PubMed PubMed Citation Articles by Hsueh, E. C. Articles by Morton, D. L.

Prolonged Survival After Complete Resection of Disseminated Melanoma and Active Immunotherapy With a Therapeutic Cancer Vaccine

From the Sonya Valley Ghidossi Vaccine Laboratory, Roy E. Coats Research Laboratories, John Wayne Cancer Institute, Saint John’s Health Center, Santa Monica, CA.

Address reprint requests to Donald L. Morton, MD, John Wayne Cancer Institute, 2200 Santa Monica Blvd, Santa Monica, CA 90404; email: mortond{at}jwci.org

PURPOSE: The curative effect of surgery in certain patients with metastatic melanoma suggests the presence of endogenous antitumor responses. Because melanoma is immunogenic, we investigated whether a therapeutic cancer vaccine called Canvaxin (CancerVax Corporation, Carlsbad, CA) could enhance antitumor immune responses and thereby prolong survival.

PATIENTS AND METHODS: Of 263 patients who underwent complete resection of American Joint Committee on Cancer stage IV melanoma, 150 received postoperative adjuvant vaccine therapy and 113 did not. The overall survival (OS) for the two groups was compared by Cox regression. Further survival analysis was performed by matched-pair analysis according to three prognostic variables: sex, metastatic site, and number of tumor-involved organ sites.

RESULTS: Five-year OS rates were 39% for vaccine and 19% for nonvaccine patients. On multivariate analysis, vaccine therapy was the most significant prognostic variable in this cohort (P = .0001). Analysis of 107 matched pairs of vaccine and nonvaccine patients revealed a significant OS advantage for vaccine therapy (P = .0009): 5-year OS was 39% for vaccine patients versus 20% for nonvaccine patients. There was a significant delayed-type hypersensitivity (DTH) response to adjuvant vaccine therapy (P = .0001), and OS was significantly correlated with DTH to vaccine (P = .0001) but not with DTH to purified protein derivative (PPD), a control antigen.

CONCLUSION: Prolonged survival was observed in patients who received postoperative active immunotherapy with Canvaxin therapeutic cancer vaccine. The correlation of survival with vaccine-DTH responses but not PPD-DTH indicates a treatment-specific effect. These findings suggest that adjuvant active specific immunotherapy should be considered after cytoreductive surgery for advanced melanoma.

Canvaxin and CancerVax are trademarks of CancerVax Corporation, Carlsbad, CA.

This article has been cited by other articles:

				A. I. Daud, N. Mirza, B. Lenox, S. Andrews, P. Urbas, G. X. Gao, J.-H. Lee, V. K. Sondak, A. I. Riker, R. C. DeConti, et al. Phenotypic and Functional Analysis of Dendritic Cells and Clinical Outcome in Patients With High-Risk Melanoma Treated With Adjuvant Granulocyte Macrophage Colony-Stimulating Factor J. Clin. Oncol., July 1, 2008; 26(19): 3235 - 3241. [Abstract] [Full Text] [PDF]

				E. K. Waller The Role of Sargramostim (rhGM-CSF) as Immunotherapy Oncologist, October 1, 2007; 12(suppl_2): 22 - 26. [Abstract] [Full Text] [PDF]

				T. Z. Belhocine, A. M. Scott, E. Even-Sapir, J.-L. Urbain, and R. Essner Role of Nuclear Medicine in the Management of Cutaneous Malignant Melanoma J. Nucl. Med., June 1, 2006; 47(6): 957 - 967. [Abstract] [Full Text] [PDF]

				V. K. Sondak, M. S. Sabel, and J. J. Mule Allogeneic and autologous melanoma vaccines: where have we been and where are we going? Clin. Cancer Res., April 1, 2006; 12(7 Pt 2): 2337s - 2341s. [Abstract] [Full Text] [PDF]

				R. M. Luiten, E. W.M. Kueter, W. Mooi, M. P.W. Gallee, E. M. Rankin, W. R. Gerritsen, S. M. Clift, W. J. Nooijen, P. Weder, W. F. van de Kasteele, et al. Immunogenicity, Including Vitiligo, and Feasibility of Vaccination With Autologous GM-CSF-Transduced Tumor Cells in Metastatic Melanoma Patients J. Clin. Oncol., December 10, 2005; 23(35): 8978 - 8991. [Abstract] [Full Text] [PDF]

				W. E. Carson Getting Melanoma Cells to Stimulate With Frequency J. Clin. Oncol., December 10, 2005; 23(35): 8929 - 8931. [Full Text] [PDF]

				K. J. Pienta and D. C. Smith Advances in Prostate Cancer Chemotherapy: A New Era Begins CA Cancer J Clin, September 1, 2005; 55(5): 300 - 318. [Abstract] [Full Text] [PDF]

				G. Keller, A. V. Schally, T. Gaiser, A. Nagy, B. Baker, G. Westphal, G. Halmos, and J. B. Engel Human Malignant Melanomas Express Receptors for Luteinizing Hormone Releasing Hormone Allowing Targeted Therapy with Cytotoxic Luteinizing Hormone Releasing Hormone Analogue Cancer Res., July 1, 2005; 65(13): 5857 - 5863. [Abstract] [Full Text] [PDF]

				A. Michael, G. Ball, N. Quatan, F. Wushishi, N. Russell, J. Whelan, P. Chakraborty, D. Leader, M. Whelan, and H. Pandha Delayed Disease Progression after Allogeneic Cell Vaccination in Hormone-Resistant Prostate Cancer and Correlation with Immunologic Variables Clin. Cancer Res., June 15, 2005; 11(12): 4469 - 4478. [Abstract] [Full Text] [PDF]

				E. C. Hsueh, E. Famatiga, S. Shu, X. Ye, and D. L. Morton Peripheral Blood CD4+ T-Cell Response Before Postoperative Active Immunotherapy Correlates with Clinical Outcome in Metastatic Melanoma Ann. Surg. Oncol., October 1, 2004; 11(10): 892 - 899. [Abstract] [Full Text] [PDF]

				M.-A. Perales and J. D. Wolchok CD4 Help and Tumor Immunity: Beyond the Activation of Cytotoxic T Lymphocytes Ann. Surg. Oncol., October 1, 2004; 11(10): 881 - 882. [Full Text] [PDF]

				J. A. Sosman, A. T. Weeraratna, and V. K. Sondak When Will Melanoma Vaccines Be Proven Effective? J. Clin. Oncol., February 1, 2004; 22(3): 387 - 389. [Full Text] [PDF]

				S. M. Santini and F. Belardelli Advances in the Use of Dendritic Cells and New Adjuvants for the Development of Therapeutic Vaccines Stem Cells, July 1, 2003; 21(4): 495 - 505. [Abstract] [Full Text] [PDF]

				M. H. Chung, R. K. Gupta, E. Hsueh, R. Essner, W. Ye, R. Yee, and D. L. Morton Humoral Immune Response to a Therapeutic Polyvalent Cancer Vaccine After Complete Resection of Thick Primary Melanoma and Sentinel Lymphadenectomy J. Clin. Oncol., January 15, 2003; 21(2): 313 - 319. [Abstract] [Full Text] [PDF]