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|Clinical benefit associated with idiotypic vaccination in patients with follicular lymphoma.|
|Authors: ||Inoges, S. (Susana)|
Rodriguez-Calvillo, M. (Mercedes)
Zabalegui, N. (Natalia)
Lopez-Diaz-de-Cerio, A. (Ascensión)
Villanueva, H. (Helena)
Soria, E. (Elena)
Suarez, L. (Lilia)
Rodriguez-Caballero, A. (Arancha)
Pastor, F. (Fernando)
Garcia-Muñoz, R. (R.)
Panizo, C. (Carlos)
Perez-Calvo, J. (Javier)
Melero, I. (Ignacio)
Rocha, E. (Eduardo)
Orfao, A. (Alberto)
Bendandi, M. (Maurizio)
|Keywords: ||Cancer Vaccines/immunology|
Lymphoma, Follicular/drug therapy
Immunoglobulin Idiotypes/therapeutic use
|Issue Date: ||2006|
|Publisher: ||Oxford University Press|
|Publisher version: ||http://jnci.oxfordjournals.org/content/98/18/1292|
|Citation: ||Inoges S, Rodriguez-Calvillo M, Zabalegui N, Lopez-Diaz de Cerio A, Villanueva H, Soria E, et al. Clinical benefit associated with idiotypic vaccination in patients with follicular lymphoma. J Natl Cancer Inst 2006 Sep 20;98(18):1292-1301.|
Follicular lymphoma is considered incurable, although cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy can induce sequential remissions. A patient's second complete response is typically shorter than that patient's first complete response. Idiotype vaccines can elicit specific immune responses and molecular remissions in patients with follicular lymphoma. However, a clinical benefit has never been formally proven.
Thirty-three consecutive follicular lymphoma patients in first relapse received six monthly cycles of CHOP-like chemotherapy. Patients who achieved a second complete response were vaccinated periodically for more than 2 years with autologous lymphoma-derived idiotype protein vaccine. Specific humoral and cellular responses were assessed, and patients were followed for disease recurrence. Statistical tests were two-sided.
Idiotype vaccine could be produced for 25 patients who had a second complete response. In 20 patients (80%), a humoral (13/20) and/or a cellular (18/20) idiotype-specific response was detected. The median duration of the second complete response has not been reached, but it exceeds 33 months (range = 20+ to 51+ months). None of the 20 responders relapsed while undergoing active vaccination. All responders with enough follow-up for the comparison to be made experienced a second complete response that was statistically significantly (P<.0001) longer than both their first complete response (18 of 18 patients) and than the median duration of a CHOP-induced second complete response, i.e., 13 months (20 of 20 patients). The five nonresponders all had a second complete response that was shorter (median = 10 months; range = 8-13 months) than their first complete response (median = 17 months; range = 10-39 months).
Idiotypic vaccination induced a specific immune response in the majority of patients with follicular lymphoma. Specific immune response was associated with a dramatic and highly statistically significant increase in disease-free survival. This is the first formal demonstration of clinical benefit associated with the use of a human cancer vaccine.
|Permanent link: ||http://hdl.handle.net/10171/18723|
|Appears in Collections:||DA - CIMA - Servicios de apoyo - Aptámeros - Artículos|
DA - CIMA - Terapia génica y Hepatología - Inmunología terapia génica - Artículos de revista
DA - Medicina - Medicina Interna - Artículos de revista
DA - CIMA - Terapia génica y Hepatología - Inmunología hepatitis virales - Artículos de revista
DA - CIMA - Oncología - Inmunoterapia - Artículos de Revista
DA - CUN - Hematología y Hemoterapia - Artículos de revista
DA - CUN - Área de Terapia Celular - Artículos de revista
DA - Medicina - Hematología - Artículos de revista
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