Immuuntherapie: Vaccin geeft hoop in kleinschalige studie tegen CML na resistentie voor Gleevec.

31 augustus 2017: Lees ook dit artikel:

https://kanker-actueel.nl/NL/immuuntherapie-met-car-t-cell-therapy-tisagenlecleucel-kymriah-goedgekeurd-door-fda-voor-gebruik-bij-kinderen-en-jong-volwassenen-met-vorm-van-acute-lymfatische-leukemie-all.html

11 december 2012: een aan onderstaand bericht gerelateerd artikel staat vandaag 11 december 2012 een groot artikel in de Volkskrant: Leukemie: Omgebouwd hiv-virus wapen tegen kanker

15 augustus 2011: ik ben kanker-actueel aan het herzien. Medscape schreef een mooi samenvattend artikel over de huidige stand van zaken bij vormen van leukemie. Als u hier klikt kunt u dit artikel vrij inzien. Zo begint dit artikel:

There are a significant number of patients diagnosed with acute leukemia who either fail to achieve remission or who relapse thereafter. Challenges in treating this patient population include accurately assessing prognosis of disease and whether remission can be achieved; assessing the ability of patients to tolerate aggressive salvage therapies; choosing a salvage therapy that is most likely to succeed; and identifying suitable patients for hematopoietic stem cell transplantation. Despite the development of a variety of new investigational therapies, relapsed or refractory acute myeloid leukemia remains a difficult clinical problem. Clinicians will need to consider all currently available approaches, including cytotoxic chemotherapy, targeted agents, and allogeneic stem cell transplantation, to optimize outcomes. Read more>>>>>>

19 februari 2005: Bron: Medscape - Lancet. 2005;365:631-632, 657-662

Een kleinschalige studie meldt hoopvolle resultaten van een vaccin voor CML = Chronische Myeloide Leukemie. Alle deelnemende patiënten waren inmiddels resistent geworden voor Gleevec. Lees in onderstaand artikel over de resultaten.

Vaccine May Enhance Treatment for Chronic Myeloid Leukemia
Laurie Barclay, MD

Feb. 18, 2005 — A vaccine may enhance treatment for chronic myeloid leukemia (CML), according to the results of a small study published in the Feb. 19 issue of The Lancet.

"Our preliminary data suggest that the addition of this vaccine to patients treated with conventional treatment might favor further reduction of the residual disease and increase the number of patients who reach a molecular response, the best surrogate of cure for those with ," lead author Monica Bocchia, from the University of Siena in Italy, says in a news release.

The authors note that imatinib is the standard treatment for CML, but not all patients reach complete cytogenetic remission (CCR) and most maintain detectable disease at the molecular level. CMLVAX100 is a multipeptide vaccine targeting the BCR-ABL-derived p210 fusion protein, and molgramostim and QS-21 were used as adjuvants.

Sixteen patients with CML (with the b3a2 fusion point of p210), stable residual disease, a minimum treatment of 12 months of imatinib or 24 months of interferon alfa, and no further reduction of residual disease for at least six months preceding enrollment each received vaccination with CMLVAX100 every two weeks for a total of six vaccinations. Assessment of immunological and disease response after treatment included detecting amounts of b3a2 transcripts by standardized quantitative real-time reverse-transcriptase polymerase chain reaction.

Of 10 patients receiving imatinib, nine started CMLVAX100 having had a median of 10 months' stable cytogenetic disease (median 10% Philadelphia-chromosome-positive metaphases), and one started while in stable CCR. After six vaccinations, all patients' cytogenetic responses improved, and five reached CCR, including three patients with undetectable amounts of b3a2 transcript (BCR-ABL:beta2 microglobulin ratio < .00001).

Of six patients receiving interferon alfa treatment, with a median of 17 months' stable residual disease (median 13% Philadelphia chromosome-positive cells), five had improved cytogenetic responses after vaccination, and two reached CCR. Overall, 11 of 16 patients had peptide-specific delayed-type hypersensitivity, 13 of 14 assessed had CD4 cell proliferation, and five of five assessed had interferon gamma production.

"Studies that focused on improving the assessment of residual disease after vaccination, including larger numbers of patients as well as longer follow-up, are underway to assess definitively the role of this vaccine against leukemia," Dr. Bocchia says.

The MIUR, CNR/MIUR 2003, PAR 2003, SIENAIL, and Monte dei Paschi Foundation 2003 supported this study. The authors report no conflict of interest.

In an accompanying commentary, Saswati Chatterjee and K.K. Wong, from the City of Hope National Medical Center in Duarte, California, note that this study is very similar to previous studies of CMLVAX100, but that it is the first to show a clinical response.

"Given the ease of administration, lack of toxicity, and early promise of efficacy, vaccine development against the fusion protein or other CML-specific antigens appears to be a reasonable avenue for further investigation," Dr. Chatterjee says. "In the meantime, we will eagerly await the results of disease-free survival in the vaccinated group and confirmatory studies by other investigators in the field."

Drs. Wong and Chatterjee report no conflict of interest.

Lancet. 2005;365:631-632, 657-662