Vaccines Health Article

Preparation

Before enrolling in a clinical trial, patients should discuss the potential benefits and risks with their doctor. Clinical trials can be located by contacting the research institutes directly or by searching the Internet. A particularly good site for getting information about clinical trials for cancer treatment is run by the National Cancer Institute (<http://www.clincialtrials.gov>).

Aftercare

One of the most striking advantages of vaccines compared to other cancer treatments is the relatively low incidence of side effects. Particularly if IFN is used as an immunoadjuvant, patients sometimes experience flu-like symptoms. However, other than some soreness at the site of injection, vaccine patients generally have no adverse reactions to this kind of treatment.

Risks

The greatest risk with cancer vaccines is that there will be no immune response and the treatment will be ineffective. Although serious adverse reactions to the antigens, such as the attack of healthy cells, are theoretically possible, these fears have not materialized. Other than some mild adverse reactions, such as fever and redness of the skin at the injection site, vaccine treatment appears relatively low-risk in the traditional sense.

Normal results

Based on a review of published clinical trials as of 2000, normal results for this treatment is, unfortunately, little or no effect. Although a response by the immunized patient's T cells against the tumor is often documented by testing, the effect on disease is generally marginal. These results could be at least partially due to the selection process for patients in the trials, who are often suffering from late-stage cancers.

Abnormal results

For each trial, there are a small percentage of patients who have complete, partial, or mixed response to the vaccine. Others show a stabilization of the disease where deterioration of condition would be expected. As traditional treatments were often unsuccessful with these patients, these results are significant. However, the very low rate of success underscores the complexity of the human immune system, the number of variables in the vaccine method, and the amount of research that will need to be done to develop an effective vaccine treatment for this disease.

See Also Monoclonal antibodies; Immunologic therapy

Resources

BOOKS

Restifo, Nicholas, et al. "Therapeutic Cancer Vaccines." InCancer Principles & Practice of Oncology, edited by DeVita, Vincent T., et al. Philadelphia: LippincottWilliams & Wilkins, 2001, pp. 3195-217.

PERIODICALS

Bocchia, Monica, et al. "Antitumor Vaccination: Where WeStand." Haematologica 85 (November 2000): 1172-206.

Monzavi-Karbassi, B., and T. Kieber-Emmons. "Current concepts in cancer vaccine strategies." Biotechniques 30 (January 2001): 170.

OTHER

"First Potential Universal Cancer Vaccine Shows Promise InLab." Science Daily Magazine. 30 August 2000. 12 April 2001. 28 June 2001 <http://www.sciencedaily.com/print/2000/08/000830073711.htm>.

"Treating Cancer with Vaccine Therapy." Cancer Trials. July 20, 1999. 12 April 2001. 28 June 2001.<http://cancertrials.nci.nih.gov/news/features/vaccine/index.html>.

Michelle Johnson, M.S., J.D.

Adjuvant

—A substance added to a vaccine to increase the immune system's response to the vaccine contents.

Allogeneic

—A type of vaccine made up of tumor cells derived from persons other than the patient.

Antigen

—A substance characteristic of a tumor that evokes an immune response.

Antigen presenting cell

—A cell of the immune system that ingests antigens and exposes them to cells of the immune system in a way that activates the cells to seek out and destroy any other cells displaying that antigen.

Autologous

—A type of vaccine made up of tumor cells from the patient's own tumor.

Cytokine

—A substance made by cells of the immune system that increases the response to a foreign substance.

Dendritic cell

—A special type of antigen-presenting cell that is effective in stimulating T cells.

Epitope

—A portion of a protein or other molecule that is the specific target of an immune response.

QUESTIONS TO ASK THE DOCTOR

• Have all the standard treatment methods for my cancer been tried?
• Is there a vaccine in clinical trials for my kind of cancer?
• Do I fulfill the requirements necessary for the clinical trial for this vaccine?
• Has this vaccine been tried on human patients before?
• If so, what were the results?