Treating Lymphoma: Will a Cus... Video Transcript

Participants

, Morton Coleman MD, FACP, John P. Leonard MD, Ronald Levy MD

Summary

Vaccines have been powerful tools against infectious diseases. Learn how cancer researchers are now developing vaccines for non-Hodgkin's lymphoma.

Webcast Transcript

ANNOUNCER: Non-Hodgkin's Lymphoma is the sixth most common cause of death from cancer. It's a disease where certain cells in the immune system grow uncontrolled.

JOHN LEONARD, MD: The cells of the immune system typically have a job to do to fight infections. And in lymphoma the switches that regulate the cell's growth are broken, and the cells accumulate. They may make a lump or they may involve or infiltrate one of the organs and cause a problem that leads to the diagnosis of lymphoma.

RONALD LEVY, MD: Among the different kinds of non-Hodgkin's lymphoma we have two major kinds, which is what we call low-grade lymphoma and high-grade lymphoma. And the low-grade lymphoma major type is follicular lymphoma.

ANNOUNCER: The low-grade or indolent NHL is a slower form of the disease. IRONALDically it's the one that can create the most difficult challenge.

RONALD LEVY, MD: The traditional treatments for follicular, low-grade lymphomas are mostly chemotherapy treatments. Many of the treatments that we have slow it down even further and keep it under control, but none of them at the moment seem to cure the condition - make it go away forever and never come back - Whereas high-grade lymphomas many of the patients actually do get cured - permanently cured - with the treatments we currently have.

For all people diagnosed with follicular lymphoma, on the average, their survival is ten to twelve years from the time that they're diagnosed

ANNOUNCER: But the outlook for follicular NHL could be changing. A new therapy being developed uses the patient's own cancer cells to create a vaccine which instructs the patient's own immune system to fight the cancer. The very nature of NHL, a b-cell lymphoma, makes this idea work

JOHN LEONARD, MD: B cell lymphomas, as they develop put on the surface of the cell something called the idiotype, and the idiotype is a molecule that is on the tumor cells. Each B-cell as it develops, wears a hat in its surface. In lymphoma, all of the B-cells come from one parent B-cell, and they all have the same hat. So it's along the lines of, all of the bad B-cells have a black hat, whereas the normal B-cells have all different-colored hats. So essentially what we're doing is to try to train the immune system to fight the black hat wherever it is. The only cells that have the black hat are the bad cells, the bad guys. So the concept is basically that we're vaccinating the patient with the black hat.

RONALD LEVY, MD: Up until now, the immunotherapy that we've been using is based on antibodies. So we can make these antibodies in the test tube and then give the antibodies to the person. And these antibodies then find the target and bind to it and eliminate it. So this is what we call "passive" immunotherapy. It's made somewhere else, it goes into the person, it works, and then it goes away.

And that's to be contrasted with active immunotherapy, where we teach the person's own immune system to make their own antibodies.

ANNOUNCER: In active immunotherapy, a vaccine is created specifically for that patients from their own tumors.

JOHN LEONARD, MD: We're trying to take a portion of the tumor and to train the patient's immune system to fight that portion of the tumor so that basically we're teaching the patient's immune system to fight the tumor on its own.

ANNOUNCER: To create the vaccine, a simple biopsy is taken.

JOHN LEONARD, MD: The biopsy has to be taken in order to make the idiotype or the black hat. That usually involves a small surgical procedure. The cells are taken and they are sent to a laboratory that basically allows for the preparation of the vaccine.