Annals of Surgical Oncology

, Volume 9, Issue 5, pp 486–492 | Cite as

Active immunotherapy by reinduction with a polyvalent allogeneic cell vaccine correlates with improved survival in recurrent metastatic melanoma

  • Eddy C. Hsueh
  • Richard Essner
  • Leland J. Foshag
  • Wei Ye
  • Donald L. Morton
Original Articles
Received:
Accepted:

Abstract

Background

We have observed prolonged survival in patients undergoing vaccine reinduction after resection of recurrent metastatic melanoma and adjuvant polyvalent allogenic cell vaccine (PACV) immunotherapy. We hypothesized that reinduction with a more intensive vaccine regimen would re-stimulate specific immune responses that were correlated with survival after recurrence.

Methods

From 1996 to 1998, 194 patients developed recurrence during adjuvant PACV (CancerVax vaccine) treatment after resection of metastatic melanoma. Recurrent disease was treated with or without vaccine reinduction. Reinduction regimen entailed an increased vaccine frequency and coadministration of two doses of bacille Calmette-Guérin (BCG). PACV Delayedtype hypersensitivity (DTH) responses were prospectively recorded. Survival was defined as the interval from recurrence to death.

Results

Ninety-four patients underwent reinduction immunotherapy. DTH responses to PACV before recurrence increased significantly after reinduction therapy (P=.0001). The median survival time was 37 months for reinduced patients and 17 months for other patients. On multivariate analysis, reinduction status remained a significant prognostic variable (P=.0277). In the reinduction group, there was a significant correlation between PACV DTH responses and survival (P=.0178).

Conclusions

Reinduction vaccine regimen can enhance immune responses in previously immunized patients and is associated with prolonged survival after recurrence in patients receiving the same active specific immunotherapy.

Key Words

Melanoma Immunotherapy Reinduction Tolerance 
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Copyright information

© The Society of Surgical Oncology, Inc. 2002

Authors and Affiliations

  • Eddy C. Hsueh
    • 1
  • Richard Essner
    • 1
  • Leland J. Foshag
    • 1
  • Wei Ye
    • 1
  • Donald L. Morton
    • 1
  1. 1.Sonya Valley Ghidossi Vaccine Laboratory of the Roy E. Coats Research Laboratories of the John Wayne Cancer InstituteSt. John’s Health CenterSanta Monica

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