title: Humoral immune response to a therapeutic polyvalent cancer vaccine after complete resection of thick primary melanoma and sentinel lymphadenectomy.
abstract: OBJECTIVE
  A therapeutic polyvalent cancer vaccine (Canvaxin vaccine; CancerVax Corp, Carlsbad, CA) induces antibodies to a glycoprotein tumor-associated antigen (TA90). However, endogenous immune responses to TA90 have also been reported. This study examined anti-TA90 antibody responses with respect to the survival of patients who received adjuvant vaccine immunotherapy after resection of thick (> or = 4 mm) primary cutaneous melanoma.
  
  
  METHODS
  Serum specimens were obtained from 54 patients immediately before and then 1, 2, 4, and 6 months after wide local excision of thick primary cutaneous melanoma and sentinel lymphadenectomy. All patients were offered adjuvant therapies with the vaccine, high-dose interferon, or other agents. An enzyme-linked immunosorbent assay was used to determine serial serum titers of immunoglobulin G (IgG) and IgM antibodies against TA90. These titers were correlated with clinical course.
  
  
  RESULTS
  Forty-three patients chose vaccine therapy, and 11 patients chose postoperative observation. Preoperative anti-TA90 IgG and IgM titers were similar for vaccine and observation groups (P =.184). At a median follow-up of 26 months, univariate analysis of Cox regression showed that disease-free survival and overall survival of vaccine patients were significantly correlated with maximal IgM response (P =.0006 and.006, respectively) but not with maximal IgG response (P =.73 and.95, respectively). Neither response predicted survival in the observation group.
  
  
  CONCLUSIONS
  Postoperative vaccine therapy may enhance IgG and IgM immune responses to TA90 after surgical resection, but only the IgM response is correlated with improved survival. These findings may become useful to guide selection of patients for postoperative adjuvant therapy of high-risk melanoma.
authors.affiliation: Sonya Valley Ghidossi Vaccine Laboratory of the Roy E. Coats Research Laboratories of the John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA 90404, USA.
authors.forename: Mathew H
authors.initials: MH
authors.lastname: Chung
authors.forename: Rishab K
authors.initials: RK
authors.lastname: Gupta
authors.forename: Eddy
authors.initials: E
authors.lastname: Hsueh
authors.forename: Richard
authors.initials: R
authors.lastname: Essner
authors.forename: Wei
authors.initials: W
authors.lastname: Ye
authors.forename: Reynold
authors.initials: R
authors.lastname: Yee
authors.forename: Donald L
authors.initials: DL
authors.lastname: Morton
mesh_terms: D000328:Adult; D000368:Aged; D000912:Antibodies, Neoplasm / Q000097:blood*; D000917:Antibody Formation; D000951:Antigens, Neoplasm / Q000276:immunology*; D019496:Cancer Vaccines / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D016233:Immunotherapy, Active; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000276:immunology* / Q000473:pathology / Q000601:surgery / Q000628:therapy; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000276:immunology* / Q000473:pathology / Q000601:surgery / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000912:Antibodies, Neoplasm; D000951:Antigens, Neoplasm; D019496:Cancer Vaccines; C464842:Canvaxin; D007074:Immunoglobulin G; D007075:Immunoglobulin M; C113885:TA90 immune complex