title: Treatment of patients with progressive unresectable metastatic melanoma with a heterologous polyvalent melanoma whole cell vaccine.
abstract: Unresectable metastatic melanoma has no elective treatment. Neither chemotherapy, intravenous IL-2 nor biochemotherapy clearly improves the overall survival. Recent assays with therapeutic vaccines have been recently yielded promising results. Here, we describe the application, clinical tolerance and antitumoural activity of a heterologous polyvalent melanoma whole cell vaccine in patients with metastatic melanoma. Twenty-eight AJCC stage III/IV melanoma patients with progressive unresectable metastatic disease were treated with our heterologous polyvalent melanoma whole cell vaccine between July 1, 1998 and July 1, 2002. All patients had already been unsuccessfully treated with high doses of IFN-alpha2 and/or polychemotherapy and/or biochemotherapy and/or perfusion of extremities, or could not receive other treatments due to their age or underlying illness. Twenty-three were assessable. The vaccine was constituted by 10 melanoma cell lines, derived from primary, lymph node and metastatic melanomas. Prior to intradermal inoculation, the cells were irradiated and mixed with BCG, and 50% were treated with DNFB. After a median follow-up of 19 months, 26% of patients responded: 3 CR (18, 16+, and 26+ months), 2 PR (8 and 22 months) and 1 MR (36+ months). The median survival of the whole group was 20.2 months. None of the 28 patients initially included in the study presented significant toxicity. This vaccination program had specific antitumoural activity in advanced metastatic melanoma patients and was well tolerated. The clinical responses and the median survival of our group of patients, together with the low toxicity of our polyvalent vaccine, suggest that this approach could be applied to earlier metastatic melanoma patients.
authors.affiliation: Department of Immunology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Vilella
authors.affiliation: Department of Immunology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Benitez
authors.affiliation: Department of Immunology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Milà
authors.affiliation: Department of Dermatology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Vilalta
authors.affiliation: Department of Surgery, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Rull
authors.affiliation: Department of Dermatology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Cuellar
authors.affiliation: Department of Radiotherapy, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Conill
authors.affiliation: Department of Nuclear Medicine, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Sergi
authors.initials: S
authors.lastname: Vidal-Sicart
authors.affiliation: Department of Microbiology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Costa
authors.affiliation: Department of Dermatology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Yachi
authors.affiliation: Department of Dermatology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Palou
authors.affiliation: Department of Dermatology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Malvehy
authors.affiliation: Department of Dermatology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Puig
authors.affiliation: Department of Dermatology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Marti
authors.affiliation: Department of Oncology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Mellado
authors.affiliation: Department of Dermatology, Hospital Clinic and IDIBAPS, Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Castel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D019496:Cancer Vaccines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D016219:Immunotherapy, Adoptive / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000556:secondary / Q000628:therapy*; D008875:Middle Aged; D009163:Mycobacterium bovis; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D017778:Vaccines, Combined
chemical_list: D015703:Antigens, CD; D019496:Cancer Vaccines; D017778:Vaccines, Combined; C094534:polyvalent melanoma cell vaccine