title: Translational development of active immunotherapy for hematologic malignancies.
abstract: Idiotype (Id) antigen is a unique, truly tumor-specific antigen. Early preclinical studies have shown Id vaccination to be efficacious against established tumors, and this effect is enhanced by addition of the cytokine granulocyte-macrophage. One clinical study showed that injections of immunoglobulin derived from each patient's tumor cells (immunoglobulin-Id protein) induced Id-specific immunologic responses of the humoral type and/or the cell-mediated type, and that those patients who experienced cell-mediated responses achieved molecular remissions. Addition of cytokines to Id vaccination can greatly influence the magnitude and phenotype of the immune response to protein antigens. One cytokine, granulocyte-macrophage colony-stimulating factor, is particularly important to the success of cancer immunotherapy. Some studies have shown the ability of granulocyte-macrophage colony-stimulating factor to enhance protective tumor immunity and help prolong survival rates. A number of trials have been conducted on the use of Id vaccination in the treatment of follicular lymphoma. Currently, the National Cancer Institute (Frederick, MD) is conducting a large, randomized, multicenter, phase III trial comparing chemotherapy alone versus chemotherapy followed by vaccination with Id-keyhole limpet hemocyanin plus granulocyte-macrophage colony-stimulating factor. This pivotal study is the final step before vaccine therapy might be considered as an option of standard care for patients with follicular lymphoma.
authors.affiliation: National Institutes of Health, Frederick, MD 21702-1201, USA.
authors.forename: Larry W
authors.initials: LW
authors.lastname: Kwak
mesh_terms: D000276:Adjuvants, Immunologic; D000951:Antigens, Neoplasm / Q000276:immunology; D019496:Cancer Vaccines / Q000276:immunology* / Q000627:therapeutic use*; D018925:Chemokines / Q000276:immunology; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000276:immunology; D003713:Dendritic Cells / Q000276:immunology; D019337:Hematologic Neoplasms / Q000276:immunology / Q000628:therapy; D006433:Hemocyanins; D006801:Humans; D007130:Immunoglobulin Idiotypes; D016233:Immunotherapy, Active; D008223:Lymphoma / Q000276:immunology / Q000628:therapy*
chemical_list: D000276:Adjuvants, Immunologic; D000951:Antigens, Neoplasm; D019496:Cancer Vaccines; D018925:Chemokines; D016207:Cytokines; D007130:Immunoglobulin Idiotypes; D006433:Hemocyanins; C032808:keyhole-limpet hemocyanin