title: Peptide vaccination after repeated resection of metastases can induce a prolonged relapse-free interval in melanoma patients.
abstract: This pilot study was carried out to gain a first insight into the effects of peptide vaccination in melanoma patients in the high-risk adjuvant disease setting. From the adjuvant peptide vaccination studies carried out in our institution since 1998, we identified all melanoma patients with a history of at least 3 completely resected metastases during the year preceding enrollment into the trial and describe the clinical and immunologic observations. Out of a total of 44 patients with resected cutaneous melanoma entered into adjuvant peptide vaccination trials, 9 patients were identified with more than 3 metastases in the year before vaccination. After initiation of vaccination, 2 patients remained relapse-free for 27 and 42+ months, 2 patients experienced single or several initial relapses and subsequent relapse-free intervals of 18 and 65+ months, whereas 5 patients progressed. In both patients with relapse after prolonged relapse-free intervals, the relapses were initially confined to the small intestine and could be resected. Induction or boosting of functional tyrosinase peptide-specific T cells was noted in 6 of 8 patients, including all 4 patients with prolonged relapse-free intervals. In conclusion, adjuvant peptide vaccination was associated with cessation of recurrences in 4 of 9 patients, of whom all 4 had an immunologic response to the vaccine.
authors.affiliation: Hematology, Oncology and Transfusion Medicine, Medizinische Klinik III, Charité Campus Benjamin Franklin, D-12200 Berlin, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Letsch
authors.forename: Ulrich
authors.initials: U
authors.lastname: Keilholz
authors.forename: Michael
authors.initials: M
authors.lastname: Fluck
authors.forename: Dirk
authors.initials: D
authors.lastname: Nagorsen
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Asemissen
authors.forename: Alexander
authors.initials: A
authors.lastname: Schmittel
authors.forename: Eckhard
authors.initials: E
authors.lastname: Thiel
authors.forename: Carmen
authors.initials: C
authors.lastname: Scheibenbogen
mesh_terms: D000276:Adjuvants, Immunologic; D000328:Adult; D000368:Aged; D019496:Cancer Vaccines; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000276:immunology* / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012307:Risk Factors; D012878:Skin Neoplasms / Q000276:immunology* / Q000601:surgery / Q000628:therapy*; D013601:T-Lymphocytes / Q000276:immunology; D013997:Time Factors; D022223:Vaccines, Subunit
chemical_list: D000276:Adjuvants, Immunologic; D019496:Cancer Vaccines; D022223:Vaccines, Subunit