title: Durable complete response of refractory, progressing metastatic melanoma after treatment with a patient-specific vaccine.
abstract: A patient with metastatic melanoma who experienced a durable complete response after treatment with a patient-specific vaccine has been described in this article. This 59-year-old woman presented with cervical spine metastases and, within the year, had experienced local disease progression and, despite various therapies, metastases to the axilla, rectum, gall bladder, and multiple soft-tissue sites. She had previously received radiation therapy, combination chemotherapy, interleukin-2 plus interferon biotherapy, and gamma knife radiosurgery, and undergone multiple surgical resections. At the time vaccine therapy was initiated, she had multiple, new, measurable, soft-tissue metastases that were increasing in size. She was treated with a vaccine consisting of autologous dendritic cells incubated with irradiated tumor cells from an autologous tumor cell line and suspended in granulocyte-macrophage colony stimulating factor (GM-CSF), with subcutaneous injections once a week for 3 weeks and monthly for 5 months. There was evidence of disease regression by the completion of therapy. A few months later a complete response was documented by radiologic scans, and subsequently reconfirmed at 6-month intervals. She remains in complete remission >2.5 years after starting the vaccine, and >2 years after completing the vaccine, and survives >4 years after her initial presentation with bone, bowel, and lymph node metastases. This is the first time she has been in a complete remission since her initial diagnosis. Patient-specific vaccines can sometimes induce durable complete regression of progressing soft-tissue melanoma metastases.
authors.affiliation: Hoag Cancer Center, Newport Beach, California 92658, USA. rdillman@hoaghospital.org
authors.forename: Robert O
authors.initials: RO
authors.lastname: Dillman
authors.forename: Andreea A
authors.initials: AA
authors.lastname: Nanci
authors.forename: Scott T
authors.initials: ST
authors.lastname: Williams
authors.forename: Richard B
authors.initials: RB
authors.lastname: Kim
authors.forename: Russell L
authors.initials: RL
authors.lastname: Hafer
authors.forename: Colleen L
authors.initials: CL
authors.lastname: Coleman
authors.forename: Peter C
authors.initials: PC
authors.lastname: Wang
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Duma
authors.forename: Peter V
authors.initials: PV
authors.lastname: Chen
authors.forename: Senthamil R
authors.initials: SR
authors.lastname: Selvan
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Cornforth
authors.forename: Carol
authors.initials: C
authors.lastname: DePriest
mesh_terms: D019496:Cancer Vaccines / Q000627:therapeutic use*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012074:Remission Induction; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D019496:Cancer Vaccines