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Published on: 4/23/2002
Last Visited: 11/13/2002
"This type of low-grade follicular lymphoma has traditionally been highly treatable, but essentially incurable," says Aaron P. Rapoport, M.D., the director of lymphoma-gene medicine at the Greenebaum Cancer Center and the chief investigator for the study."This technique for harnessing the immune system may result in long-term disease remission and potential cures for some patients."
So far, four people have been enrolled in the study at the Greenebaum Cancer Center, but researchers hope to recruit a total of 12 to 15 patients in the Phase III clinical trial.The first patient to be vaccinated, a 45-year-old Baltimore woman, started her treatment earlier this month after completing a course of chemotherapy.
About 480 patients are expected to participate in the nationwide study at 25 institutions in the United States and Canada.
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Lymphomas and other types of cancers use mechanisms to evade the body's immune system," says Dr. Rapoport, an associate professor of medicine at the University of Maryland School of Medicine.
He said that in earlier clinical trials, about two-thirds of the patients showed positive immunological responses to the vaccinations."But it is difficult to know the clinical impact of that," he says."Does it mean that they have better responses or longer-lasting responses?That's what this study is designed to show."
In this trial, patients first receive eight rounds of chemotherapy with three drugs - cytoxan, vincristine, and prednisone.If they experience at least a 50% remission, they remain in the study and are observed for another five months while their bodies rest from the chemotherapy.If there is still no progression of their disease, two-thirds of the patients receive a vaccine crafted from their own tumor cells, plus an immune system stimulant, while one-third receive a vaccine using only a carrier protein and the stimulant, which may also activate the immune system in a beneficial way.
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Low-grade follicular lymphomas are generally treated with radiation if they are localized or chemotherapy if they are widespread, Dr. Rapoport says.The cancer responds well to treatment, but is likely to recur.
"I believe this technology offers the potential for better treatment results than we have previously seen," Dr. Rapoport says.
Related Chapters:Harrisons Chapter 112: Malignancies of Lymphoid CellsHarrisons Chapter 79: Approach to the Patient With Cancer