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Ovarian Cancer Vaccine - Clinical Trials Raise Treatment Possibility
#1
Promising Ovarian Cancer Vaccine Shows Efficacy in Early Clinical Trials.

Currently, most cancer treatments involve chemotherapy and radiation. Both of these therapies target rapidly-replicating cells in the body, and result in the death of these cells. Cancer cells are targeted by these therapies; unfortunately, many healthy cells are also targeted. This results in side effects ranging from nausea, to hair loss, skin problems, anemia, and a compromised immune system. In addition, the current therapies are may have low efficacy rates in certain types of cancers or late stage cancers, and even after a patient enters remission, he or she may eventually relapse.

One new therapy recently put through clinical trials actually helps train a patient’s immune system to fight ovarian cancer tumors. The vaccine therapy uses tumor cells from the patient to train immune cells from the patient to fight the cancer, thus creating a personalized vaccine for each individual patient. The process involved removing tumor cells and a type of white blood cell from patients. The white blood cells, called monocytes, are innate immune cells. The monocytes will mature into cells called Dendritic Cells, which will help to prime the adaptive immune system by ingesting foreign invaders and altered host cells (called altered self). After the Dendritic Cell ingests a problematic cell, it presents antigen to the adaptive immune system. This activates adaptive immune cells, called T cells. The T cells are able to specifically recognize the problematic cell (either foreign or altered self) and will work to remove other infectious or cancerous cells.

The clinical trial involved the use of Dendritic Cell therapy. The procedure involved isolating monocytes from the patient’s blood. Once monocytes have been isolated from the patient’s blood, they are matured into Dendritic cells, and are expanded in a cell culture system. This increases the number of Dendritic Cells available to function in the patient’s immune system. After the Dendritic Cells have been expanded, they are incubated with tumor cells. The Dendritic Cells will ingest the tumor cells, and display the tumor antigen on the cell surface. The Dendritic Cells are next injected back into the patient, where they will activate T cells to fight the ovarian cancer tumor. This is a typical procedure used in Dendritic Cell therapy.

For the clinical trial studying ovarian cancer treatment, 25 of 31 patients who developed anti-tumor responses but still were affected by disease, were additionally treated with adoptive T cell therapy. T cells from the patient were expanded and primed in cell culture, then injected back into the patient, similar to the Dendritic Cell therapy. The T cells, which are the adaptive part of the immune system, are able to recognize and kill ovarian cancer cells in the patient. The T adoptive T cell therapy was supplemented with a cancer drug called Avastin, which helps prevent growth of blood vessels to feed the tumor.

A major advantage to using Dendritic Cell therapy and adoptive T cell transfer is that both of these therapies are personalized to the patient. All cells used in the therapy, including the cancer cells that prime the immune cells, originate from the patient. This means that the Dendritic Cells and T cells will be specifically designed to fight the patient’s own cancer, as opposed to cancer cells obtained from other sources. In addition, this prevents any potential adverse immune reaction that can occur when patients receive transplants from other donors, such as bone marrow or stem cell transfers.

This early clinical trial studied 35 patients with stage 3 and stage 4 ovarian cancer. Of the patients treated with only the Dendritic Cell vaccination, 61% had a noticeable clinical response. Of the patients treated with both the Dendritic Cell vaccination and the adoptive T cell transfer, 75% showed a clinical benefit. Eight patients had no signs of disease at the end of the study, and continued to receive maintenance vaccinations to prevent relapse of the cancer. One of the 31 patients even went into complete remission, meaning the cancer was completely undetectable even 42 months after the end of the study. This was the first such clinical study in which two immunotherapies were combined to treat cancer. The results provide exciting evidence that by combining two powerful anti-cancer therapies, patients’ immune systems can have a better chance to fight cancer.

References:
http://www.medicalnewstoday.com/articles/258769.php
http://www.foxnews.com/health/2013/04/08...-in-trial/
http://dendritic.info/
http://www.jci.org/articles/view/31446
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#2
Cervical cancer vaccine

The previous article describes a promising clinical trial aimed at developing immunotherapy against the scourge of ovarian cancer. Another gynaecological cancer of women, namely cervical cancer, already has a vaccine available. Cervical cancer is the most prevalent preventable cancer of women in developing countries. It is caused by sexual transmission of human papillomavirus (HPV); it is estimated that in excess of 80% of sexually active women will be infected with HPV in their lifetime. Cervical cancer arises when certain oncogenic subtypes of HPV persist, resulting in firstly precancerous change (cervical intraepithelial neoplasia (CIN)) and ultimately cervical cancer. When considering a potential vaccine/immunotherapy to ovarian cancer it is worth bearing in mind the issue that have arisen in introducing the cervical cancer vaccine.

Two HPV vaccines are available, namely Merck & Co.'s Gardasil() and GlaxoSmithKline's Cervarix(). The optimal regime for vaccination dictates that girls be vaccinated prior to becoming sexually active, with the hope being that the incidence of cervical cancer be reduced in the future. However, concerns raised in the media about potential safety risks associated with the vaccine have impacted on vaccine uptake. This is a challenge for public health workers, who need to focus on education of parents and adolescent girls on the proven link of HPV to cervical cancer. In the UK, a school-based vaccination programme has had a positive effect on uptake, with an uptake rate in England of 76% for 2009/2010.

In addition to the vaccine, some countries including the UK have an effective cervical screening programme, in which CIN is recognised and treated before cervical cancer can develop. Studies suggest that the optimal method for reduction of cervical cancer incidence within a sustainable budget is to implement a combination of HPV vaccination in 80% of pre-sexually active girls along with sreening at a longer interval than currently practiced in the UK, i.e. every six years instead of every three.

it is to be hoped that a situation can develop where ovarian cancer can be tackled as effectively as it is beginning to be possible to tackle cervical cancer.

Sources

DEMARTEAU, N., BREUER, T. and STANDAERT, B., 2012. Selecting a mix of prevention strategies against cervical cancer for maximum efficiency with an optimization program. PharmacoEconomics, 30(4), pp. 337-353

RUSSELL, M., RAHEJA, V. and JAIYESIMI, R., 2013. Human papillomavirus vaccination in adolescence. Perspectives In Public Health,
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#3
One of the best treatment for cancer are therapy and radiation and it is a good medical study that a vaccine is now effective to treat cancer particularly Cervical cancer which is a big advantage for medical doctors and patients because using this, they are not going to undergo in any operation. Besides with this trial it give a big hope for those cancer patients.
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