Dendric cell vaccine for breast cancer

[Ellie F]

I wondered if anyone was receiving this type of vaccine for metastatic breast cancer.
A patient at my centre is travelling to Alabama to get this. I understand it is not her 2 specific but works by targeting a protein found in large quantities in breast and other cancers.
My own oncologist is not optimistic about vaccines but I know there are others that feel this is a positive way forward as it targets the patients own immune system.
Would be grateful for any information
Ellie

[chrisy]

Hope someone chimes in, I too believe that in the end if we can wake up the innate immune system, reeducate it to destroy the cancer, and then get out of it's way that is where the answer would be.

[Chelee]

Maybe our dearest Becky will give us her opinion on this? She is so good at explaining everything. I hope she knows something about this?

Chelee

['lizbeth]

Im in the Walter Reed vaccine trial, but it is the GP2 vaccine. I was wondering how many of us are currently in vaccine trials.

[Jackie07]

I remember there are several members who have successfully completed a vaccine trial and are currently NED. I think if you use the 'Search' button and put in 'Vaccine', you will find all the postings involving the subject.

[Becky]

I have never really been a proponent of vaccines (as they are now) for a couple of reasons. Firstly, the trials are always set up for those that are HLA+ (having a certain genetic immunity make up) and the HLA neg people are the controls. This inherently sets up the data to seem more positive than it is since HLA+ people respond better to the regime (even though the response rate is less than a third anyway). So the data is sequed from the get go. Second, of course there is always a target so the immune system makes antibodies that will kill the cancer cells. So, in my example, we will use Her2 (as there are many vaccine trials that target that anyway). But Her2 receptors are a natural part of cells and are abundant in the heart (there just is too many of them in our bc). So, you make antibodies against Her2 and destory your heart too? Could happen. I want a vaccine that targets something cancer cells have that normal cells do not. And that gets to the heart of the matter. Your cancer cells are you. They are different but they were made by you. This is why the immune system or the immune system enhanced by a vaccine does not do a good job against the cancer. We all have some components in the immune system that cause us not to attack ourselves (although there are diseases in which we do such as lupus, MS etc - auto immune diseases) and this actually protects the cancer. I think we have alot to learn - maybe from autoimmune diseases itself, to design a vaccine that will trick certain Bcell components and actually attack just the cancer and do it well. I think it will come but it will take awhile.

The main point is that cancer is self - our horrible Mr. Hyde to our normal Dr. Jekyll.

[Ellie F]

Thanks to all for your replies and thanks to Becky for taking the time to expand the discussion further on vaccines.
Why I was particularly drawn to know more about this dendric cell vaccine was that it targets an onco-fetal antigen, not her 2, which I understand is present on cancer cells but not normal cells. I felt as it is targeted this specific abnormality i would only 'kill' the baddies not the 'goodies' therefore having a less destructive effect on other systems.If my memory of high school biology serves me right this onco- fetal antigen is present on foetuses up till about 20 weeks gestation to facilitate rapid growth and then it is 'turned off' genetically.How it appears on tumour cells I guess is unknown at present but seems to facilitate there rapid growth.
Ellie

['lizbeth]

Thank you Jackie, I'll try that. I've noticed the women that participate in the vaccine trials seem to remain NED. That is what attracted me. Not a fan of chemotherapy.

I just want everyone to know that I am HLA+ and I am blindly randomized. Everyone receives a vaccine with the first injection. For the remaining injections I could be receiving the vaccine or just the GM-CSF.

I don't see the logic in discounting a treatment for women who are HLA-A2+. That seems to me like someone who is triple negative upset that they can't use Herceptin.

I would encourage all of us to research all our options. I personally feel I have a responsibility to the next generation to help find better treatments that leave a better quality of life.

My heart is pumping just fine, I walked 2 hours yesterday and no shortness of breath.

My 2 cents.

Elizabeth

[Rich66]

Sometimes I feel blindly randomized too. Just trying to do my part.

[StephN]

It seems to me that for the DNA vaccine trial in Seattle (U of W) does not require the HLA-2. I did not qualify for the vaccine trial with the HLA-2 requirement because my test showed another HLA number.

So I next tried for the DNA trial. Could not get in that one because I am ANA positive and the FDA regs for that trial say only ANA negative patients can enroll.

So, it is not for lack of effort, just that my body does not have the requirements so far.

[Chelee]

Elizabeth, There's so much I don't understand about vaccines and how they work...but like you...I've sure noticed what seems like alot of women that had the vaccines are NED. I've always wondered about that. It's one of those things that make you go hummmm? :)

Chelee

['lizbeth]

The AE37 arm of the trial is for HLA-A2-

Steph, you had to finish primary treatment within the last 6 months. But who knows the criteria for phase III maybe it will be more inclusive.

I'm in the GP2 arm for the HLA-A2+

Chelee, I sure hope this works for me. I came off the one year of Herceptin and just didn't want to sit around and wait and see. I'm so happy I can participate in a trial.

[Debbie L.]

I agree with Becky.

I'm underwhelmed (so far) with vaccine trials. They enthuse about being able to show "immune response" but then are not able to show clinical benefit. Yes, some women who have participated are NED. But some are dead, too.

I was initially very enthused about vaccines, especially as relates to HER2+. I had been accepted to a trial myself, when it was halted by GSK.

I attended NBCC's Project LEAD in Seattle in 2003, where Mary(Nora) Disis of UoW was one of the lecturers, and she graciously held a special extra lunchtime session for those of us who were interested in vaccine/immunity r/t breast cancer. A headline had appeared in the national news that week proclaiming that stress depleted the immune system (which may be true) and caused cancer (absolutely no evidence to support that one). She called that theory "bullshit" and won my heart.

Anyway, if you're interested in the potential of vaccines, watch a plenary that's now online, from December's SABCS - choose "Saturday, Plenary lecture3":
http://sabcs09.m2usa.com/sabcsol.html

I'm no expert, but Curiel's reasoning made good sense to me. I am not saying there's no hope in vaccine research. But I fear that like everything else, it's going to be incredibly complex and hard to figure out, especially without inducing auto-immune disease, which some would argue can be more misery-inducing than cancer.

Debbie Laxague, drawn out of lurkdom by one of my special-interest topics. I've been holding this list in my heart, with love and support - so many hard losses lately.

['lizbeth]

Debbie,

of course I feel the opposite from you and Becky, but I appreciate any input and any information.

Elle, I didn't mean to hijack your thread.

Debbie, I understand I'm taking a risk with the trial and that down the road I might be dealing with some unforseen consequences.
But I am willing to take the risk to help move cancer research forward. This is something dear to me as I was raised in a family that was opposed to medical treatments such as chemotherapy. I researched extensively to build up comfort with making the decision to take Taxotere and Herception. Looking back it was the best treatment available for me. But I look hard for other options that didn't involve chemo. I couldn't find a treatment that omitted chemo unless I took it first, then enrolled in a clincial trial.

When Dr. Slamon wanted to make Herceptin available to women he ran into many that opposed him. Yet he persisted. And there were problems, big problems with developing a monoclonol antibody that the human body would accept. Herceptin is a god-send, but it doesn't work for everyone. That doesn't mean that it is a "bad" drug. That just means we all must do more to determine what works for each cancer patient.

As we develop more possible treatments we see the pattern emerge that cancer is very individualist. What is a miracle for one, is a disappoint for another who is suffering.

Just because a vaccine does not work for some, but can help others - should we discount it? Thank heavens that Dr. Slamon was so persistent with Herceptin. I don't believe I would be in such great shape today without receiving it.

There is still a lot of work to do in finding ways to prevent suffering and death from cancer. Progress is slow. But I want to look for the good in a possible treatment.

Cancer is like the accident chain in aviation. A disaster does not occur from one event, but a series of events that leads to the point of no return. In cancer we all have different strengths and weaknesses. I believe that when enough weaknesses in the immune system accrue, the cancer thrives. Some of us share the same weaknesses, others have different ones. This is why different treatments succeed for some, not for others.

I hope that neither of us ever has to suffer from cancer again.

And I hope that perhaps you will look at vaccines, a little less skeptically.

I must say for the first time in ages, physically I feel much better. Hopefully, I am one of the lucky ones.

Warm regards.

['lizbeth]

Sorry about all the typos. Still a bit of expressive dysphasia from the chemo.

[Becky]

Look at the Plenary talk that Debbie sites. I went to that discussion at SABCS this year with Sheila. I couldn't find that talk to post it with my first post on this thread.

However, it does site how current vaccine trials really don't work for anyone and that when analyzing the results, there is no current benefit. The reasoning is the "self" component and that the immune system needs to be taken hijack for a vaccine against "self" to work.

I am more than suspect on current technology vaccine trials. They need to dramatically change approach and the population they accept (who don't really gain anything versus the GM-CSF arm of which I think this drug is significant moreso than the vaccine itself).

[Ellie F]

Thanks for the link to the talk on vaccines from San Antonio.He seems to suggest that vaccines may at some point be effective however it implies that at present we are barking up totally the wrong tree!!
Ellie