WEDNESDAY, March 7 (HealthDay News) -- Combining the
immune-based drug ipilimumab with targeted radiation therapy
improved one advanced melanoma patient's ability to fight the
deadly skin cancer, a new study says.
The treatment triggered a strong immune response, which resulted
in shrinkage of both the tumor treated with radiation as well as
tumors located at distant locations in the body, according to the
study, published in the March 8 issue of the
New England Journal of Medicine.
The patient was followed for seven years, from her initial
diagnosis of melanoma in 2004, through a series of treatments, to
her eventual disease regression in April 2011.
According to health experts, this is a rare documented case of
an immune response called the "abscopal effect" that can occur in
cancer treatment.
Although the results were dramatic in this patient, one expert
said such cases are isolated.
"Although this patient represents a successful outcome, it does not mean that this treatment approach will be as effective in other patients," said Dr. Craig Devoe, oncologist at the Monter Cancer Center, part of the North Shore-Long Island Jewish Health System, in Lake Success, N.Y. He was not involved in the study.
In this case, the patient had a preexisting immune response to
an antigen called NY-ESO-1. This immune response occurs in certain
cancer patients and they are more likely to respond to ipilimumab
than others, explained the scientists at the Ludwig Institute for
Cancer Research and Memorial Sloan-Kettering Cancer Center in New
York City.
"The use of radiation therapy modulated the patient's immune system, resulting in an increased antibody response to one portion of the NY-ESO-1 protein, as well as increased antibody responses to other antigens," research leader Dr. Jedd Wolchok said in a Ludwig Institute news release. Wolchok is associate attending physician and director of Immunotherapy Clinical Trials at Memorial Sloan-Kettering, and director of the Ludwig Institute/Cancer Research Institute Cancer Vaccine Collaborative.
At the same time that the therapy was evoking this strong
immune-system response, "the radiation lowered the level of a
population of [immunosuppressive] cells, allowing the immune system
to function more robustly, leading to better recognition and
control of the disease," Wolchok said.
This case report illustrates the power of harnessing the human
immune system to fight cancer, the researchers said.
"The immune system differs in each of us," Wolchok said. "In studying one person's response, we were able to carefully investigate the clinical findings with in-depth laboratory studies, which suggested that a change in the immune system was vital to the successful results."
This case has sparked interest in clinical trials to test this
treatment approach for melanoma and prostate cancer, the research
team said.
Devoe agreed that the woman's successful treatment may offer
intriguing new avenues of research.
"Dr. Wolchok and his team are outstanding researchers in the field of melanoma," Devoe said. "The immune system has been and continues to be one of the most important aspects of melanoma treatment."
Devoe believes the case of this one patient "does increase the
evidence that the NY-ESO-1 protein is a very important immune
system target and further study of this particular phenomenon is
needed."
More information
The American Cancer Society has more about
melanoma.