Woman’s Recovery From Advanced Melanoma Could Help Guide Research

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.

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