Relationship between immune response to melanoma vaccine immunization and clinical outcome in stage II malignant melanoma

The authors investigated whether there was a relationship between the induction of a delayed‐type hypersensitivity (DTH) response to melanoma vaccine immunization and disease recurrence. They studied prospectively 94 evaluable patients with surgically resected Stage II malignant melanoma who were im...

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Bibliographic Details
Published in:Cancer 1992-03, Vol.69 (5), p.1157-1164
Main Authors: Bystryn, Jean‐Claude, Oratz, Ruth, Roses, Daniel, Harris, Matthew, Henn, Milagros, Lew, Robert
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Dermatology
Female
Follow-Up Studies
Humans
Hypersensitivity, Delayed - immunology
Immunotherapy
Male
Medical sciences
Melanoma - immunology
Melanoma - mortality
Melanoma - pathology
Melanoma - therapy
Middle Aged
Neoplasm Recurrence, Local - immunology
Neoplasm Staging
Prospective Studies
Skin Neoplasms - immunology
Skin Neoplasms - mortality
Skin Neoplasms - pathology
Skin Neoplasms - therapy
Skin Tests
Survival Rate
Treatment Outcome
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Summary:The authors investigated whether there was a relationship between the induction of a delayed‐type hypersensitivity (DTH) response to melanoma vaccine immunization and disease recurrence. They studied prospectively 94 evaluable patients with surgically resected Stage II malignant melanoma who were immunized to a partially purified, polyvalent, melanoma antigen vaccine. The DTH response to skin tests to the vaccine was measured before treatment and at the fourth vaccine immunization. Vaccine treatment induced a strong DTH response in 29 (31%) patients, an intermediate response in 24 (25%), and no response in 41 (44%). The median disease‐free survival (DFS) of patients with a strong, intermediate, and no DTH response to vaccine immunization was more than 72 months, 24 months, and 15 months, respectively. The relationship between an increase in the DTH response and a prolonged DFS was statistically significant (P = 0.02); clinically meaningful (the median DFS of patients with a strong DTH response was 4.7 years longer than that of nonresponders); and, by multivariate analysis, independent of disease severity or overall immune competence. These findings suggest, but do not prove, that vaccine treatment can slow the progression of melanoma in some patients.
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.2820690516