Two melanoma patients with liver metastasis have achieved long-term survival of more than 8.5 and 12 years following administration of a vaccine containing the patients’ own dendritic cells loaded with proteins isolated from their melanoma cells, called eltrapuldencel-T.
The findings were published in Cancer Biotherapy and Radiopharmaceuticals, in the study “Long-Term Progression-Free and Overall Survival in Two Malanoma Patients Treated with Patient-Specific Therapeutic Vaccine Eltrapuldencel-T After Ressection of a Solitary Liver Metastasis“.
Liver metastasis from eye or skin melanoma have an extremely poor diagnosis with only a small number of patients suitable for surgical resection (removal). Those patients are later prone to develop more metastasis in the liver or elsewhere in the body; survival is approximately two years following resection.
Eltrapuldencel-T (CLBS20), developed as an adjuvant therapy to increase survival after hepatic resection, has already been shown to improve survival, with 72% of patients with Stage 4 or recurrent melanoma achieving a two-year survival.
In the study however, researchers described two patient cases showing long-term progression-free survival and long-term survival associated with eltrapuldencel-T treatment.
In one reported case, a 56-year-old male patient with metastatic melanoma of unknown primary (the primary tumor site was not determined) who was first diagnosed with a lung mass. The mass was resected and the patient enrolled in the CancerVax trial for stage 4 melanoma patients. One month after treatment ended, a small bowel metastatis was identified. The metastasis was resected and the patient resumed CancerVax treatment, but a new liver metastasis was found four months later. The patient then at age 58, had his solitary liver metastasis surgically excised (removed) and entered a clinical trial for eltrapuldencel-T (NCT00948480) in December 2003.
“Before initiating this therapy, his longest progression-free intervals had been 14 months following resection of the lung metastasis, and then six months following resection of the small bowel metastasis. As of January 2016, he is known to be alive and remains disease free more than 12 years later, without having had any therapy other than eltrapuldencel-T,” the authors explained in the study.
The second patient, a 50-year-old male, was diagnosed with eye melanoma. The tumor was excised and the patient did well for three years, after which a mass in the optic nerve was found. The mass was treated with radiation therapy and soon after a liver metastasis was found. It was excised and, in October 2007, at age 54, the patient entered a Phase 2 clinical trial for eltrapuldencel-T.
In the second patient, the eye mass remained stable and did not regress, with multiple foci of residual melanoma found. The patient remained disease free for two more years but multiple liver metastasis were found in December 2011. The patient underwent several therapies, including interleukin-2, nivolumab, and radiation of the liver by four cycles of ipilimumab, the latter being administered by the Spring of 2014 and throughout 2015.
The journal’s co-editor in chief Donald J. Buchsbaum, Ph.D., called the findings “exciting.” Buchsbaum is from the Department of Radiation Oncology, Division of Radiation Biology, University of Alabama at Birmingham.
“These exciting results illustrate the potential for melanoma patient-specific therapeutic vaccines to enhance long-term survival and add to the progress being made on the immmunotherapy of melanoma,” Buchsbaum said in a press release.
