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Conrad Notes
a timely medical meeting newsletter
L.M. Schuchter, MD, University of Pennsylvania Cancer Center, Philadelphia, Penn, moderated a press conference on novel cancer-fighting approaches. The session included reports on a cancer vaccine, gene therapy, and the inhibition of tumor new blood vessel formation. Extension of the early results to clinical application in melanoma, prostate cancer, and renal cancer awaits supportive data from well-controlled Phase II and III studies.
Tyrosinase peptide vaccine (TPV) in melanoma J.J. Lewis, MD, Memorial Sloan-Kettering Cancer Center, New York, NY, tested a 9-amino acid vaccine plus adjuvant QS-21 in 9 melanoma patients. The new vaccine increases the number of CD8+ T lymphocytes which directly kill cancer cells. Two of 9 stage 4 melanoma patients responded after 4 intradermal injections of 5 or 50 mcg of TPV. The immune response consisted of recognition of the antigen, tyrosine peptide, normally found in healthy and cancerous melanocytes. Lewis found no serious or unexpected adverse effects using TPV. Further studies are underway or planned to improve the immune response in melanoma and other cancers.
Gene treatment of localized prostate cancer P.T. Scardino, MD, Baylor College of Medicine, Houston, Tex, used a highly infective virus, herpes simplex, to carry the thymidine kinase gene (TKG) directly into the cancerous prostate of 18 males. The dose escalation study involved single injections of giga units of vaccine followed by 14 days iv gangciclovir to eliminate the virus carrier. As the TKG dose increased, a corresponding decrease in prostate serum antigen (PSA) occurred. The higher doses of TKG led to a >50% decrease in PSA in 3/14 men and a negative prostate biopsy in 1/14. Severe thrombocytopenia and abnormal liver function developed in 1/5 patients who received the highest dose of gene therapy. Scardino et al completed the first study to show activity with gene therapy in localized prostate cancer.
Angiogenesis inhibition in renal cancer N.J. Vogelzang, MD, University of Chicago School of Medicine, Ill, described the results of an open, multicenter Phase II study. Each of 33 metastatic kidney cancer patients self-medicated at home with iv TNP-470 using 60 mg/msq 3 days/week. TNP-470 is a fumagillin derivative. Nearly all of the study patients failed previously on interleukin-2, interferon, or chemotherapy.

The results are encouraging. About 65% of the patients are still alive after 12 weeks treatment (ave). Four of 33 patients continue with TNP-470 after 39, 41, 42, and 54 weeks, respectively. One patient shows a 50% shrinkage in metastases and 5/20 remain progression-free at 16 weeks or longer. Central nervous system grade 3/4 toxicity occurred in 2/33 patients as slurred speech and disorientation or dizziness. Vogelzang sees a need for an oral or subcutaneous formulation to allow long-term dosing with TNP-470.

For professional correspondence, please contact Dr. Schuchter by Fax at: (215) 349-8144

Eugene A. Conrad

Presented at the American Society of Clinical Oncology (ASCO) Meeting, May 16-19, 1998
Copyright © 1998 Conrad Group Inc. All Rights Reserved
Eugene A. Conrad, PhD, MPH / ISSN 1078-2230 / June 1998
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