Gastric cancer

The inducing course of immunotherapy consists of 10 subcutaneous vaccinations (five at weekly and five at fortnight intervals) and takes about 3 months. The supporting vaccination schedule is determined by both a disease stage and a health state of a patient. The treatment is conducted on an outpatient basis.

The vaccine-induced, immune processes destroy the tumor cells and suppress the development of residual disease.

Xenogenic polyantigenic vaccine (XPV) is sterile.

The development of an influenza-like syndrome in the form of a body temperature rise up to 38°, but also and musculoskeletal discomfort are possible. Those symptoms are usually self-limited. The immunotherapy has no side effects attributable to chemoradiotherapy.

Xenovaccinotherapy for gastric cancer

Therapeutic vaccination is a strategy that uses tumor-associated antigens to induce tumor-specific, immune responses. The xenogenic (murine) polyantigenic vaccine (XPV) -in which there are main families of common tumor associated antigens - has been developed in the Institute of Clinical immunology. The small structural distinctions of xenogenic tumor-associated antigens from their human analogues render these antigens highly immunogenic and capable of stimulating immune-mediated, antitumor responses in a patient not only at early, but also at late stages of a disease, when tumor-derived immunosuppression is significant for more information.

Gastric cancer is one of the most common cancers. Surgical resection of early-stage localized disease is the only curative treatment. Advanced gastric cancer is usually resistant to standard cytotoxic therapy including chemotherapy and radiotherapy. On the other hand, evidence is accumulated that immune-based approaches may materially affect course of this disease.

Our own experience suggests that a clinical effect of various grades (complete or partial response, disease stabilization) with a duration not shorter than 6 months may be achieved in nearly 55 % stage IV patients. These results should be considered as preliminary because they are based on a very small number of patients with very advanced disease. We suggest that the xenovaccinotherapy might be much more effective, when it is started as early as before or immediately after surgical resection of primary tumor and its metastases.

The examples of applying xenovaccinotherapy in patients with metastatic gastric cancer are described below.

A 44 year-old female patient I (a history № 3086) was diagnosed with signet ring cell gastric carcinoma in November 2002.Combined gastrectomy was carried out in December 2002. One course of polychemotherapy was further conducted. In February 2003 signs of disease progression were noted: UI revealed enlarged lymph nodes within both the gate of the liver and the retroperitoneal space. Vaccinotherapy was started in an intensified regime. The treatment was well tolerated. At 3 months after vaccinotherapy initiation UI revealed no signs of disease. The reduction of ESR to norma and the elevation of Hb level were noted in blood analysis. In the final analysis, at 2 years after vaccinotherapy initiation the patient was in good condition, no evidence for disease was observed.

A 54 year-old male patient I (a history № 2009) diagnosed with low-grade differentiated, gastric adenocarcinoma, multiple lesions in the left lung (the condition after radiochemotherapy) started to vaccinate in August 2002. At that time there were complains of general weakness, periodic vomiting, and low grade fever. In December 2002 the state of his health became worse. Daily vomiting, lack of appetite, significant loss of weight and intense paints within the epigastric region were noted. In spite of everything, vaccinotherapy was not stopped. In February 2002 the state of the patients was somewhat improved : attacks of vomiting became less frequent, blood parameters returned to norma. UI revealed a lesion of 15 mm diameter in the bottom pole of the right kidney. The patient’s state was stable until June 2002, when gastric obstruction developed. In July 2003 surgery (Bilrot 2 operation) was performed. On surgical inspection no metastases were noted. No pathological signs were detected by UI. A chest x-ray also revealed no tumor signs in lungs. In the final analysis, at 2 years after vaccinotherapy initiation no evidence for disease progression was observed.

For more information see the publications.