Experimental vaccine offers hope against brain cancer
HACKENSACK, N.J. - An experimental vaccine made from a cancer patient's own brain tumor - and then injected back into that patient - is showing promise in extending life, a New Jersey physician said.
Early data show the vaccine increased life expectancy by nearly three years for some people with the deadliest form of brain cancer and added more than five years for a few others, said Dr. Michael Gruber, a neuro-oncologist and Englewood, N.J., resident.
Until now, the life expectancy for these patients has been about 15 months to less than a year. "This is an awful disease," he said.
Gruber, former chief of neurology at Englewood Hospital and Medical Center, is conducting clinical trials of the vaccine at Overlook Hospital in Summit, N.J., and New York University Medical Center, two of five study sites nationwide.
"I've never seen a clinical trial that's had this promise," said Gruber, who is medical director of the Brain Tumor Center of New Jersey at Overlook.
The vaccine is personalized for each patient after their tumor is surgically removed. Protein antigens extracted from the tumor are combined with disease-fighting white cells from the patient.
The vaccine is then injected into the patient, where it "teaches" the immune system to recognize and kill any cancer cells left behind by the surgery. The shots are given in the arm, just under the skin - first bi-weekly, then monthly, then less frequently, for three years.
"The proteins stimulate the immune system to create T-cells, and sends all those immune soldiers into battle," Gruber said.
The nationwide study will eventually enroll 250 patients with the tumor, called glioblastoma multiforme. The vaccine, called DCVax-Brain, is made by Northwest Biotherapeutics Inc. in Bothell, Wash.
Each year, brain cancer affects about 20,000 Americans and 13,000 die from a brain tumor. Hopes are that the vaccine will increase some patients' chance of survival by as much as 50 percent, Gruber said.
Kathryn Montag of Cranford, N.J., a neurosurgical nurse at Overlook, is grasping at that hope. Montag, 53, had a brain tumor removed in January. She has been undergoing radiation and chemotherapy and will begin receiving the vaccine at the end of this month.
The irony is that Montag has been caring for patients with brain tumors for more than 30 years.
"I call it my cosmic kick in the ass," she said in an interview. "This is like a sick joke. I've been a neurosurgical nurse a long time. I've taken care of a lot of patients. I've been there with their families when they got the news, and I always said, 'There but for the grace of God' ...
"Now, I'm on the other side of the coin and it's frightening, very frightening."
Montag's symptoms began one morning with a splitting headache, which she first thought was part of menopause. When nausea, vomiting and migraine-like flashing lights followed days later, she went for a CAT scan and an MRI.
Surgery to remove the tumor from the right temporal lobe of her brain left an L-shaped scar, from her temple to her ear, which is well covered by her full head of hair. Fortunately she did not suffer other side effects, such as slurred speech or blurred vision. She is able to drive a car on short trips, but is not yet ready to return to work.
The doctors, nurses and her other colleagues at Overlook - and the vaccine - are her safety net.
"They gave me a chance, and I'm grabbing it with both hands," she said.
Preliminary data on the vaccine are "encouraging," said Dr. Joseph Landolfi, a neuro-oncologist in Edison, N.J., who is not involved in the study. There are long-term survivors among patients receiving surgery, radiation and chemotherapy, so more data are needed to see if the vaccine makes a difference, said Landolfi, director of neuro-oncology at JFK Medical Center.
"We're dealing with a very aggressive tumor," Landolfi said. "The only way we can make strides to combat disease is to do research and test theories."
Montag, who is married and has two college-age children, is stalwart despite her very real fears.
"There's stuff I don't want to be robbed of: I've got weddings to interfere with," she said, laughing. "I've got stuff I've got to do. I still want to finish my nursing career.
"I don't know what's going to happen," she said. "But I want people to know, if they get a diagnosis like this, there's some hope."
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