Last week we discussed the importance of host immunity in survival of the cancer patient and how we evaluate that immunity.
Now we want to briefly tell you what we do with that information about a cancer patients immune system.
Cancer vaccines may be used as additional (adjuvant) treatment after completion of the standard of care therapy to help prevent cancer recurrence, or in a combination with chemotherapy and sometimes radiation in the Stage IV patients.
After the patient completes standard of care therapy which may be a combination of surgery, chemotherapy and radiation all of which are immunosuppressive; they should be rested 3-4 months before the immune system is tested. (Please see the previous blog on Understanding your immune system on July 19, 2017 for the blood tests we use to evaluate a person’s immune system.) If a patient has a depressed lymphocyte immunity, an adjuvant cancer vaccine is indicated.
The use of a cancer vaccine in a Stage IV patient can be done, but the timing of the vaccine depends on other treatment protocols. For instance, what type of chemotherapy cycle and is radiation involved? The type of drugs used in chemotherapy are very important, as some complement immunotherapy by causing cancer cells to die an immunogenic cell death. This promotes better tumor cell antigen presentation to dendritic cells that then drain to the lymph nodes to stimulate effector T-cells. The vaccine is timed and given during the chemotherapy cycle based on parameters to be discussed later.
Sometimes a great immune cascade occurs causing marked tumor reduction and a tremendous host response.
Robert L. Elliott, M.D., Ph.D.
Catherine C. Baucom, M.D., Ph.D.