Which patients with advanced melanoma would benefit the most from a cancer vaccine?

This study investigated which patients with advanced melanoma would benefit the most from a cancer vaccine. The study found that the vaccine was most effective in patients with stage IV melanoma who has surgery to remove the tumor completed all treatment doses.

Melanoma is an aggressive type of skin cancer. Treatment for early-stage melanoma includes surgery to remove the tumor. For more advanced melanoma, some patients need add-on therapy following surgery to ensure all the cancer cells are killed. Add-on therapy options can include immunotherapy or targeted therapy. 

A type of immunotherapy is cancer vaccines. These can be given to give the immune system an activating boost. The TLPLDC (tumor lysate, particle loaded, dendritic cell) vaccine is created using inactive versions of the patient’s tumor. When the immune system meets the vaccine, it knows the characteristics of the tumor that needs to be targeted and killed. TLPLDC vaccine was recently shown to be safe and effective in patients with advanced melanoma. However, studies investigating which group of patients would benefit the most from this vaccine are lacking.

This study included 144 patients with stage III/IV melanoma. All patients underwent surgery to remove the tumor. 103 patients received the TLPLDC vaccine. 41 patients received a placebo. The average follow-up time ranged from 19.0 to 19.8 months.

In patients who completed all treatment doses, more patients in the vaccine group were alive and disease-free (62.9%) compared to the placebo group (34.8%) after 2 years.

Among patients with stage III melanoma, there were no clinical, pathologic, or treatment differences between the groups. In stage IV patients who completed all treatment doses, 73% of the patients in the vaccine group were alive and disease-free compared to 0% of the patients in the placebo group after 2 years.

For patients with cancer coming back after surgery, 80.9% of the patients in the vaccine group were alive and disease-free compared to 33.3% of the patients in the placebo group after 2 years.

The survival benefit was only seen in patients who completed all 4 treatment doses.

This study concluded that the TLPLDC vaccine improved the outcome of patients with stage IV melanoma who completed all treatment doses.

The sample size for each subgroup was very small. The follow-up time was short. This study was funded by Elios Therapeutics, the manufacturer of the TLPLDC vaccine.