- The Washington Times - Monday, June 1, 2009

ORLANDO, Fla. | First there was surgery, then chemotherapy and radiation. Now, doctors have overcome 30 years of false starts and found success with a fourth way to fight cancer - using the body’s natural defender, the immune system.

The approach is called a cancer vaccine, although it treats the disease rather than prevents it.

At a cancer conference Sunday, researchers said one such vaccine kept a common form of lymphoma from worsening for more than a year. The result is huge in this field, where progress is glacial and success with a new treatment is often measured in weeks or even days.

Experimental vaccines against three other cancers - prostate, the deadly skin disease melanoma and an often fatal childhood tumor called neuroblastoma - also gave positive results in late-stage testing in recent weeks, after decades of struggles in the lab.

“I don’t know what we did differently to make the breakthrough,” said Dr. Len Lichtenfeld of the American Cancer Society.

Instead of a single “A-ha!” moment, there have been many “ah, so” discoveries about the immune system that now seem to be paying off, said Dr. John Niederhuber, director of the National Cancer Institute.

It’s too soon to declare victory, however. No one knows how long the benefits will last, whether people will need “boosters” to keep their disease in check, or whether vaccines will ever become a cure. Many vaccines must be custom-made for each patient - how practical will that be, and what will it cost?

Those are all good questions, but there are no answers to them yet, said Dr. Richard Schilsky, a University of Chicago cancer specialist who is president of the American Society of Clinical Oncology.

Several vaccine studies were reported over the weekend at the oncology group’s annual meeting in Florida.

A big problem has been getting the immune system to “see” cancer as a threat, said Dr. Patrick Hwu, melanoma chief at the University of Texas M.D. Anderson Cancer Center. Viruses like the flu or polio are easily spotted by the immune system because they look different from human cells.

“But cancer comes from our own cells. And so it’s more like guerrilla warfare - the immune system has trouble distinguishing the normal cells from the cancer cells,” he said.

To help it do that, many cancer vaccines take a substance from a cancer cell’s surface and attach it to something the immune system already recognizes as foreign - in the lymphoma vaccine’s case, a shellfish protein.

“It’s a mimic to what you’re trying to kill, a training device to train the immune system to kill something,” Dr. Hwu explained.

To make the attack as strong as possible, doctors add a substance to put the immune system on high alert.

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