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Melanoma vaccines

Cancer vaccines are a type of biological therapy. These are treatments that use natural body substances, or drugs that block them, to treat cancer. Vaccine treatment is not yet widely available because it is still experimental. You can usually only have it as part of a clinical trial. Vaccines are being used

  • As treatment for people with advanced melanoma that has spread to another part of the body
  • As treatment after surgery for people with high risk melanoma particularly where it has spread to the lymph nodes

The vaccines are designed to try to stimulate the body's own immune system to fight the melanoma. Several different types of vaccine are being tested.

How is the treatment given?

Cancer vaccines are usually given as a small injection just under the skin. The vaccine has to be repeated often. You may have a vaccination every week for a few weeks. And then two weekly or monthly injections. The treatment may be given over a long period of time.

What are the side effects?

Apart from soreness at the place where the injection is given in some people, there do not appear to be many side effects. Some people have flu like symptoms.

 

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What melanoma vaccines are

Cancer vaccines are a type of biological therapy. These are treatments that use natural body substances, or drugs that block them, to treat cancer. Vaccine treatment is not yet widely available because it is still being tested. You can usually only have it as part of a clinical trial.

There are two areas of research. Vaccines are being used

  • As treatment for people with advanced melanoma that has spread to another part of the body
  • As treatment after surgery for people with high risk melanoma particularly where it has spread to the lymph nodes

Cancer vaccines are designed to try to stimulate the body's own immune system to fight the melanoma. The immune system does this by making antibodies to specific proteins (antigens) found on melanoma cells.

Antigens are large molecules found on all cells. Cancer cells have antigens that the body recognises as abnormal. Antibodies are proteins made by the body that match each antigen exactly. The antibody combines with the antigen and marks that cell to be killed off by the immune system. There is more information about antibodies and antigens in our immune system section.

A cancer vaccine can either

  • Be made individually with one person's melanoma cells and used to treat just that person
  • Be made using lots of different melanoma antigens from different melanomas and used to treat many people

Vaccines made individually contain all the antigens that come from that person's melanoma. Making it this way can be expensive and time consuming. But it is a good way of trying to make sure the vaccine works.

Other vaccines use several different strains of melanoma cells and have a large number of different antigens. Patients who have this vaccine will have some of the antigens on their melanoma cells and not others. This type of vaccine can be made in large quantities and can treat many people.

 

How you have the treatment

Cancer vaccines are usually given as a small injection just under the skin. The vaccine usually has to be repeated often because the melanoma antigens do not stimulate the immune system for long. You may have a vaccination every week for a few weeks. And then two weekly, or monthly injections. The treatment is also given over a long period of time. In some people, perhaps indefinitely.

 

How long it takes to work

Vaccines take longer to work than other types of cancer drug treatment. The immune response in the body can be measured by taking blood samples. Research shows that it takes up to 4 months for an immune response to take place. If the vaccine works, the rate of growth of the melanoma will then begin to slow down. Then it may become stable (not growing any more) for a while. Eventually, the melanoma may start to shrink.

 

How long vaccines go on working

We don't have enough information at the moment to be sure. In early research studies, the response to the vaccine has lasted for months in some people. In others it has lasted for years. In some people, it doesn't work at all. Researchers are not yet sure why it works in some people and not in others.

 

Side effects of melanoma vaccines

Apart from soreness at the place where the injection is given in some people, there do not appear to be many side effects. Some people have similar side effects to other biological therapies – such as flu like symptoms, with a headache, aching and high temperature.

 

Trial results so far

In trials that have been completed so far people who had vaccine treatment for advanced melanoma have had varied results including

  • No response at all
  • The cancer completely disappearing
  • Some shrinking of the melanoma
  • Some slowing down of the rate of growth of their melanoma

Some of these patients had operations to remove their melanoma secondaries before having the vaccine. The operations were not done to cure the cancer. But the researchers think the vaccine might work better if there is less melanoma to fight.

Researchers also believe that their vaccine might help stop melanoma from spreading to new areas in the body by stimulating the immune system to kill off melanoma cells in the blood or tissues.

People with high risk melanoma (where the melanoma has spread into the lymph nodes) have also had a mixed response to vaccines. The vaccine may help stop the cancer coming back in some people but not in others. 

Some research now seems to show that adding vaccines to biological therapy or chemotherapy may help to control advanced melanoma for some people. You can read about vaccines and biological therapy for melanoma on the melanoma research page. 

 

The future of vaccines for melanoma

Trials are continuing to test cancer vaccines to treat melanoma. Doctors need to understand why the vaccine works in some people and not others. They are beginning to be able to see who will benefit and who won't by looking at the immune response in the first few weeks of treatment. If you have a good immune response, the vaccine is more likely to work for you. 

New research has begun, which is trying to stimulate an immune response by combining the vaccine with other triggers to the immune system such as the TB vaccine BCG. Combining biological therapy with a vaccine has shown promising results in small studies. 

Research is continuing and the results from such trials will help us find out if vaccine treatment really can help people with melanoma.

 

Clinical trials

First you must check whether you fit into the entry criteria for the trial you are interested in. This is very important. Trials have to select groups of patients in similar circumstances so that direct comparisons between new and established treatments can be made. If you don't meet the entry criteria, you can't be accepted onto the trial. For example, a trial protocol may ask that you

  • Have a particular stage of melanoma
  • Don't have secondaries in certain organs (for example, the brain or bone)
  • Are at a certain point in your treatment

There are several research centres working on melanoma vaccines. You can ask your specialist whether vaccine treatment is a possible treatment for you. You can also look for vaccine trials in melanoma on our clinical trials database. Pick 'melanoma skin cancer' from the dropdown menu of cancer types.

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Updated: 23 January 2014