Active Idiotypic Vaccination Versus Control Immunotherapy for Follicular Lymphoma

Abstract

This trial failed to demonstrate clinical benefit of specific immunotherapy. The subset of vaccinated patients mounting specific anti-Id responses had superior outcomes. Whether this reflects a therapeutic benefit or is a marker for more favorable underlying prognosis requires further study.

Highly clonal regulatory T-cell population in follicular lymphoma – inverse correlation with the diversity of CD8+T cells

“…36,37 Infiltration of CD4 + and T reg cells has previously been reported in some studies to correlate with improved outcome. 31,32 Because FL can spontaneously regress or remit, 5 and in some cases vaccination approaches are effective, 6 it will be very important in the future to characterize more precisely the immune milieu of individual patients to better define those who may be more likely to respond to immune-based therapies, such as checkpoint blockade therapies with anti-PD-1 or anti-CTLA-4 antibodies, anti-idiotype vaccines, and, possibly in the future, adoptive cell therapy. Simple quantitative measurement of different immune cell subsets in FL has been of limited usefulness in predicting future outcome.…”

“…Second, longlasting remissions in some FL patients following tumor-specific anti-idiotype vaccination have been reported in clinical trials, particularly in a subset of patients who mounted a detectable anti-idiotype immune response. 6 Third, FL tissues are often highly enriched for T cells and macrophages, and their varied numbers and location within or around the malignant follicles have been correlated with clinical outcomes. ; yet, the specificities and the functional relevance of tumor-infiltrating T cells in FL remain unknown.…”

Are We Nearing an Era of Chemotherapy-Free Management of Indolent Lymphoma?

“…However, three phase III trials in follicular lymphoma had disappointing results wherein the primary endpoint was not achieved (45-47) except for one trial with a significant disease-free survival coprimary endpoint as per protocole (47). An interesting correlation between the immune response against the tumor B-cell idiotype and the PFS was demonstrated in one of these trials (46).…”

Cancer Vaccines: Can They Improve Survival?

“…2 Notable failures have included allogeneic cell lines in melanoma, 3 gp100 in melanoma, 4 and anti-idiotype vaccines in lymphoma. 5 However, potential vaccines vary in terms of their antigen sources, adjuvants, and routes and schedules of administration; so, one should not conclude that all therapeutic vaccines are ineffective. 2,6 The theoretical limitations of allogeneic, single-antigen, and oligo-antigen vaccines have been noted, and there has been increasing focus on autologous TAAs.…”