Direct Injection of Vaccine into Pancreatic Tumor Linked to Stable Disease

Research has revealed that in patients who are not candidates for surgery, a series of vaccine injections given directly into a pancreatic cancer tumor is associated with stable disease.

Early results of a clinical trial being conducted at The Cancer Institute of New Jersey are being presented on Tuesday at the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics meeting being held in San Francisco. CINJ is a Center of Excellence of UMDNJ-Robert Wood Johnson Medical School.

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Previous studies by scientists at CINJ have shown that injecting a vaccine and other immunity-producing drugs into a cancer tumor itself -- rather than the traditional site of the skin -- can result in a reversal of the traditional immune blockade and the development of specific immunity to the tumor. This body-wide tumor-specific immunity has the potential of blocking the growth of the original tumor as well as eliminating small deposits of tumor that can cause the cancer to spread. Stemming from this research is a clinical trial that is the focus of this poster presentation. The study by CINJ investigators further tests this vaccine strategy, designed to harness the body''s own immune system to fight cancer.

Researchers are utilizing two types of the investigational vaccine known as PANVAC. PANVAC contains gene additives that might stimulate a person''s immune system to recognize and develop an immune response to the disease. PANVAC-V, which uses the same virus as the smallpox vaccine, is a live but weakened vaccinia vaccine (meaning the virus can still multiply) that is given in the arm. PANVAC-F (a live Fowlpox virus that can not multiply) is injected into the arm and into the tumor itself. Direct tumor injection takes place through a procedure known as endoscopic ultrasound, in which a scope is inserted through the mouth and into the stomach.

During the first phase of the study, which looked at six participants whose cancer could not be removed through surgery, patients were evaluated for toxicity, tumor progression and the presence of tumor markers for pancreatic cancer. Two patients were removed from the study after two weeks due to rapid disease progression. Of the remaining four patients, three had received gemcitabine - a standard treatment for pancreatic cancer - after receiving vaccination treatment. The other patient was treated with gemcitabine, followed by capecitabine and radiation, prior to the vaccination regimen and received no other treatment after.

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Of these four patients, all were shown to have clinically stable disease after 15 months, 13 months, 12 months and nine months respectively. The second part of the trial is accruing additional participants, who are being given a higher dosage of PANVAC-F during direct injection of the tumor.

Elizabeth Poplin, MD, medical oncologist at CINJ and professor of medicine at UMDNJ-Robert Wood Johnson Medical School, is the lead researcher on the study, which is sponsored by the National Cancer Institute (NCI). "By utilizing the body''s own defenses in this way in combination with traditional therapies, we have an opportunity to better identify more effective treatment and management options for this disease, which unfortunately only has a five-year, five-percent survival rate," said Dr. Poplin.

Other investigators include David A. August, Tamir Ben-Menachem, Hazar Michael, and Rene Artymyshyn, CINJ and UMDNJ-Robert Wood Johnson Medical School; James L. Gulley and Jeffrey Schlom, NCI; and Robert S. DiPaola and Edmund C. Lattime, CINJ and UMDNJ-Robert Wood Johnson Medical School.

The work was supported by The NCI Cancer Therapy Evaluation Program and by NCI U01-CA07031 and P30-CA72720.

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CINJ members will be among the more than 3,000 academics, scientists and pharmaceutical industry representatives at the meeting to discuss the latest discoveries in molecular biology and how those advances are shaping targeted cancer therapies. The event is open to registered participants.

About The Cancer Institute of New Jersey
The Cancer Institute of New Jersey (www.cinj.org) is the state''s first and only National Cancer Institute-designated Comprehensive Cancer Center dedicated to improving the detection, treatment and care of patients with cancer, and serving as an education resource for cancer prevention. CINJ''s physician-scientists engage in translational research, transforming their laboratory discoveries into clinical practice, quite literally bringing research to life. To make a tax-deductible gift to support CINJ, call 732-235-8614 or visit www.cinjfoundation.org. CINJ is a Center of Excellence of UMDNJ-Robert Wood Johnson Medical School. Follow us on Facebook at www.facebook.com/TheCINJ.

The CINJ Network is comprised of hospitals throughout the state and provides the highest quality cancer care and rapid dissemination of important discoveries into the community. Flagship Hospital: Robert Wood Johnson University Hospital. System Partner: Meridian Health (Jersey Shore University Medical Center, Ocean Medical Center, Riverview Medical Center, Southern Ocean Medical Center, and Bayshore Community Hospital). Major Clinical Research Affiliate Hospitals: Carol G. Simon Cancer Center at Morristown Medical Center, Carol G. Simon Cancer Center at Overlook Medical Center, and Cooper University Hospital. Affiliate Hospitals: CentraState Healthcare System, JFK Medical Center, Mountainside Hospital, Robert Wood Johnson University Hospital Hamilton (CINJ Hamilton), Somerset Medical Center, The University Hospital/UMDNJ-New Jersey Medical School*, and University Medical Center at Princeton. *Academic Affiliate

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