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GVAX Immunotherapy and Hematologic Status in Pancreatic Cancer

As noted in an earlier blog, GVAX is a kind of vaccine that appears to work by enhancing “granulocyte-macrophage colony-stimulating factor” (GM-CSF) which in turn enhances white blood cells including monocytes that can somewhat freely move and have the ability to transform into so-called “professional” antigen-presenting cells such as macrophages and dendritic cells – which can augment the internal immune system’s own ability to fight cancer.

We were alerted to recent GVAX work by David Desert, and want to thank him for this. In an article first presented by electronic release on September 18, 2013, Laheru and colleagues from Johns Hopkins University published work in the Annals of Surgical Oncology that noted a possible relationship between hematologic status and survival in patients with pancreatic cancer (ductal adenocarcinoma of the pancreas) who had received treatment with GVAX.

The researchers studied 59 pancreatic cancer patients in an existing Phase II clinical trial who received adjuvant chemoradiation plus GVAX after initial surgery. The Hopkins team found that those who carried a baseline total lymphocyte count of less than 1,500 cells per mm³ were at higher risk of poor overall survival and of progression-free survival from their pancreatic cancer. The authors also found that the chemoradiation treatment significantly reduced lymphocyte counts from baseline levels, and that those patients with such suppression to lower than 500 cells per mm³ were also at a disadvantage in terms of overall pancreatic cancer survival and of progression-free survival.

This is an interesting study that links potential efficacy of treatment (or lack thereof) of pancreatic cancer with immunologic therapy under conditions of immunosuppression. These are early findings with a number of potential confounders, but nonetheless a highly interesting study result.

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Dale O’Brien, MD