Vaccine Studied to Prevent Tumor Recurrence in Children

A vaccine that could prevent the recurrence of neuroblastoma will be the subject of a pilot study at Texas Children's Cancer Center.

Neuroblastoma, a cancer that usually appears as a mass in the stomach or chest, is the second most common type of solid tumor found in children. After the age of 1 year, the tumor is usually spread throughout the body.

"We can get most of these children into remission," says Dr. Douglas Strother, assistant professor of pediatrics at Baylor College of Medicine. "However, in 75 percent of these kids, the tumor will eventually come back. Then the disease is almost always fatal."

In the pilot study, children will be treated with a vaccine following the completion of chemotherapy and a bone marrow transplant.

"We want to give these kids the vaccine after the tumor has been treated, and they have as little tumor as they can possibly have. In most of these children, there will be no sign of disease at that point," says Dr. Strother.

The study will attempt to determine if the immune system can be used to keep the disease from recurring. The vaccine is produced at Baylor and is made from tumor cells that have been changed by gene therapy to stimulate the immune system.

"When we diagnose children with widespread neuroblastoma at the center, we will create a vaccine for them, freeze it and keep it until other treatment has been completed," Dr. Strother says.

"When kids who were diagnosed elsewhere come here for vaccine therapy, we will try to make a vaccine for them from their own tumors. If they need treatment in the meantime, we will give them the vaccine from the tumor grown in the lab," he says. "We are seeing immune response generated by both these vaccines in preliminary studies."

The pilot study will be the second phase of neuroblastoma vaccine research. Currently, the cancer center is conducting trials of a neuroblastoma vaccine in children whose tumors have continued to grow back.

The cause of neuroblastoma is unknown. While children of any age can be diagnosed with neuroblastoma, it is very uncommon after the age of 10 years.

The first signs are usually detected by a pediatrician or parent who may notice that the child looks pale and has a lump in the stomach. Other times, a chest x-ray ordered for an unrelated purpose will show the tumor, Dr. Strother says.

The disease has a much better cure rate in children younger than 1 year old.

The pilot study is a collaborative effort with The University of Texas M.D. Anderson Cancer Center. Although the vaccines will be produced at Baylor, M.D. Anderson patients can receive them from their own care team.

- LORI WILLIAMS

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©2006 Texas Medical Center

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