My understanding is that one still needs surgery to get rid of the tumor burden. Then 18 weeks after the vaccine. Out of eight patients, six patients had no evidence of disease four years after followup. Two patients had intially melanoma metastases to the lungs as well and were put on checkpoint inhibitor immunotherapy following the vaccine. Even in those two patients, the researchers detected signs that T cells had made their way into the tumor tissue, where they could be most lethal to melanoma cells.
The problem are the melanoma cancer stem cells. Regular treatments try to kill daughter melanoma cells but the melanoma stem cells are much more resistant and seem to evade attack, eventually wreak havoc coming back even stronger than before. The analogy would be similar to a bee hive. Conventional treatment kills the worker bees (melanoma daughter cells) but somehow the Queen Bee (melanoma stem cells) remains alive and well and eventually if conditions are ripe, these seem to explode with a vengence. The vaccine teaches our own immune system to recognize the cancer cells and it has lasting memory to remember the intruder when it returns.
So low tumor burden seems to be the key and probably this is why all eight patients had surgery initially and vaccine 18 weeks later. This way the patient’s immune system can concentrate on just a few floating cells instead of fighting larger tumor masses at the same time.
It takes three months to manufacture the vaccine for each specific person’s tumor. Remember, they need your tumor to identify your specific tumor receptors so surgery is first. Thus the 18 weeks delay.
The nice thing is that if one does not have spread to other organs, they possibly do not need immunotherapy and mole removal followed by a personalized vaccine is all that is required for NED status.
This is the same study but different write-up where glioblastoma is also mentioned
https://gizmodo.com/personalized-skin-cancer-vaccine-shows-promise-in-new-t-1846100296
Best regards,
Melanie
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