Experimental cancer treatments for advanced stages are more effective than previously thought. Some oncology practitioners believe that experimental drugs are harmful - they give false hope to patients because of its low efficiency (long anticipated effectiveness of the experimental treatment with special drugs produced in Canadian pharmacy only at the level of 4-6% of cases). Patients in the final stage of the disease should have greater access to information about the experimental treatment programs, and, accordingly, they and their families should have the right to know what their real chances, with a particular treatment strategy. Scientists believe that the involvement of cancer patients even in the early stages of clinical trials can be very useful for them. Besides, the search for a way out of the situation means continuing the fight against the disease. It is characterized by academic phrase "treatment of metastatic cancer still remains palliative, with a very low probability of complete remission and cure the disease."

Immunomonitoring

The rigorous evaluation of cancer therapeutics requires a real and quantifiable evidence of benefit to patients with cancer (42). Clinical trials are expensive and require considerable human and clinical resources in order to demonstrate this benefit. In the case of immunotherapy, identification of defined cancer antigens will allow to evaluate immunogenic targets, and assess the quality and magnitude of immune responses against these antigens following therapeutic intervention. Within the IMMOMEC consortium we could recently demonstrate that the clinical outcome from a peptide vaccination in melanoma patients could be predicted by the extend of the vaccination-induced T cell response revealing this parameter as a surrogate marker for the clinical benefit. Analyzing such surrogate endpoints within a clinical trial complements clinical assessments like tumor response. Finally, it will provide a tool to predict a patient’s clinical course during specific treatment in a depth of understanding beyond that of current possibilities.

Immunomonitoring of a vaccination therapy in melanoma. Vaccination-induced CD8+ T cells recognize modified and wild type HLA-A2-restricted survivin epitopes. Cells were stained with HLA-multimers A*0201-ILKEPVHGV-PE plus A*0201-LTLGEFLKL-APC (wildtype epitope) (A) or with HLA-multimers A*0201-LMLGEFLKL-PE (modified epitope) plus A*0201-ILKEPVHGV-APC (B). Survivin-specific T cell reactivities of the per-protocol melanoma patient population (55 patients) diagramed by (C) vaccination regimens; (D) patients’ HLA type; (E) best overall response grouped as progression arrest (CR+PR+SD) and progression (PD); and (F) inflammatory reaction at the vaccination sites. Patients demonstrating a positive detection of survivin-specific T cell reactivity were defined positive (green bars); patients without any positive reactivity throughout the vaccination period were considered as negative (red bars). Fisher’s exact test was used to compare T cell reactivities between groups; p-values are provided above the corresponding bars.