Peptide vaccination after repeated resection of metastases can induce a prolonged relapse‐free interval in melanoma patients

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Abstract
This pilot study was carried out to gain a first insight into the effects of peptide vaccination in melanoma patients in the high‐risk adjuvant disease setting. From the adjuvant peptide vaccination studies carried out in our institution since 1998, we identified all melanoma patients with a history of at least 3 completely resected metastases during the year preceding enrollment into the trial and describe the clinical and immunologic observations. Out of a total of 44 patients with resected cutaneous melanoma entered into adjuvant peptide vaccination trials, 9 patients were identified with more than 3 metastases in the year before vaccination. After initiation of vaccination, 2 patients remained relapse‐free for 27 and 42+ months, 2 patients experienced single or several initial relapses and subsequent relapse‐free intervals of 18 and 65+ months, whereas 5 patients progressed. In both patients with relapse after prolonged relapse‐free intervals, the relapses were initially confined to the small intestine and could be resected. Induction or boosting of functional tyrosinase peptide‐specific T cells was noted in 6 of 8 patients, including all 4 patients with prolonged relapse‐free intervals. In conclusion, adjuvant peptide vaccination was associated with cessation of recurrences in 4 of 9 patients, of whom all 4 had an immunologic response to the vaccine.