Weng W-K et al. (2004) Clinical outcome of lymphoma patients after idiotype vaccination is correlated with humoral immune response and immunoglobulin G Fc receptor genotype. J Clin Oncol 22: 4717–4724

A recent study by Weng and co-workers has investigated the effects of idiotype (Id) vaccination in lymphoma patients. This approach is based on custom vaccines derived from a patient's own tumor.

The study included 136 patients with follicular lymphoma who received Id vaccination following chemotherapy. The patients' humoral immune response to the vaccine was assessed by comparing the anti-Id titer in postvaccine and prevaccine serum samples. T-cell proliferation assays were used to assess the cellular immune response. In addition, the investigators carried out immunoglobulin G Fc receptor (FcγR) genotyping, to assess the predictive value of FcγR polymorphism.

An idiotype-specific humoral immune response was detected in 48 (35%) patients; progression-free survival (PFS) after the last chemotherapy dose was significantly longer in these patients than in those who did not develop anti-Id antibodies. PFS was also longer in patients with FcγRIIIa 158 valine/valine genotype than in those with heterozygous valine/phenylalanine or homozygous phenylalanine/phenylalanine genotypes. Multivariate analysis showed that humoral immune responses and valine/valine genotype were both independent positive predictors for longer PFS. Surprisingly, a cellular immune response, detected in a fifth of all patients, showed no relationship with clinical outcome.

Weng et al. conclude that a humoral immune response to idiotype vaccination is beneficial, and that the antitumor effect is mediated by FcγR-bearing cells. They note that the efficacy of this therapeutic approach might be improved, therefore, by enhancing the antibody response.