Yesterday U.S. Army surgeons exhibited new research findings in two poster presentations at the American College of Surgeons Clinical Congress.
The poster presentation titled, "Assessment of Disease Features and Immune Response in Breast Cancer Patients with Recurrence after Receiving AE37, a HER2 Peptide Vaccine," outlined outcomes of injecting AE37, a HER-2 derived vaccine, in breast cancer survivors following completion of standard therapy. Those who received injections of AE37 were more likely to survive disease-free than the control group.
Meanwhile, the poster presentation titled, "A NSQIP Evaluation of Practice Patterns and Outcomes Following Surgery for Anorectal Abscess and Fistula in Patients with and without Crohn's Disease," showed patients with Crohn's Disease (CD) - a form of inflammatory bowel disease - had more aggressive anorectal abscess and fistula disease and suffered more complications following emergency surgery than patients who did not have CD.
AE37 breast cancer vaccine creates robust immunologic response in cancer survivors
The poster "Assessment of Disease Features and Immune Response in Breast Cancer Patients with Recurrence after Receiving AE37, a HER2 Peptide Vaccine," showed after completing standard treatment, breast cancer survivors who received injections of AE37 with granulocyte-macrophage colony-stimulating factor (GM-CSF) - an immune stimulant - were more likely to survive five years disease-free than a control group that received GM-CSF alone. AE37 works by stimulating the immune system to recognize and target for destruction a protein called HER2 that is expressed at some level by most breast cancer cells.
While AE37 did not prevent recurrence in all patients, it provoked an immunologic response in patients across the board, including survivors at high risk of recurrence, those with the hard-to-treat "triple negative" form of breast cancer and those with lower levels of HER2 expression. "Patients with a lower level of expressed HER2 protein, who wouldn't be eligible for the HER2-binding antibody, trastuzumab (Herceptin), had a survival rate of more than 88 percent, compared to 70 percent in the control group," said U.S. Army Capt. John Berry, MD, a research associate. "The vaccine may have benefited patients with less aggressive cancers."
Study director Col. George E. Peoples, M.D., explained how the Cancer Vaccine Development Program differs from other groups investigating cancer vaccines. "Our program was one of the first to enroll cancer survivors with healthy immune systems rather than focus on people with end-stage, metastatic cancer. Our goal is to increase health and survivorship in this group, including specifically those with a high risk of cancer recurrence."
This study is part of an ongoing prospective, multi-center, randomized, single-blinded phase IIb adjuvant therapy trial. AE37 was co-developed by the Cancer Vaccine Development Program, housed at Brooke Army Medical Center in San Antonio, Texas.
Capt. Diane F. Hale, M.D., Sonia Perez, Ph.D., Capt. Timothy Vreeland, M.D., Capt. Dabney Raetasha, M.D., Michael Papamichail, M.D., Ph.D., Maj. Guy T. Clifton, M.D., Capt. Alan Sears, M.D., Sathibalan Ponniah Ph.D., and Elizabeth A. Mittendorf, M.D., FACS, also participated in the study.
More complications for Crohn's Disease patients following emergency colorectal surgery
Also presented today at Clinical Congress, the poster "A NSQIP Evaluation of Practice Patterns and Outcomes Following Surgery for Anorectal Abscess and Fistula in Patients with and without Crohn's Disease," discussed outcomes for CD patients following emergency surgery for anorectal abscess and fistula.
Lt. Col. Scott R. Steele, M.D., based at Madigan Army Medical Center, presented a retrospective review of medical data from the American College of Surgeons National Surgical Quality Improvement Program database (ACS-NSQIP, 2005-2010) to calculate 30-day outcomes of patients with and without underlying CD.
"People with Crohn's Disease are known for having a more aggressive form of anorectal disease and this study affirms that," said Steele. "Study results also showed that complications following emergency colorectal procedures were more prominent in patients with CD than patients without the disease."
The study data included 7,218 patients who met inclusion criteria with a mean age of 45 years. Even though the majority of patients studied were male (64 percent), CD patients presenting with anorectal disease were younger and more frequently female.
Capt. Marlin Wayne Causey, M.D., Capt. Dan Nelson, D.O., Lt. Col. Eric K. Johnson, M.D., Justin A. Maykel, M.D., Brad Davis, M.D., David E. Rivadeneira, M.D., and Brad Champagne, M.D., also participated in the study.