To Alan Rosenkranz, a Florida native, it was a miracle that he could take his 8-year-old granddaughter on a trip to New York City this past summer. Doctors did not have much hope for Rosenkranz’s recovery from renal cell cancer. But Duke University Health System doctors came to Rosenkranz’s rescue with a new treatment for his cancer of the kidneys—vaccine therapy, which the Food and Drug Administration approved just a few months ago.
The idea of a cancer vaccine is not new, but it has only recently been successful. Once doctors remove a tumor from the patient, they extract white blood cells from it and collect RNA samples. A vaccine is then prepared from the patient’s own genetic makeup that is designed to specifically target only that patient’s cancer cells.
The antibodies in the vaccine destroy the patient’s immune system and as a result, more effective lymphocytes are created to replace the old ones. The patient’s immune system adopts the new donor immune system, which doctors hope will destroy any new growth of tumor cells.
“We are really optimistic about the benefits of this procedure,” said Dr. David Rizzieri, associate professor of medicine. “We can more safely provide a new immune system and manipulate it without all the toxic side effects of other methods.”
Duke doctors began looking into alternative treatments to battle cancer after observing the toxic effects of traditional radiation and chemotherapeutic agents and the stress on the body from undergoing transplant surgery.
Rosenkranz recalls his experience with toxic treatments—bioimmunotherapy infusions—that only resulted in minimal reduction of the tumor. “You were freezing inside and out. Your blood pressure dropped to 50/30,” he said. “It was just like being dead.”
For patients who are not strong enough to endure these approaches, vaccine therapy offers them a new opportunity to get better. “It is gratifying to deal with patients who have no other hope,” said Dr. Johannes Vieweg, one of the leading research physicians in vaccine therapy. “With a few more years of research, it will stand alone and try to replace chemo.”
Rosenkranz considers Vieweg “beyond cutting-edge,” and as a former designer of pharmaceutical equipment, he believes this type of technology is the future of medicine.
“This really is very promising,” said Kim Lyerly, director of the Duke Comprehensive Cancer Center. “It is exciting to think of teams of physicians, in this case a hematologist/oncologist teaming with an urologist to devise a novel form of therapy for a very difficult cancer.”
Rosenkranz first went to see doctors at Memorial Sloan-Kettering Cancer Center and Mount Sinai Hospital in New York City but he said they were “not eager” to treat his cancer. He then turned to Duke physicians who were willing to help him.
Since May, Rosenkranz has had approximately six infusions and reports that there have been no new cancerous developments. He does his treatments as part of a day trip from his home in Palm Beach and spends a majority of his time conserving his strength in order to fight this disease.
“I feel like I’m 61 going on 30,” he said. “Without the people at Duke, I wouldn’t be here. They have given me hope and a chance to stay alive and live a decent life.”
Although this is one of the most aggressive and promising approaches to treat cancer, about 10 percent of patients do not survive, researchers said. There are many complications and doctors warn that the treatment is not for everyone, but Rosenkranz is satisfied with his experience.
“They have really given me my life back,” Rosenkranz said. “I could just kiss them all.”
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