We used a VSV-cDNA library to treat recurrent
melanoma, identifying immunogenic
antigens, allowing us to target recurrences with
immunotherapy or
chemotherapy. Primary
B16 melanoma tumors were induced to regress by frontline
therapy. Mice with recurrent
tumors were treated with VSV-
cDNA immunotherapy. A Th17 recall response was used to screen the VSV-cDNA library for individual viruses encoding rejection
antigens, subsequently targeted using
immunotherapy or
chemotherapy. Recurrent
tumors were effectively treated with a VSV-cDNA library using
cDNA from recurrent B16
tumors. Recurrence-associated rejection
antigens identified included Topoisomerase-IIα, YB-1, cdc7
kinase, and BRAF. Fourteen out of 16 recurrent
tumors carried BRAF mutations (595-605 region) following frontline
therapy, even though the parental B16
tumors were BRAF wild type. The emergence of mutated BRAF-containing recurrences served as an excellent target for BRAF-specific immune-(VSV-BRAF), or chemo-(PLX-4720)
therapies. Successful
PLX-4720 therapy of recurrent
tumors was associated with the development of a broad spectrum of T-cell responses. VSV-
cDNA technology can be used to identify recurrence specific
antigens. Emergence of mutated BRAF may be a major effector of
melanoma recurrence which could serve as a target for chemo or immune
therapy. This study suggests a rationale for offering patients with initially wild-type BRAF
melanomas an additional biopsy to screen for mutant BRAF upon recurrence.