Safety and immunogenicity study of NY-ESO-1b peptide and montanide ISA-51 vaccination of patients with epithelial ovarian cancer in high-risk first remission

Cornell University, Итак, New York, United States
Clinical Cancer Research (Impact Factor: 8.19). 05/2008; 14(9):2740-8. DOI: 10.1158/1078-0432.CCR-07-4619
Source: PubMed

ABSTRACT The cancer-testis antigen NY-ESO-1 is expressed by >40% of advanced epithelial ovarian cancers and is a promising immunotherapeutic target. In this study, we describe the effects of vaccination with the HLA-A*0201-restricted NY-ESO-1b peptide on patients with epithelial ovarian cancer in high-risk first remission.
After primary surgery and chemotherapy, high-risk epithelial ovarian cancer patients in first clinical remission received NY-ESO-1b peptide and Montanide every 3 weeks for five vaccinations. Tumor expression was evaluated by immunohistochemistry. Toxicity was monitored using National Cancer Institute Common Toxicity Criteria Scale Version 2. NY-ESO-1 specific humoral immunity (ELISA), T-cell immunity (tetramer and ELISPOT), and delayed-type hypersensitivity were assessed on weeks 0, 1, 4, 7, 10, 13, and 16.
Treatment-related adverse events included grade 1 fatigue, anemia, pruritus, myalgias, and hyperthyroidism and grade 2 hypothyroidism. There were no grade 3/grade 4 adverse events. Three of four patients (75%) with NY-ESO-1-positive tumor showed T-cell immunity by tetramer (0.6-9.5%) and ELISPOT (range, 35-260 spots). Four of five patients (80%) with NY-ESO-1-negative tumor showed T-cell immunity by tetramer (1.0-12.1%) and/or ELISPOT (range, 35-400 spots). With a median follow-up of 11.3 months, six of nine patients (67%) have recurred, with a median progression-free survival of 13 months (95% confidence interval, 11.2 months-not reached). Three of nine patients remain in complete clinical remission at 25, 38, and 52 months.
Vaccination of high-risk HLA-A*0201-positive epithelial ovarian cancer patients with NY-ESO-1b and Montanide has minimal toxicity and induces specific T-cell immunity in patients with both NY-ESO-1-positive and NY-ESO-1-negative tumors. Additional study is warranted.

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    • "Montanide has been tested in clinical trials (Diefenbach et al., 2008; Fourcade et al., 2008; Kakimi et al., 2011) and is the adjuvant component of the CIMAvax EGF therapeutic anticancer vaccine licensed in Latin America for use in adult patients with stage IIIB/ IV non-small-cell lung cancer (Rodriguez et al., 2010). In addition, Montanide in combination with CpG ODN and the recombinant NY-ESO-1 protein induced antigen-specific CD8 + T-cell responses in cancer patients, presumably via cross-presentation (Table 1) (Karbach et al., 2010; Valmori et al., 2007). "
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    • "Therefore, discovery of multiple tumor antigens in EOC may provide opportunities for multiantigen immunotherapeutic strategies that can induce sufficient clinical responses. Tumor antigens that are inherently immunogenic and oncogenic in ovarian cancer are p53 [16] [17] [18], Sperm Protein 17 (SP17) [14] [19] [20], Wilms' tumor gene 1 (WT1) [21] [22] [23], survivin [24] [25] [26], and NY-ESO-1 [12] [27] [28]. "
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