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16型和18型人乳头瘤病毒E7脉冲树突状细胞疫苗用于IB期或IIA期宫颈癌患者:一项I期剂量递增试验。

Human papillomavirus type 16 and 18 E7-pulsed dendritic cell vaccination of stage IB or IIA cervical cancer patients: a phase I escalating-dose trial.

作者信息

Santin Alessandro D, Bellone Stefania, Palmieri Michela, Zanolini Alessandro, Ravaggi Antonella, Siegel Eric R, Roman Juan J, Pecorelli Sergio, Cannon Martin J

机构信息

UAMS Medical Center, Division of Gynecologic Oncology, University of Arkansas, 4301 W. Markham, Little Rock, AR 72205-7199, USA.

出版信息

J Virol. 2008 Feb;82(4):1968-79. doi: 10.1128/JVI.02343-07. Epub 2007 Dec 5.

Abstract

The safety and immunogenicity of the human papillomavirus type 16 (HPV16) or HPV18 (HPV16/18) E7 antigen-pulsed mature dendritic cell (DC) vaccination were evaluated for patients with stage IB or IIA cervical cancer. Escalating doses of autologous DC (5, 10, and 15 x 10(6) cells for injection) were pulsed with recombinant HPV16/18 E7 antigens and keyhole limpet hemocyanin (KLH; an immunological tracer molecule) and delivered in five subcutaneous injections at 21-day intervals to 10 cervical cancer patients with no evidence of disease after they underwent radical surgery. Safety, toxicity, delayed-type hypersensitivity (DTH) reaction, and induction of serological and cellular immunity against HPV16/18 E7 and KLH were monitored. DC vaccination was well tolerated, and no significant toxicities were recorded. All patients developed CD4(+) T-cell and antibody responses to DC vaccination, as detected by enzyme-linked immunosorbent spot (ELISpot) and enzyme-linked immunosorbent assays (ELISA), respectively, and 8 out of 10 patients demonstrated levels of E7-specific CD8(+) T-cell counts, detected by ELISpot during or immediately after immunization, that were increased compared to prevaccination baseline levels. The vaccine dose did not predict the magnitude of the antibody or T-cell response or the time to detection of HPV16/18 E7-specific immunity. DTH responses to intradermal injections of HPV E7 antigen and KLH were detected for all patients after vaccination. We conclude that HPV E7-loaded DC vaccination is safe and immunogenic for stage IB or IIA cervical cancer patients. Phase II E7-pulsed DC-based vaccination trials with cervical cancer patients harboring a limited tumor burden, or who are at significant risk of tumor recurrence, are warranted.

摘要

对IB期或IIA期宫颈癌患者评估了人乳头瘤病毒16型(HPV16)或HPV18型(HPV16/18)E7抗原脉冲成熟树突状细胞(DC)疫苗接种的安全性和免疫原性。用重组HPV16/18 E7抗原和钥孔戚血蓝蛋白(KLH;一种免疫示踪分子)对递增剂量的自体DC(注射用5×10⁶、10×10⁶和15×10⁶个细胞)进行脉冲处理,并在10例接受根治性手术后无疾病证据的宫颈癌患者中每隔21天进行5次皮下注射。监测安全性、毒性、迟发型超敏反应(DTH)以及针对HPV16/18 E7和KLH的血清学和细胞免疫诱导情况。DC疫苗接种耐受性良好,未记录到明显毒性。分别通过酶联免疫斑点法(ELISpot)和酶联免疫吸附测定(ELISA)检测发现,所有患者均对DC疫苗接种产生了CD4⁺ T细胞和抗体反应,并且10例患者中有8例在免疫期间或免疫后立即通过ELISpot检测到E7特异性CD8⁺ T细胞计数水平与接种前基线水平相比有所增加。疫苗剂量无法预测抗体或T细胞反应的强度或检测HPV16/18 E7特异性免疫的时间。所有患者在接种疫苗后均检测到对皮内注射HPV E7抗原和KLH的DTH反应。我们得出结论,对于IB期或IIA期宫颈癌患者,HPV E7负载的DC疫苗接种是安全且具有免疫原性的。有必要对肿瘤负荷有限或有显著肿瘤复发风险的宫颈癌患者进行基于E7脉冲DC的II期疫苗接种试验。

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