地塞米松并未抑制晚期前列腺癌患者个性化肽疫苗接种带来的免疫增强作用。

Dexamethasone did not suppress immune boosting by personalized peptide vaccination for advanced prostate cancer patients.

作者信息

Naito Masayasu, Itoh Kyogo, Komatsu Nobukazu, Yamashita Yuichi, Shirakusa Takafumi, Yamada Akira, Moriya Fukuko, Ayatuka Hitoshi, Mohamed Elnisr Rashed, Matsuoka Kei, Noguchi Masanori

机构信息

Department of Immunology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.

出版信息

Prostate. 2008 Dec 1;68(16):1753-62. doi: 10.1002/pros.20847.

DOI:10.1002/pros.20847

PMID:18767041

Abstract

BACKGROUND

To evaluate the immunological responses of personalized peptide vaccination combined with low-dose glucocorticoids for advanced hormone refractory prostate cancer (HRPC) patients (pts).

METHODS

Eleven pts with advanced HRPC were treated with the vaccination and low-dose glucocorticoids; 6 pts with 10 mg/day of prednisolone (PDL) followed by 1 mg/day of dexamethasone at the time of progression, 1 pt with PDL, and 4 pts with dexamethasone. Peptide-specific cellular and humoral responses were employed to monitor pre- and post- (6th) vaccination samples.

RESULTS

The vaccination combined with glucocorticoids was well tolerated with no severe adverse effects. Increments of IgG responses were observed in 1 of 4 or 8 of 10 pts tested who received PDL or dexamethasone, respectively, increment of cytotoxic T lymphocyte activity was observed in 2 of 4 or 5 of 7 pts tested, respectively. Vaccination with PDL or dexamethasone resulted in a decline of PSA (at least 50%) in 1 of 7 or 6 of 10 pts with significantly longer median TTP in the dexamethasone group, respectively.

CONCLUSION

Vaccination combined with dexamethasone could be recommended for further clinical trials from both immunological and clinical points of view.

摘要

背景

评估个性化肽疫苗联合低剂量糖皮质激素对晚期激素难治性前列腺癌（HRPC）患者的免疫反应。

方法

11例晚期HRPC患者接受疫苗接种和低剂量糖皮质激素治疗；6例患者先服用10mg/天泼尼松龙（PDL），病情进展时改为1mg/天地塞米松，1例患者仅服用PDL，4例患者仅服用地塞米松。采用肽特异性细胞和体液反应监测接种疫苗前和接种后（第6次）的样本。

结果

疫苗联合糖皮质激素耐受性良好，无严重不良反应。分别在接受PDL或地塞米松治疗的4例受测患者中的1例或10例受测患者中的8例中观察到IgG反应增加，分别在4例受测患者中的2例或7例受测患者中的5例中观察到细胞毒性T淋巴细胞活性增加。服用PDL或地塞米松进行疫苗接种分别使7例患者中的1例或10例患者中的6例患者的前列腺特异性抗原（PSA）下降（至少50%），地塞米松组的中位无进展生存期显著更长。