Elkord Eyad, Dangoor Adam, Burt Deborah J, Southgate Thomas D, Daayana Sai, Harrop Richard, Drijfhout Jan W, Sherlock David, Hawkins Robert E, Stern Peter L
CR UK Immunology Group, Paterson Institute for Cancer Research, University of Manchester, Christie Hospital NHS Trust, Wilmslow Road, Manchester, M20 4BX, UK.
Cancer Immunol Immunother. 2009 Oct;58(10):1657-67. doi: 10.1007/s00262-009-0674-y. Epub 2009 Feb 17.
We have recently reported the results of a phase II trial in which two TroVax [modified vaccinia ankara (MVA) encoding the tumour antigen 5T4] vaccinations were given to patients both pre- and post-surgical resection of liver metastases secondary to colorectal cancer (CRC). 5T4-specific cellular responses were assessed at the entry and 2 weeks after each vaccination by proliferation of fresh lymphocytes and ELISA for antibody responses; 18 from the 19 CRC patients mounted a 5T4-specific cellular and/or humoral response. Here, we present a comparison of individual and between patient responses over the course of the treatments using cryopreserved peripheral blood mononuclear cells (PBMC) samples from the baseline until after the fourth vaccination at 14 weeks. Assays used were proliferation assay with 5T4-Fc fusion protein, overlapping 32mer 5T4 peptides, MVA-LacZ and MVA-5T4 infected autologous monocytes. Responses to 5T4 protein or one or more peptide pools were pre-existing in 12/20 patients and subsequently 10 and 12 patients showed boosted and/or de novo responses, respectively. Cumulatively, 13/20 patients showed proliferative responses by week 14. We also assessed the levels of systemic T regulatory cells, plasma cytokine levels, phenotype of tumour-infiltrating lymphocytes including T regulatory cells and tumour HLA class I loss of expression. More than half of the patients showed phenotypes consistent with relative immune suppression and/or escape highlighting the complexity of positive and negative factors challenging any simple correlation with clinical outcome.
我们最近报告了一项II期试验的结果,该试验对结直肠癌(CRC)继发肝转移患者在手术切除肝转移灶前后均给予两次TroVax[编码肿瘤抗原5T4的改良安卡拉痘苗病毒(MVA)]疫苗接种。在每次接种疫苗时及接种后2周,通过新鲜淋巴细胞增殖和ELISA检测抗体反应来评估5T4特异性细胞反应;19例CRC患者中有18例产生了5T4特异性细胞和/或体液反应。在此,我们使用从基线到第14周第四次接种疫苗后的冷冻保存外周血单个核细胞(PBMC)样本,对治疗过程中个体反应和患者间反应进行了比较。所使用的检测方法包括用5T4-Fc融合蛋白、重叠32聚体5T4肽、MVA-LacZ和MVA-5T4感染的自体单核细胞进行增殖检测。12/20例患者预先存在对5T4蛋白或一个或多个肽池的反应,随后分别有10例和12例患者表现出增强和/或新生反应。到第14周时,累计有13/20例患者表现出增殖反应。我们还评估了全身调节性T细胞水平、血浆细胞因子水平、肿瘤浸润淋巴细胞包括调节性T细胞的表型以及肿瘤HLA I类分子表达缺失情况。超过一半的患者表现出与相对免疫抑制和/或逃逸一致的表型,这突出了正负因素的复杂性,这些因素挑战了与临床结果的任何简单关联。