Chemical Biology Laboratory, National Cancer Institute, NIH, Frederick, Maryland 21702, USA.
Clin Cancer Res. 2013 Mar 1;19(5):1290-9. doi: 10.1158/1078-0432.CCR-12-2478. Epub 2013 Jan 29.
There is evidence that therapeutic cancer vaccines can lengthen survival for some patients with cancer, but responses vary widely from one person to another. Methods to predict clinical outcomes will advance the field and provide new insights into critical determinants of in vivo efficacy.
This retrospective study included 141 subjects from phase II trials of PROSTVAC-VF, a poxvirus-based cancer vaccine currently in phase III clinical trials for advanced prostate cancer. A glycan microarray was used to profile prevaccination antiglycan antibody populations in sera as potential biomarkers for PROSTVAC-VF. The screen for predictive biomarkers identified antiglycan antibodies that consistently stratified subjects into groups with different Kaplan-Meier survival estimates. Because of the potential for overfitting, a permutation test was used to estimate the false discovery rate.
Prevaccination antibody levels to blood group A trisaccharide (BG-Atri) were found to have a statistically significant correlation with survival. Long-term survival was approximately doubled in subjects with abundant anti-BG-Atri immunoglobulin M (IgM) relative to subjects with little or no preexisting IgM for BG-Atri. This survival correlation was specific to vaccine treatment, as no correlation was observed in control patients immunized with wild-type poxviruses lacking the key tumor antigen, prostate-specific antigen (PSA). Moreover, anti-BG-Atri IgM levels were not correlated with general measures of disease severity, such as PSA levels, Gleason score, or Halabi predicted survival.
In addition to reporting a new potentially predictive biomarker for PROSTVAC-VF, this study highlights the use of glycan microarray technology for improving our understanding of vaccine immunology. Clin Cancer Res; 19(5); 1290-9. ©2012 AACR.
有证据表明,治疗性癌症疫苗可以延长某些癌症患者的生存期,但个体之间的反应差异很大。预测临床结果的方法将推动该领域的发展,并为体内疗效的关键决定因素提供新的见解。
本回顾性研究纳入了正在进行的 III 期临床试验中的晚期前列腺癌 PROSTVAC-VF 疫苗的 II 期临床试验中的 141 名受试者。使用聚糖微阵列来分析疫苗接种前血清中针对聚糖的抗体群体,作为 PROSTVAC-VF 的潜在生物标志物。用于预测生物标志物的筛选确定了一致地将受试者分为具有不同 Kaplan-Meier 生存估计的组的针对聚糖的抗体。由于存在过度拟合的可能性,因此使用置换检验来估计错误发现率。
发现疫苗接种前抗血型 A 三糖(BG-Atri)的抗体水平与生存具有统计学显著相关性。与 BG-Atri 抗体水平低或无的受试者相比,大量存在抗-BG-Atri 免疫球蛋白 M(IgM)的受试者的长期生存率约提高了一倍。这种生存相关性是疫苗治疗特有的,因为在接种缺乏关键肿瘤抗原前列腺特异性抗原(PSA)的野生型痘病毒的对照患者中未观察到相关性。此外,抗-BG-Atri IgM 水平与一般疾病严重程度的衡量标准(如 PSA 水平、Gleason 评分或 Halabi 预测的生存)无关。
除了报告 PROSTVAC-VF 的一种新的潜在预测性生物标志物外,本研究还强调了使用聚糖微阵列技术来提高我们对疫苗免疫学的理解。临床癌症研究;19(5);1290-9。©2012AACR。