Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, FOB-3, Tampa, FL, USA.
Expert Rev Vaccines. 2015 Mar;14(3):341-50. doi: 10.1586/14760584.2015.989990. Epub 2014 Dec 3.
Passive immunization against CMV is desirable to minimize or perhaps eliminate complications related to CMV disease. In allogeneic hematopoietic cell transplantation (allo-HCT), the major challenge facing a successful anti-CMV vaccine is inducing immunity in an immunocompromised host. To date, only one CMV vaccine, ASP0113, has been evaluated in a randomized, placebo-controlled Phase II study. ASP0113 is a bivalent product containing two plasmids that encode CMV glycoprotein B and tegument phosphoprotein 65, respectively. Although there was no significant difference in rate of initiation of anti-CMV therapy, rates of CMV viremia were lower in the ASP0113 group when measured by a central laboratory. Also, time-to-first episode of viremia was longer in subjects receiving ASP0113. These findings paved the way for an ongoing placebo-controlled Phase III study aiming at enrolling 500 subjects. Results of this Phase III trial, especially if it meets clinically meaningful endpoints, will ultimately determine the role of anti-CMV vaccine strategies in allo-HCT.
针对 CMV 的被动免疫是理想的,可以最大限度地减少或消除与 CMV 疾病相关的并发症。在异基因造血细胞移植(allo-HCT)中,成功的抗 CMV 疫苗所面临的主要挑战是在免疫功能低下的宿主中诱导免疫。迄今为止,只有一种 CMV 疫苗,即 ASP0113,在一项随机、安慰剂对照的 II 期研究中进行了评估。ASP0113 是一种双价产品,包含分别编码 CMV 糖蛋白 B 和被膜磷酸蛋白 65 的两种质粒。尽管在开始抗 CMV 治疗的比率方面没有显著差异,但在中央实验室测量时,ASP0113 组的 CMV 病毒血症发生率较低。此外,接受 ASP0113 治疗的受试者的首次病毒血症发作时间更长。这些发现为正在进行的旨在招募 500 名受试者的安慰剂对照 III 期研究铺平了道路。该 III 期试验的结果,特别是如果达到有临床意义的终点,将最终确定抗 CMV 疫苗策略在 allo-HCT 中的作用。