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基于树突状细胞的免疫治疗,用 Wilms 肿瘤 1 肽和黏蛋白 1 脉冲作为辅助治疗,用于根治性切除术后的胰腺导管腺癌:一项 I/IIa 期临床试验。

Dendritic Cell-based Immunotherapy Pulsed With Wilms Tumor 1 Peptide and Mucin 1 as an Adjuvant Therapy for Pancreatic Ductal Adenocarcinoma After Curative Resection: A Phase I/IIa Clinical Trial.

机构信息

Transfusion and Cell Therapy Unit, Nagasaki University Hospital, Nagasaki, Japan

Department of Surgery, Nagasaki University Hospital, Nagasaki, Japan.

出版信息

Anticancer Res. 2020 Oct;40(10):5765-5776. doi: 10.21873/anticanres.14593.

Abstract

BACKGROUND/AIM: We evaluated the safety, feasibility, and preliminary efficacy of Wilms tumor gene 1 (WT1) peptide and Mucin 1 (MUC1)-pulsed dendritic cell (DC) (WT1/MUC1-DC) vaccination as an adjuvant immunotherapy for surgically resectable pancreatic ductal adenocarcinoma (PDA) patients.

PATIENTS AND METHODS

Eligible patients were administered WT1/MUC1-DC vaccination at least seven times every 2 weeks with concomitant adjuvant chemotherapy after surgical resection of PDA.

RESULTS

Ten patients were enrolled and no Grade 2 or higher toxicities were associated with DC vaccination. The estimated overall survival (OS) and relapse-free survival (RFS) at 3-years from the time of surgical resection were 77.8% and 35.0%, respectively. Immunohistochemical analysis suggested a possible relationship between induction of WT1-specific cytotoxic T lymphocyte after DC vaccination and higher infiltration of CD3/CD4/CD8 lymphocytes in tumor tissues.

CONCLUSION

WT1/MUC1-DC vaccination in the adjuvant setting was safe and well-tolerated in PDA patients after tumor resection. A large-scale prospective study is warranted to evaluate the clinical benefit of this modality.

摘要

背景/目的:我们评估了 Wilms 肿瘤基因 1(WT1)肽和黏蛋白 1(MUC1)-脉冲树突状细胞(DC)(WT1/MUC1-DC)疫苗作为可切除胰腺导管腺癌(PDA)患者辅助免疫治疗的安全性、可行性和初步疗效。

患者和方法

符合条件的患者在 PDA 手术后至少每 2 周接受 WT1/MUC1-DC 疫苗接种 7 次以上,并同时接受辅助化疗。

结果

共纳入 10 例患者,DC 疫苗接种无 2 级或更高级别的毒性。从手术切除时间算起,估计的总生存(OS)和无复发生存(RFS)分别为 77.8%和 35.0%。免疫组织化学分析提示 DC 疫苗接种后诱导 WT1 特异性细胞毒性 T 淋巴细胞与肿瘤组织中 CD3/CD4/CD8 淋巴细胞浸润增加之间可能存在关系。

结论

WT1/MUC1-DC 疫苗在肿瘤切除后的 PDA 患者辅助治疗中是安全且耐受良好的。需要进行大规模前瞻性研究来评估这种方式的临床获益。

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