Department of Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Departments of Immuno-Gene Therapy and Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Japan.
Cancer Immunol Immunother. 2021 Nov;70(11):3081-3091. doi: 10.1007/s00262-021-02892-w. Epub 2021 Mar 22.
The nanoparticle complex of cholesteryl pullulan (CHP) and NY-ESO-1 antigen protein (CHP-NY-ESO-1) presents multiple epitope peptides to MHC class I and II pathways, leading to CD8 and CD4 T cell responses. Poly-ICLC is a synthetic, double-stranded RNA, an agonist of toll-like receptor (TLR)-3, and a cytoplasmic receptor of melanoma differentiation-associated gene (MDA)-5. It should be a suitable immune adjuvant of cancer vaccine to overcome the inhibitory tumor microenvironment. We conducted a phase 1 clinical trial of CHP-NY-ESO-1 with poly-ICLC in patients with advanced or recurrent esophageal cancer. CHP-NY-ESO-1/poly-ICLC (μg/mg) was administered at a dose of 200/0.5 or 200/1.0 (cohorts 1 and 2, respectively) every 2 weeks for a total of six doses. The primary endpoints were safety and immune response. The secondary endpoint was tumor response. In total, 16 patients were enrolled, and six patients in each cohort completed the trial. The most common adverse event (AE) was injection site skin reaction (86.7%). No grade 3 or higher drug-related AEs were observed. No tumor responses were observed, and three patients (30%) had stable disease. The immune response was comparable between the two cohorts, and all patients (100%) achieved antibody responses with a median of 2.5 vaccinations. Comparing CHP-NY-ESO-1 alone to the poly-ICLC combination, all patients in both groups exhibited antibody responses, but the titers were higher in the combination group. In a mouse model, adding anti-PD-1 antibody to the combination of CHP-NY-ESO-1/poly-ICLC suppressed the growth of NY-ESO-1-expressing tumors. Combining the vaccine with PD-1 blockade holds promise in human trials.
胆固醇支链淀粉(CHP)与 NY-ESO-1 抗原蛋白的纳米颗粒复合物(CHP-NY-ESO-1)向 MHC Ⅰ类和Ⅱ类途径呈递多个表位肽,导致 CD8 和 CD4 T 细胞反应。聚肌苷酸:聚胞苷酸(poly-ICLC)是一种合成的双链 RNA,是 Toll 样受体(TLR)-3 的激动剂,也是黑色素瘤分化相关基因(MDA)-5 的细胞质受体。它应该是克服抑制性肿瘤微环境的癌症疫苗的合适免疫佐剂。我们在晚期或复发性食管癌患者中进行了 CHP-NY-ESO-1 与 poly-ICLC 的 I 期临床试验。CHP-NY-ESO-1/poly-ICLC(μg/mg)以 200/0.5 或 200/1.0(分别为队列 1 和 2)的剂量每 2 周给药一次,共 6 剂。主要终点是安全性和免疫反应。次要终点是肿瘤反应。共纳入 16 例患者,每个队列 6 例患者完成试验。最常见的不良事件(AE)是注射部位皮肤反应(86.7%)。未观察到 3 级或更高级别的药物相关 AE。未观察到肿瘤反应,3 例患者(30%)病情稳定。两个队列的免疫反应相当,所有患者(100%)在中位数为 2.5 次接种后均产生抗体反应。与单独使用 CHP-NY-ESO-1 相比,两组所有患者均表现出抗体反应,但联合组的滴度更高。在小鼠模型中,在 CHP-NY-ESO-1/poly-ICLC 联合中加入抗 PD-1 抗体抑制了 NY-ESO-1 表达肿瘤的生长。将疫苗与 PD-1 阻断联合在人类试验中具有前景。
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