González G, Crombet T, Catalá M, Mirabal V, Hernández J C, González Y, Marinello P, Guillén G, Lage A
Center of Molecular Immunology, Havana, Cuba.
Ann Oncol. 1998 Apr;9(4):431-5. doi: 10.1023/a:1008261031034.
There is evidence of a relationship between epidermal growth factor (EGF) and tumor cell proliferation, such as the overexpression of EGF receptor (EGF-R) in different human tumors, which makes this system an interesting target for cancer treatment. Up to now, passive immunotherapy with monoclonal antibodies against the EGF-R has been assayed in clinics. Our approach consists of active immunotherapy with human EGF (hu-EGF). We conducted a pilot clinical trial to define the safety, toxicity and immunogenicity of vaccination with hu-EGF coupled to a carrier protein.
Ten patients with histologically-proven malignant carcinomas (colon, lung, stomach and prostate) in advanced clinical stages were enrolled. Patients were immunized twice (on days 0 and 15) with hu-EGF linked to either tetanic toxoid (TT, five patients) or P64K Neisseria Meningitidis recombinant protein (P64k, five patients), intradermically, using aluminium hydroxyde as adjuvant.
In both groups 60% of patients developed anti-EGF antibody titers without evidence of toxicity. Secondary reactions were very mild, limited to erythema and itching at the site of injection, which disappeared without medication.
We conclude that the proposed vaccination with hu-EGF was well tolerated and that antibody titers against self EGF were developed. The results of this trial may be useful in the design of new clinical trials with higher dose immunization protocols and using more effective adjuvants.
有证据表明表皮生长因子(EGF)与肿瘤细胞增殖之间存在关联,比如在不同人类肿瘤中表皮生长因子受体(EGF-R)的过表达,这使得该系统成为癌症治疗的一个有趣靶点。到目前为止,针对EGF-R的单克隆抗体被动免疫疗法已在临床中进行了试验。我们的方法是用人表皮生长因子(hu-EGF)进行主动免疫治疗。我们开展了一项试点临床试验,以确定与载体蛋白偶联的hu-EGF疫苗接种的安全性、毒性和免疫原性。
招募了10例组织学确诊为晚期临床阶段恶性癌(结肠癌、肺癌、胃癌和前列腺癌)的患者。患者分别于第0天和第15天接受两次免疫,皮内注射与破伤风类毒素(TT,5例患者)或脑膜炎奈瑟菌重组蛋白P64K(P64k,5例患者)偶联的hu-EGF,使用氢氧化铝作为佐剂。
两组中60%的患者产生了抗EGF抗体滴度,且无毒性证据。二级反应非常轻微,仅限于注射部位的红斑和瘙痒,无需用药即可消失。
我们得出结论,所提议的hu-EGF疫苗接种耐受性良好,且产生了针对自身EGF的抗体滴度。该试验结果可能有助于设计更高剂量免疫方案并使用更有效佐剂的新临床试验。