title: Immune response to the carcinoembryonic antigen in patients treated with an anti-idiotype antibody vaccine.
abstract: We have generated an IgG1 murine monoclonal anti-idiotype antibody (Ab2) designated 3H1, which mimics a specific epitope on the carcinoembryonic antigen (CEA). Patients with CEA positive tumors are immunologically "tolerant" to CEA. We used 3H1 as a surrogate for CEA for vaccine therapy of 12 patients with advanced colorectal cancer. Each of the patients received a minimum of four intracutaneous injections of aluminum hydroxide precipitated 3H1 at either 1, 2, or 4 mg dosage per injection. 9 of 12 patients demonstrated anti-anti-idiotypic (Ab3) response to 3H1. All nine patients generated specific anti-CEA antibody demonstrated by reactivity with radiolabeled purified CEA; some cases were confirmed by immunoprecipitation of purified CEA. We also demonstrated Ab3 stained both autologous and allogeneic colonic tumors. 7 of 12 patients demonstrated idiotype specific T cell proliferative responses and four also showed T cell proliferation to CEA. Toxicity was limited to local reaction with mild fever and chills. All 12 patients eventually progressed after finishing 4-13 dosages. This is the first report demonstrating that a vaccine therapy is capable of breaking "immune tolerance" to CEA in patients with CEA positive tumors. Future studies will focus on treating patients with minimal residual disease.
authors.affiliation: Lucille Parker Markey Cancer Center, University of Kentucky Medical Center, Lexington 40536-0093, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Foon
authors.forename: M
authors.initials: M
authors.lastname: Chakraborty
authors.forename: W J
authors.initials: WJ
authors.lastname: John
authors.forename: A
authors.initials: A
authors.lastname: Sherratt
authors.forename: H
authors.initials: H
authors.lastname: Köhler
authors.forename: M
authors.initials: M
authors.lastname: Bhattacharya-Chatterjee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology*; D000917:Antibody Formation; D002272:Carcinoembryonic Antigen / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D014612:Vaccines / Q000276:immunology*
chemical_list: D000888:Antibodies, Anti-Idiotypic; D002272:Carcinoembryonic Antigen; D014612:Vaccines