title: Bioactivity of autologous irradiated renal cell carcinoma vaccines generated by ex vivo granulocyte-macrophage colony-stimulating factor gene transfer.
abstract: Granulocyte-macrophage colony-stimulating factor (GM-CSF) gene-transduced, irradiated tumor vaccines induce potent, T-cell-mediated antitumor immune responses in preclinical models. We report the initial results of a Phase I trial evaluating this strategy for safety and the induction of immune responses in patients with metastatic renal cell carcinoma (RCC). Patients were treated in a randomized, double-blind dose-escalation study with equivalent doses of autologous, irradiated RCC vaccine cells with or without ex vivo human GM-CSF gene transfer. The replication-defective retroviral vector MFG was used for GM-CSF gene transfer. No dose-limiting toxicities were encountered in 16 fully evaluable patients. GM-CSF gene-transduced vaccines were equivalent in toxicity to nontransduced vaccines up to the feasible limits of autologous tumor vaccine yield. No evidence of autoimmune disease was observed. Biopsies of intradermal sites of injection with GM-CSF gene-transduced vaccines contained distinctive macrophage, dendritic cell, eosinophil, neutrophil, and T-cell infiltrates similar to those observed in preclinical models of efficacy. Histological analysis of delayed-type hypersensitivity responses in patients vaccinated with GM-CSF-transduced vaccines demonstrated an intense eosinophil infiltrate that was not observed in patients who received nontransduced vaccines. An objective partial response was observed in a patient treated with GM-CSF gene-transduced vaccine who displayed the largest delayed-type hypersensitivity conversion. No replication-competent retrovirus was detected in vaccinated patients. This Phase I study demonstrated the feasibility, safety, and bioactivity of an autologous GM-CSF gene-transduced tumor vaccine for RCC patients.
authors.affiliation: Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Simons
authors.forename: E M
authors.initials: EM
authors.lastname: Jaffee
authors.forename: C E
authors.initials: CE
authors.lastname: Weber
authors.forename: H I
authors.initials: HI
authors.lastname: Levitsky
authors.forename: W G
authors.initials: WG
authors.lastname: Nelson
authors.forename: M A
authors.initials: MA
authors.lastname: Carducci
authors.forename: A J
authors.initials: AJ
authors.lastname: Lazenby
authors.forename: L K
authors.initials: LK
authors.lastname: Cohen
authors.forename: C C
authors.initials: CC
authors.lastname: Finn
authors.forename: S M
authors.initials: SM
authors.lastname: Clift
authors.forename: K M
authors.initials: KM
authors.lastname: Hauda
authors.forename: L A
authors.initials: LA
authors.lastname: Beck
authors.forename: K M
authors.initials: KM
authors.lastname: Leiferman
authors.forename: A H
authors.initials: AH
authors.lastname: Owens
authors.forename: S
authors.initials: S
authors.lastname: Piantadosi
authors.forename: G
authors.initials: G
authors.lastname: Dranoff
authors.forename: R C
authors.initials: RC
authors.lastname: Mulligan
authors.forename: D M
authors.initials: DM
authors.lastname: Pardoll
authors.forename: F F
authors.initials: FF
authors.lastname: Marshall
mesh_terms: D000328:Adult; D000368:Aged; D019496:Cancer Vaccines / Q000009:adverse effects / Q000276:immunology / Q000528:radiation effects / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000276:immunology / Q000628:therapy*; D003673:Defective Viruses / Q000235:genetics; D004311:Double-Blind Method; D003875:Drug Eruptions / Q000209:etiology / Q000276:immunology / Q000473:pathology; D005260:Female; D018014:Gene Transfer Techniques; D005822:Genetic Vectors / Q000235:genetics; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000235:genetics*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000473:pathology; D007680:Kidney Neoplasms / Q000276:immunology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D014611:Vaccination / Q000009:adverse effects
chemical_list: D019496:Cancer Vaccines; D016178:Granulocyte-Macrophage Colony-Stimulating Factor