title: Effects of interleukin-12 on the immune response to a multipeptide vaccine for resected metastatic melanoma.
abstract: OBJECTIVE
  Forty-eight patients with high-risk re-sected stage III or IV melanoma were immunized with two tumor antigen epitope peptides derived from gp100(209-217)(210M) (IMDQVPSFV) and tyrosinase(368-376)(370D) (YMDGTMSQV) emulsified with incomplete Freund's adjuvant (IFA). Patients received peptides/IFA with or without interleukin (IL)-12 30 ng/kg to evaluate the toxicities and immune responses in either arm with time to relapse and survival as secondary end points.
  
  
  METHODS
  Immunizations were administered every 2 weeks for 8 weeks, then every 4 weeks for 12 weeks, and then once 8 weeks later. A leukapheresis to obtain peripheral-blood mononuclear cells for immune analyses was done before and after vaccination. Skin testing with peptides and recall reagents was performed before and after vaccinations.
  
  
  RESULTS
  Local pain and granuloma formation, fever, and lethargy of grade 1 or 2 were observed. Transient vaccine-related grade 3-but no grade 4-toxicity was observed. Thirty-four of 40 patients developed a positive skin test response to the gp100 peptide but none to tyrosinase. Immune responses were measured by release of gamma-interferon in an enzyme-linked immunosorbent assay (ELISA) by effector cells in the presence of peptide-pulsed antigen-presenting cells or by an antigen-specific tetramer flow cytometry assay. Thirty-three of 38 patients demonstrated an immune response by ELISA after vaccination, as did 37 of 42 patients by tetramer assay. Twenty-four of 48 patients relapsed with a median follow-up of 20 months, and 10 patients in this high-risk group have died.
  
  
  CONCLUSIONS
  These data suggest a significant proportion of patients with resected melanoma mount an antigen-specific immune response against a peptide vaccine and indicate that IL-12 may increase the immune response and supporting further development of IL-12 as a vaccine adjuvant.
authors.affiliation: Department of Medicine, Division of Medical Oncology, Keck/University of Southern California School of Medicine, Los Angeles, USA.
authors.forename: P
authors.initials: P
authors.lastname: Lee
authors.forename: F
authors.initials: F
authors.lastname: Wang
authors.forename: J
authors.initials: J
authors.lastname: Kuniyoshi
authors.forename: V
authors.initials: V
authors.lastname: Rubio
authors.forename: T
authors.initials: T
authors.lastname: Stuges
authors.forename: S
authors.initials: S
authors.lastname: Groshen
authors.forename: C
authors.initials: C
authors.lastname: Gee
authors.forename: R
authors.initials: R
authors.lastname: Lau
authors.forename: G
authors.initials: G
authors.lastname: Jeffery
authors.forename: K
authors.initials: K
authors.lastname: Margolin
authors.forename: V
authors.initials: V
authors.lastname: Marty
authors.forename: J
authors.initials: J
authors.lastname: Weber
mesh_terms: D000293:Adolescent; D019496:Cancer Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D017024:Chemotherapy, Adjuvant; D005260:Female; D005620:Freund's Adjuvant; D006801:Humans; D007371:Interferon-gamma / Q000032:analysis; D018664:Interleukin-12 / Q000627:therapeutic use*; D007937:Leukapheresis; D008055:Lipids; D008297:Male; D008545:Melanoma / Q000097:blood / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology; D009367:Neoplasm Staging; D012878:Skin Neoplasms / Q000097:blood / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery; D012882:Skin Tests; D016019:Survival Analysis; D013997:Time Factors; D014611:Vaccination
chemical_list: D019496:Cancer Vaccines; D008055:Lipids; C114843:incomplete Freund's adjuvant; D018664:Interleukin-12; D007371:Interferon-gamma; D005620:Freund's Adjuvant