Phase I trial of a B7-1 (CD80) gene modified autologous tumor cell vaccine in combination with systemic interleukin-2 in patients with metastatic renal cell carcinoma.
OBJECTIVE
A reason that the immune system may fail to reject tumors is that T cells encounter tumor antigen derived peptides on the surface of tumor cells in a tolerizing rather than activating context since tumor cells do not express T cell co-stimulatory molecules such as B7-1 (CD80). In preclinical models over expression of B7-1 on the surface of tumor cells has been shown to activate T cells which kill tumor cells. We conducted a phase I clinical trial testing this approach in patients with metastatic renal cell carcinoma.


METHODS
Resected tumors from 15 patients were disaggregated and adapted to tissue culture, transduced with the B7-1 gene and injected subcutaneously as a vaccine. The dose of the vaccine was escalated in 3 separate cohorts of patients, and systemic interleukin-2 (IL-2) was administered as an adjuvant designed to enhance the proliferation of the vaccine activated T cells.


RESULTS
Of the 15 patients 9 had measurable disease, 2 had a partial response and 2 had stable disease. Perivascular T cell infiltrates at autologous tumor delayed type hypersensitivity skin test sites developed in 3 of the 4 patients with stable disease or partial response. Although the patients experienced the usual and expected toxicity from the IL-2, there was no significant toxicity observed with the vaccine.


CONCLUSIONS
The B7-1 gene modified autologous tumor cell vaccine is safe and can be combined with systemic IL-2 with acceptable toxicity. Immunological and clinical responses were observed in some of the patients. A phase II trial is reasonable to determine the efficacy of this approach.
Antonia
Scott J
SJ
Interdisciplinary Oncology Program and Genitourinary Program, H. Lee Moffitt Cancer Center, Tampa, Florida 33612, USA.
Seigne
John
J
Diaz
Jose
J
Muro-Cacho
Carlos
C
Extermann
Martine
M
Farmelo
Mary Jane
MJ
Friberg
Maria
M
Alsarraj
Marwan
M
Mahany
J J
JJ
Pow-Sang
Julio
J
Cantor
Alan
A
Janssen
William
W
D000328:Adult; D000368:Aged; D018122:B7-1 Antigen / Q000235:genetics / Q000276:immunology*; D019496:Cancer Vaccines / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000276:immunology; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007271:Injections, Intradermal; D007376:Interleukin-2 / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010166:Palliative Care; D013601:T-Lymphocytes / Q000276:immunology; D014162:Transfection; D014407:Tumor Cells, Cultured / Q000276:immunology; D019444:Vaccines, DNA / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*
D018122:B7-1 Antigen; D019496:Cancer Vaccines; D007376:Interleukin-2; D019444:Vaccines, DNA