title: Use of the anti-idiotype breast cancer vaccine 11D10 in conjunction with autologous stem cell transplantation in patients with metastatic breast cancer.
abstract: The results of cytotoxic therapy, including dose-intensive therapy requiring autologous stem cell transplantation (ASCT), have been disappointing in patients with metastatic breast cancer, as almost all patients eventually experience disease progression. There has been a renewed interest in immunotherapeutic strategies in this disease, including evaluation of several breast cancer vaccines. In the current study, we describe the results of a program in which the anti-idiotype breast cancer vaccine 11D10 (TriAb) was administered before and after ASCT in patients with metastatic breast cancer chemosensitive to previous conventional therapy. The toxicity of this approach was acceptable, and idiotype-specific humoral and T-cell proliferative responses were observed in the majority of patients within a few weeks post-ASCT. The actuarial 3-year overall survival rate was 48% (95% CI, 32%-64%), while the progression-free survival rate was 32% (95% CI, 19%-45%). Multivariate analysis identified achievement of a strong antibody and cellular immune response to the vaccine as the only significant prognostic factors for outcome. The ability to reliably produce robust immune responses after ASCT is encouraging. Further studies are required to determine if the immune response mediates an antitumor benefit in these patients.
authors.affiliation: Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada. donna.reece@uhn.on.ca
authors.forename: Donna E
authors.initials: DE
authors.lastname: Reece
authors.forename: Ken A
authors.initials: KA
authors.lastname: Foon
authors.forename: Malaya
authors.initials: M
authors.lastname: Bhattarcharya-Chatterjee
authors.forename: Doug
authors.initials: D
authors.lastname: Adkins
authors.forename: E Randolph
authors.initials: ER
authors.lastname: Broun
authors.forename: D Gerald
authors.initials: DG
authors.lastname: Connaghan
authors.forename: John F
authors.initials: JF
authors.lastname: Dipersio
authors.forename: H Kent
authors.initials: HK
authors.lastname: Holland
authors.forename: Dianna A
authors.initials: DA
authors.lastname: Howard
authors.forename: Greg A
authors.initials: GA
authors.lastname: Hale
authors.forename: Hans G
authors.initials: HG
authors.lastname: Klingemann
authors.forename: Rita K
authors.initials: RK
authors.lastname: Munn
authors.forename: Anatasios
authors.initials: A
authors.lastname: Raptis
authors.forename: Gordon L
authors.initials: GL
authors.lastname: Phillips
mesh_terms: D000328:Adult; D000368:Aged; D000888:Antibodies, Anti-Idiotypic; D001943:Breast Neoplasms / Q000276:immunology* / Q000473:pathology / Q000628:therapy*; D019496:Cancer Vaccines / Q000627:therapeutic use*; D005260:Female; D006017:Glycolipids / Q000276:immunology; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D007271:Injections, Intradermal; D008875:Middle Aged; D009362:Neoplasm Metastasis; D036102:Peripheral Blood Stem Cell Transplantation; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D000888:Antibodies, Anti-Idiotypic; D019496:Cancer Vaccines; D006017:Glycolipids; D006023:Glycoproteins