Use of the anti-idiotype breast cancer vaccine 11D10 in conjunction with autologous stem cell transplantation in patients with metastatic breast cancer.
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.
Reece
Donna E
DE
Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada. donna.reece@uhn.on.ca
Foon
Ken A
KA
Bhattarcharya-Chatterjee
Malaya
M
Adkins
Doug
D
Broun
E Randolph
ER
Connaghan
D Gerald
DG
Dipersio
John F
JF
Holland
H Kent
HK
Howard
Dianna A
DA
Hale
Greg A
GA
Klingemann
Hans G
HG
Munn
Rita K
RK
Raptis
Anatasios
A
Phillips
Gordon L
GL
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
D000888:Antibodies, Anti-Idiotypic; D019496:Cancer Vaccines; D006017:Glycolipids; D006023:Glycoproteins