title: A phase II study evaluating the safety and efficacy of an adenovirus-ΔLMP1-LMP2 transduced dendritic cell vaccine in patients with advanced metastatic nasopharyngeal carcinoma.
abstract: BACKGROUND
  Individuals with metastatic Epstein-Barr virus (EBV)-positive nasopharyngeal carcinoma (NPC) continue to have poor outcomes. To evaluate the ability of a dendritic cell (DC) vaccine to target subdominant EBV antigens LMP1 and LMP2 expressed by NPC cells, we vaccinated patients using autologous DCs transduced with an adenovirus encoding a truncated LMP1 (ΔLMP1) and full-length LMP2 (Ad-ΔLMP1-LMP2).
  
  
  METHODS
  Sixteen subjects with metastatic NPC received Ad-ΔLMP1-LMP2 DC vaccines i.d. biweekly for up to five doses. Toxicity, immune responses and clinical responses were determined.
  
  
  RESULTS
  Most patients had extensive disease, with a median of three visceral sites of involvement (range 1-7). No significant toxicity was observed. Ad-ΔLMP1-LMP2 DCs induced delayed type hypersensitivity responses in 9 out of 12 patients, but although these DCs activated LMP1/2-specific T cells in vitro, no such increase in the frequency of peripheral LMP1/2-specific T cells was detected. Three patients had clinical responses including one with partial response (for 7½ months) and two with stable disease (for 6½ and 7½ months).
  
  
  CONCLUSIONS
  Ad-ΔLMP1-LMP2 transduced DCs can be successfully generated and safely administered to patients with advanced NPC. Since efficacy was limited, future studies should focus on DC vaccines with greater potency administered to subjects with less tumor burden.
authors.affiliation: Department of Medical Oncology, National Cancer Centre, Singapore.
authors.forename: W K
authors.initials: WK
authors.lastname: Chia
authors.forename: W-W
authors.initials: WW
authors.lastname: Wang
authors.forename: M
authors.initials: M
authors.lastname: Teo
authors.forename: W M
authors.initials: WM
authors.lastname: Tai
authors.forename: W T
authors.initials: WT
authors.lastname: Lim
authors.forename: E H
authors.initials: EH
authors.lastname: Tan
authors.forename: S S
authors.initials: SS
authors.lastname: Leong
authors.forename: L
authors.initials: L
authors.lastname: Sun
authors.forename: J J
authors.initials: JJ
authors.lastname: Chen
authors.forename: S
authors.initials: S
authors.lastname: Gottschalk
authors.forename: H C
authors.initials: HC
authors.lastname: Toh
mesh_terms: D000256:Adenoviridae / Q000235:genetics*; D000328:Adult; D019496:Cancer Vaccines / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D002277:Carcinoma / Q000401:mortality / Q000628:therapy* / Q000821:virology; D002478:Cells, Cultured; D018920:Coculture Techniques; D003713:Dendritic Cells / Q000276:immunology* / Q000378:metabolism / Q000637:transplantation / Q000821:virology; D018572:Disease-Free Survival; D020031:Epstein-Barr Virus Infections / Q000150:complications; D005260:Female; D005822:Genetic Vectors; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality / Q000628:therapy* / Q000821:virology; D017384:Sequence Deletion; D016896:Treatment Outcome; D014763:Viral Matrix Proteins / Q000235:genetics / Q000276:immunology* / Q000378:metabolism
chemical_list: D019496:Cancer Vaccines; C037662:EBV-associated membrane antigen, Epstein-Barr virus; D014763:Viral Matrix Proteins