Immunological evaluation of personalized peptide vaccination in refractory small cell lung cancer.
Since the prognosis of small cell lung cancer (SCLC) remains poor, development of new therapeutic approaches, including immunotherapies, would be desirable. In the current study, to evaluate immunological responses in refractory SCLC patients, we conducted a small scale phase II clinical trial of personalized peptide vaccination (PPV), in which vaccine antigens are selected based on pre-existing host immunity. Ten refractory SCLC patients, who had failed to respond to chemo- and/or chemoradiotherapies (median number of regimens, 2.5; median duration, 20.5 months), were enrolled. A maximum of four human leukocyte antigen (HLA)-matched peptides showing higher antigen-specific humoral responses were subcutaneously administered (weekly for six consecutive weeks and then bi-weekly thereafter). PPV was terminated before the 3rd administration in four patients because of rapid disease progression, whereas the remaining six patients completed at least one cycle (six times) of vaccinations. Peptide-specific immunological boosting was observed in all of the six patients at the end of the first cycle of vaccinations, with their survival time of 25, 24.5 (alive), 10 (alive), 9.5, 6.5, and 6 months. Number of previous chemotherapy regimens and frequency of CD3(+) CD26(+) cells in peripheral blood were potentially prognostic in the vaccinated patients (hazard ratio [HR] = 2.540, 95% confidence interval [CI] = 1.188-5.431, P = 0.016; HR = 0.941, 95% CI = 0.878-1.008, P = 0.084; respectively). Based on the feasible immune responses in refractory SCLC patients who received at least one cycle (six times) of vaccinations, PPV could be recommended for a next stage of larger-scale, prospective clinical trials.
Department of Surgery, Kurume University School of Medicine, Kurume, Japan.
Yasuhiro
Y
Terazaki
Koichi
K
Yoshiyama
Satoko
S
Matsueda
Noriko
N
Watanabe
Akihiko
A
Kawahara
Yoshiki
Y
Naito
Shigetaka
S
Suekane
Nobukazu
N
Komatsu
Tetsuya
T
Ioji
Akira
A
Yamada
Takashi
T
Mine
Mizuhiko
M
Terasaki
Kyogo
K
Itoh
Shinzo
S
Takamori
Tetsuro
T
Sasada
D000368:Aged; D017252:CD3 Complex; D019496:Cancer Vaccines / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D018819:Dipeptidyl Peptidase 4; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D016131:Lymphocyte Subsets / Q000276:immunology; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology; D008297:Male; D008875:Middle Aged; D055752:Small Cell Lung Carcinoma / Q000628:therapy*; D022223:Vaccines, Subunit / Q000276:immunology* / Q000627:therapeutic use
D017252:CD3 Complex; D019496:Cancer Vaccines; D022223:Vaccines, Subunit; D018819:Dipeptidyl Peptidase 4