title: IL-12p70-producing patient DC vaccine elicits Tc1-polarized immunity.
abstract: BACKGROUND
  Systemic administration of IL-12p70 has demonstrated clinical activity in cancer patients, but dose-limiting toxicities have hindered its incorporation in vaccine formulations. Here, we report on the immunological and clinical outcomes upon vaccination with CD40L/IFN-γ-matured, IL-12p70-producing DCs.
  
  
  METHODS
  7 HLA-A*0201+ newly diagnosed stage IV melanoma patients were immunized against the gp100 melanoma antigen using autologous peptide-pulsed, CD40L/IFN-γ-matured DCs. PBMCs were taken weekly for immune monitoring by tetramer analysis and functional assays. CT imaging was performed at baseline, week 9, and week 18 for clinical assessment using RECIST.
  
  
  RESULTS
  6 of 7 treated patients developed sustained T cell immunity to all 3 melanoma gp100 antigen-derived peptides. 3 of the 6 immunological responders developed confirmed clinical responses (1 complete remission >4 years, 2 partial response). Importantly, DC vaccine-derived IL-12p70 levels positively correlated with time to progression (P = 0.019, log-rank), as did T-cytotoxic 1 (Tc1) immunity, as assessed by IFN-γ/IL-13 and IFN-γ/IL-5 ratios (P = 0.035 and P = 0.030, respectively, log-rank). In contrast, a pathway-specific defect in IL-12p35 transcription was identified upon CD40L/IFN-γ activation in clinical nonresponder patient DCs, and gp100-specific T cells from these patients displayed a Tc2 phenotype. Incorporation of TLR3 and TLR8 agonists into the CD40L/IFN-γ activation protocol corrected the IL-12p70 production defect in DCs derived from clinical nonresponder patients.
  
  
  CONCLUSIONS
  These findings underscore the essential role of IL-12p70 in the development of therapeutic type 1 antigen-specific CD8+ T cell immunity in humans with cancer.
authors.affiliation: Department of Medicine, Division of Oncology, Washington University School of Medicine, St. Louis, Missouri 63110, USA. bcarreno@dom.wustl.edu
authors.forename: Beatriz M
authors.initials: BM
authors.lastname: Carreno
authors.forename: Michelle
authors.initials: M
authors.lastname: Becker-Hapak
authors.forename: Alexander
authors.initials: A
authors.lastname: Huang
authors.forename: Megan
authors.initials: M
authors.lastname: Chan
authors.forename: Amer
authors.initials: A
authors.lastname: Alyasiry
authors.forename: Wen-Rong
authors.initials: WR
authors.lastname: Lie
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Aft
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Cornelius
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Trinkaus
authors.forename: Gerald P
authors.initials: GP
authors.lastname: Linette
mesh_terms: D000328:Adult; D000368:Aged; D023201:CD40 Ligand / Q000502:physiology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D019496:Cancer Vaccines / Q000276:immunology; D016764:Cell Polarity; D002478:Cells, Cultured; D003602:Cytotoxicity, Immunologic; D003713:Dendritic Cells / Q000276:immunology / Q000378:metabolism / Q000637:transplantation; D005260:Female; D015870:Gene Expression / Q000276:immunology; D006801:Humans; D007371:Interferon-gamma / Q000502:physiology; D018664:Interleukin-12 / Q000235:genetics / Q000378:metabolism*; D008297:Male; D008545:Melanoma / Q000276:immunology / Q000628:therapy*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000276:immunology / Q000628:therapy*; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D016896:Treatment Outcome
chemical_list: D019496:Cancer Vaccines; C544395:gp100(209-2M) vaccine; D023201:CD40 Ligand; D018664:Interleukin-12; D007371:Interferon-gamma