title: Phage idiotype vaccination: first phase I/II clinical trial in patients with multiple myeloma.
abstract: BACKGROUND
  Multiple myeloma is characterized by clonal expansion of B cells producing monoclonal immunoglobulins or fragments thereof, which can be detected in the serum and/or urine and are ideal target antigens for patient-specific immunotherapies.
  
  
  METHODS
  Using phage particles as immunological carriers, we employed a novel chemically linked idiotype vaccine in a clinical phase I/II trial including 15 patients with advanced multiple myeloma. Vaccines composed of purified paraproteins linked to phage were manufactured successfully for each patient. Patients received six intradermal immunizations with phage idiotype vaccines in three different dose groups.
  
  
  RESULTS
  Phage idiotype was well tolerated by all study participants. A subset of patients (80% in the middle dose group) displayed a clinical response indicated by decrease or stabilization of paraprotein levels. Patients exhibiting a clinical response to phage vaccines also raised idiotype-specific immunoglobulins. Induction of a cellular immune response was demonstrated by a cytotoxicity assay and delayed type hypersensitivity tests.
  
  
  CONCLUSIONS
  We present a simple, time- and cost-efficient phage idiotype vaccination strategy, which represents a safe and feasible patient-specific therapy for patients with advanced multiple myeloma and produced promising anti-tumor activity in a subset of patients.
authors.forename: Tim
authors.initials: T
authors.lastname: Roehnisch
authors.forename: Cornelia
authors.initials: C
authors.lastname: Then
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Nagel
authors.forename: Christina
authors.initials: C
authors.lastname: Blumenthal
authors.forename: Todd
authors.initials: T
authors.lastname: Braciak
authors.forename: Mariel
authors.initials: M
authors.lastname: Donzeau
authors.forename: Thomas
authors.initials: T
authors.lastname: Böhm
authors.forename: Michael
authors.initials: M
authors.lastname: Flaig
authors.forename: Carole
authors.initials: C
authors.lastname: Bourquin
authors.affiliation: Division of Hematology and Oncology, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany. fuat.oduncu@med.uni-muenchen.de.
authors.forename: Fuat S
authors.initials: FS
authors.lastname: Oduncu
mesh_terms: D000888:Antibodies, Anti-Idiotypic / Q000276:immunology*; D000917:Antibody Formation; D017104:Bacteriophage M13 / Q000276:immunology*; D019496:Cancer Vaccines / Q000008:administration & dosage / Q000276:immunology / Q000627:therapeutic use*; D006801:Humans; D009101:Multiple Myeloma / Q000276:immunology / Q000628:therapy*
chemical_list: D000888:Antibodies, Anti-Idiotypic; D019496:Cancer Vaccines