title: Feasibility study of personalized peptide vaccination for advanced non-small cell lung cancer patients who failed two or more treatment regimens.
abstract: The prognosis of non-small cell lung cancer (NSCLC) patients who failed two or more treatment regimens remains very poor. We conducted a phase II study to explore the feasibility of personalized peptide vaccination (PPV), in which peptides are selected and administered based on the pre-existing host immunity before vaccination, as a third or more line treatment in advanced NSCLC patients who failed two or more regimens. Among 57 patients enrolled, 23 or 16 patients received PPV with chemotherapy or targeted therapy, respectively, whereas 18 patients received PPV alone. A maximum of four HLA-matched peptides showing higher peptide-specific IgG responses in pre-vaccination plasma were selected from 31 pooled peptide candidates applicable for patients with HLA-A2, -A24, -A3 supertypes, and/or -A26, followed by subcutaneous administration. No severe adverse events related to PPV were observed. Median survival time was 692, 468, or 226 days in the group of PPV/chemotherapy, PPV/targeted therapy, or PPV alone, respectively. CTL responses to the vaccinated peptides became detectable after vaccination in 58, 50, or 42% of patients in each of these three groups, respectively. In contrast, peptide-specific IgG responses after vaccination augmented in 55, 75, or 62% of patients in each of these groups, respectively. These results suggest the feasibility of PPV for heavily treated advanced NSCLC patients from the view of both immunological responses and safety. Therefore, further evaluation of PPV by prospective randomized trial is warranted for a third or fourth line treatment of advanced NSCLC.
authors.affiliation: Department of Immunology and Immunotherapy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Terazaki
authors.affiliation: Department of Immunology and Immunotherapy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Sakamoto
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Yoshiyama
authors.affiliation: Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Matsueda
authors.affiliation: Department of Immunology and Immunotherapy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Komatsu
authors.affiliation: Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Waki
authors.affiliation: Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamada
authors.affiliation: Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kawahara
authors.affiliation: Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kage
authors.affiliation: Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Sugawara
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Department of Immunology and Immunotherapy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Sasada
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Shinzo
authors.initials: S
authors.lastname: Takamori
authors.affiliation: Department of Immunology and Immunotherapy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Kyogo
authors.initials: K
authors.lastname: Itoh
mesh_terms: D000328:Adult; D000368:Aged; D019496:Cancer Vaccines / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D057285:Precision Medicine; D016879:Salvage Therapy; D014611:Vaccination / Q000009:adverse effects
chemical_list: D019496:Cancer Vaccines