cancer vaccine

癌症疫苗
  • 文章类型: Journal Article
    肿瘤相关抗原(TAA)是皮肤黑色素瘤中基于T细胞的免疫治疗方法的潜在靶标。BNT111,一种研究性脂质复合物配制的基于mRNA的治疗性癌症疫苗,编码黑色素瘤TAAsNY-ESO-1,酪氨酸酶,MAGE-A3和TPTE,正在成人中接受临床试验。这些TAA在小儿黑色素瘤中的表达尚不清楚,但这是该治疗方法在儿童黑色素瘤中可行性的先决条件。我们的主要目标是表征与对照组相比,这些TAA在小儿黑色素瘤中的表达。在这项回顾性病例对照研究中,NY-ESO-1、酪氨酸酶、MAGE-A3和TPTE在25例小儿黑色素瘤的队列中进行了分析,31年轻人的黑色素瘤,29个成人黑色素瘤,30例儿童良性黑素细胞痣采用免疫组化染色、数字病理(QuPath)和逆转录定量PCR。基于IHC分析,小儿黑色素瘤表达酪氨酸酶(100.0%),TPTE(44.0%),MAGE-A3(12.0%),和NY-ESO-1(8.0%)。年轻成人黑色素瘤表达酪氨酸酶(96.8%),NY-ESO-1(19.4%),MAGE-A3(19.4%),和TPTE(3.2%)。成人黑色素瘤表达酪氨酸酶(86.2%),MAGE-A3(75.9%),NY-ESO-1(48.3%),和TPTE(48.3%)。儿童黑素细胞痣仅表达酪氨酸酶(93.3%)。个别TAA的表达患病率在小儿黑色素瘤的亚型之间没有差异,未发现与预后相关。所有四种TAAs都在小儿黑色素瘤中表达,尽管NY-ESO-1和MAGE-A3的程度低于成人黑色素瘤。这些数据支持研究靶向这些TAA的疫苗用于治疗小儿黑色素瘤的可能性。
    Tumor-associated antigens (TAAs) are potential targets for T cell-based immunotherapy approaches in cutaneous melanoma. BNT111, an investigational lipoplex-formulated mRNA-based therapeutic cancer vaccine encoding melanoma TAAs NY-ESO-1, tyrosinase, MAGE-A3, and TPTE, is undergoing clinical testing in adults. Expression of these TAAs in pediatric melanoma is unclear but is a prerequisite for feasibility of this treatment approach in children with melanoma. Our main objective was to characterize expression of those TAAs in pediatric melanomas compared to control cohorts. In this retrospective case control study, protein and transcript expression of NY-ESO-1, tyrosinase, MAGE-A3, and TPTE were analyzed in a cohort of 25 pediatric melanomas, 31 melanomas of young adults, 29 adult melanomas, and 30 benign melanocytic nevi in children using immunohistochemical staining and digital pathology (QuPath) and reverse transcription quantitative PCR. Based on IHC analysis, pediatric melanomas expressed tyrosinase (100.0%), TPTE (44.0%), MAGE-A3 (12.0%), and NY-ESO-1 (8.0%). Young adult melanomas expressed tyrosinase (96.8%), NY-ESO-1 (19.4%), MAGE-A3 (19.4%), and TPTE (3.2%). Adult melanomas expressed tyrosinase (86.2%), MAGE-A3 (75.9%), NY-ESO-1 (48.3%), and TPTE (48.3%). Childhood melanocytic nevi only expressed tyrosinase (93.3%). Expression prevalence of individual TAAs did not differ between subtypes of pediatric melanoma, and no association with prognosis was found. All four TAAs were expressed in pediatric melanoma, albeit NY-ESO-1 and MAGE-A3 to a lesser extent than in adult melanoma. These data support the possibility of investigating vaccines targeting these TAAs for the treatment of pediatric melanoma.
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  • 文章类型: Journal Article
    癌症疫苗努力诱导健壮的,抗原靶向,T细胞介导的免疫反应,但一直在努力在实体瘤中产生有意义的消退。一种自体细胞疫苗,SQZ-PBMC-HPV,由SQZBiotechnologies开发,使用微流体挤压技术在HLA-A*02+患者中加载具有HPV16E6和E7抗原的PBMC。SQZ-PBMC-HPV-1011期试验(NCT04084951)纳入了无法治愈的HPV16+癌症患者。这里,我们对治疗后CD8+T细胞浸润与患者预后之间的关系进行了事后分析.SQZ-PBMC-HPV作为单一疗法每3周施用。在治疗开始后4周,在给药前和给药后收集肿瘤样品。生物标志物包括CD8、MHC-I、E6,E7,GZMB,和Ki67通过免疫组织化学进行评估,免疫荧光,和RNA原位杂交,并与临床反应相关,生存,和药物产品组成。18名患者进行了配对的给药前和给药后活检。在筛选和C2D8之间,六个(33%)在肿瘤实质中CD8+T细胞密度增加。CD8+T细胞密度增加的患者疾病控制率(66.7%vs16.7%)和中位总生存期(606.5天vs170.0天,p=0.0078)。在增加的CD8+T细胞密度组中,药物产品显著富集了较高的T细胞和较低的单核细胞。在使用SQZ-PBMC-HPV治疗的无法治愈的HPV16实体瘤患者中,肿瘤实质内CD8+T细胞密度的增加与优越的疾病控制率和总生存期相关.针对具有增加的CD8+T细胞密度的患者的产物组合物对T细胞进行富集。
    Cancer vaccines strive to induce robust, antigen-targeted, T-cell-mediated immune responses but have struggled to produce meaningful regression in solid tumors. An autologous cell vaccine, SQZ-PBMC-HPV, was developed by SQZ Biotechnologies using microfluidic squeezing technology to load PBMCs with HPV16 E6 and E7 antigens in HLA-A*02+ patients. The SQZ-PBMC-HPV-101 Phase 1 trial (NCT04084951) enrolled patients with incurable HPV16+ cancers. Here, we present a post hoc analysis of the relationship between Posttreatment CD8+ T cell infiltration and patient outcomes. SQZ-PBMC-HPV was administered as monotherapy every 3 weeks. Tumor samples were collected pre-dose and post-dose 4 weeks after treatment start. Biomarkers including CD8, MHC-I, E6, E7, GZMB, and Ki67 were evaluated by immunohistochemistry, immunofluorescence, and RNA in situ hybridization, and were correlated with clinical response, survival, and drug product composition. Eighteen patients had paired pre- and post-dose biopsies. Six (33%) had an increase in CD8+ T cell density in tumor parenchyma between screening and C2D8. Patients with increased CD8+ T cell density had improved disease control rate (66.7% vs 16.7%) and median overall survival (606.5 days vs 170.0 days, p = 0.0078). Drug product was significantly enriched for higher T cells and lower monocytes in the increased CD8+ T cell density group. In patients with incurable HPV16+ solid tumors treated with SQZ-PBMC-HPV, an increase in CD8+ T cell density within the tumor parenchyma was associated with superior disease control rate and overall survival. The product composition for patients with increased CD8+ T cell density was enriched for T cells.
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  • 文章类型: Journal Article
    全球,头颈部鳞状细胞癌(HNSCC)是第七常见的恶性肿瘤。尽管采取了积极的多模式治疗方法,>50%的患者发生复发性和/或转移性(R/M)疾病。在此设置中,派姆单抗被批准用于PD-L1表达患者。然而,检查点抑制剂单药治疗的应答率仍然有限,因此需要加强肿瘤导向免疫应答的策略.
    FOCUS试验旨在评估UV1疫苗与pembrolizumab联合使用与pembrolizumab作为单一药物在R/MHNSCC患者中的有效性。
    FOCUS审判是两臂的,随机化,多中心II期研究,旨在评估hTERT靶向癌症疫苗UV1作为pembrolizumab在R/MPD-L1阳性(合并阳性评分≥1)HNSCC患者一线治疗中的疗效和可行性。次要目标是探索最有可能从这种新型组合中受益的患者亚组,并在HNSCC中建立液体活检肿瘤监测。
    本临床研究的设计和实施将符合良好临床实践和赫尔辛基宣言。旨在在同行评审的科学期刊上发表这项研究的结果,并在学术会议上介绍其内容。
    大量R/MHNSCC患者身体虚弱,可能无法耐受化疗,这些患者可能仅适用于pembrolizumab单药治疗.然而,长期疾病稳定仍然是例外,因此需要为该患者人群开发有效的联合治疗方案.FOCUS研究旨在使用这种有前途的新治疗方法优化R/MHNSCC患者的治疗。
    https://clinicaltrials.gov/study/NCT05075122,标识符NCT05075122。
    UNASSIGNED: Globally, head and neck squamous cell carcinoma (HNSCC) is the seventh most common malignancy. Despite aggressive multimodal treatment approaches, recurrent and/or metastatic (R/M) disease develops in >50% of patients. In this setting, pembrolizumab was approved for patients with PD-L1 expression. However, response rates with checkpoint inhibitor monotherapy remain limited and strategies to strengthen tumor-directed immune responses are needed.
    UNASSIGNED: The FOCUS trial is designed to estimate the effectiveness of UV1 vaccination in combination with pembrolizumab versus pembrolizumab as a single agent in patients with R/M HNSCC.
    UNASSIGNED: The FOCUS trial is a two-armed, randomized, multicenter phase II study which was designed to evaluate the efficacy and feasibility of the hTERT-targeted cancer vaccine UV1 as add-on to pembrolizumab in the 1st line treatment of patients with R/M PD-L1 positive (combined positive score ≥1) HNSCC. Secondary objectives are the exploration of patient subgroups most likely deriving benefit from this novel combination and the establishment of liquid biopsy tumor monitoring in HNSCC.
    UNASSIGNED: This clinical study was designed and will be conducted in compliance with Good Clinical Practice and in accordance with the Declaration of Helsinki. It is intended to publish the results of this study in peer-reviewed scientific journals and to present its content at academic conferences.
    UNASSIGNED: A significant number of patients with R/M HNSCC are frail and may not tolerate chemotherapy, these patients may only be suitable for pembrolizumab monotherapy. However, long term disease stabilizations remain the exception and there is a need for the development of efficacious combination regimens for this patient population. The FOCUS study aims to optimize treatment of R/M HNSCC patients with this promising new treatment approach.
    UNASSIGNED: https://clinicaltrials.gov/study/NCT05075122, identifier NCT05075122.
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  • 文章类型: Journal Article
    癌症疫苗是肿瘤免疫治疗的重要组成部分。越来越多的研究表明,癌症疫苗具有相当大的临床益处。随着肿瘤精准医学的发展,癌症疫苗由于其个性化的靶向作用而变得重要。然而,很少有文献计量学研究在这一领域进行全面的系统评价。本研究旨在从全球角度评估癌症疫苗研究的科学产出和趋势。
    我们从WebofScienceCoreCollection数据库收集了有关癌症疫苗的出版物,仅限于英文文章和评论。MicrosoftExcel,VOSViewer,和CiteSpaceV用于定量和视觉分析。
    共包括7807篇文章。从1991年到2022年,出版物数量逐年增加。美国在这一领域发表的文章数量最多(48.28%),最高引用频率(183,964次),和最高的H指数(182)。美国国立卫生研究院以476篇文章位居榜首。SchlomJ发表的文章数量最多(128),是该领域的主要研究者。杂志,癌症免疫学免疫治疗,在相关领域发表的文章数量最多。近年来,肿瘤微环境,免疫检查点抑制剂,颗粒疫苗,肿瘤抗原,和树突状细胞已成为与癌症疫苗相关的研究热点。
    癌症疫苗是肿瘤免疫治疗领域的热门研究课题。相关研究和出版物将进入繁荣阶段。“免疫检查点抑制剂”,“肿瘤微环境”和“树突状细胞”可能成为未来的研究热点,而“T细胞抑制因子”是一个有待解决的潜在难题。
    UNASSIGNED: Cancer vaccines are an important component of tumour immunotherapy. An increasing number of studies have shown that cancer vaccines have considerable clinical benefits. With the development of tumour precision medicine, cancer vaccines have become important because of their individualised targeting effects. However, few bibliometric studies have conducted comprehensive systematic reviews in this field. This study aimed to assess the scientific output and trends in cancer vaccine research from a global perspective.
    UNASSIGNED: We collected publications on cancer vaccines from the Web of Science Core Collection database, which was limited to articles and reviews in English. Microsoft Excel, VOS Viewer, and CiteSpace V were used for quantitative and visual analyses.
    UNASSIGNED: A total of 7807 articles were included. From 1991 to 2022, the number of publications increased annually. The United States had the highest number of articles published in this field (48.28 %), the highest citation frequency (183,964 times), and the highest H-index (182). The National Institutes of Health topped the list with 476 articles. Schlom J had the highest number of published articles (128) and was the main investigator in this field. The journal, Cancer Immunology Immunotherapy, had published the highest number of articles in related fields. In recent years, tumour microenvironment, immune checkpoint inhibitors, particle vaccines, tumour antigens, and dendritic cells have become research hotspots related to cancer vaccines.
    UNASSIGNED: Cancer vaccines are a popular research topic in the field of tumour immunotherapy. Related research and publications will enter a boom stage. \"Immune checkpoint inhibitors\", \"tumour microenvironment\" and \"dendritic cells\" may become future research hotspots, while \"T-cell suppressor\" is a potential puzzle to be solved.
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  • 文章类型: Randomized Controlled Trial
    目的:接受免疫检查点阻滞剂(ICB)治疗的晚期非小细胞肺癌(NSCLC)患者最终进展迅速(原发耐药)或获得持久获益(继发耐药)。癌症疫苗OSE2101可以在ICB失败后增强抗肿瘤特异性免疫应答。ATALANTE-1的目的是评估其在这些患者中的疗效和安全性。
    方法:ATALANTE-1是一项两步开放标签研究,与标准治疗(SoC)化疗(CT)相比,评估OSE2101的疗效和安全性。HLA-A2阳性晚期NSCLC患者无可操作改变,未通过序贯或同时行CT和ICB的患者被随机(2∶1)纳入OSE2101或SoC(多西他赛或培美曲塞).主要终点是总生存期(OS)。根据弗莱明的设计计划了临时操作系统无用性分析。2020年4月中期分析时,已决定过早停止因COVID-19而产生的应计费用。对所有患者和ICB继发性耐药患者亚组进行最终分析,ICB单药治疗二线≥12周后失败。
    结果:219名随机患者(139OSE2101,80SOC),118对序贯ICB有继发性抗性。总的来说,OSE2101优于SoC(HR[95CI]:0.86[0.62-1.19],P=0.36)。在次级阻力子群中,与SoC相比,OSE2101显着改善了中位OS(11.1对7.5个月;HR[95CI]:0.59[0.38,0.91];P=0.017),并显著改善患者的进展后生存(HR0.46,P=0.004),与SoC相比,ECOG性能状态恶化的时间(HR0.43,P=0.006)和QLQ-C30全球健康状态(P=0.045)。6个月疾病控制率和无进展生存期两组间相似。OSE2101患者中11.4%和SoC患者中35.1%发生≥3级不良反应(P=0.002)。
    结论:在HLA-A2阳性的晚期非小细胞肺癌和继发性免疫疗法耐药患者中,与化疗相比,OSE2101增加了生存率,安全性更好。有必要对这一人群进行进一步评估。
    Patients with advanced non-small-cell lung cancer (NSCLC) treated with immune checkpoint blockers (ICBs) ultimately progress either rapidly (primary resistance) or after durable benefit (secondary resistance). The cancer vaccine OSE2101 may invigorate antitumor-specific immune responses after ICB failure. The objective of ATALANTE-1 was to evaluate its efficacy and safety in these patients.
    ATALANTE-1 was a two-step open-label study to evaluate the efficacy and safety of OSE2101 compared to standard-of-care (SoC) chemotherapy (CT). Patients with human leukocyte antigen (HLA)-A2-positive advanced NSCLC without actionable alterations, failing sequential or concurrent CT and ICB were randomized (2 : 1) to OSE2101 or SoC (docetaxel or pemetrexed). Primary endpoint was overall survival (OS). Interim OS futility analysis was planned as per Fleming design. In April 2020 at the time of interim analysis, a decision was taken to prematurely stop the accrual due to coronavirus disease 2019 (COVID-19). Final analysis was carried out in all patients and in the subgroup of patients with ICB secondary resistance defined as failure after ICB monotherapy second line ≥12 weeks.
    Two hundred and nineteen patients were randomized (139 OSE2101, 80 SoC); 118 had secondary resistance to sequential ICB. Overall, median OS non-significantly favored OSE2101 over SoC {hazard ratio (HR) [95% confidence interval (CI)] 0.86 [0.62-1.19], P = 0.36}. In the secondary resistance subgroup, OSE2101 significantly improved median OS versus SoC [11.1 versus 7.5 months; HR (95% CI) 0.59 (0.38-0.91), P = 0.017], and significantly improved post-progression survival (HR 0.46, P = 0.004), time to Eastern Cooperative Oncology Group (ECOG) performance status deterioration (HR 0.43, P = 0.006) and Quality of Life Questionnaire Core 30 (QLQ-C30) global health status compared to SoC (P = 0.045). Six-month disease control rates and progression-free survival were similar between groups. Grade ≥3 adverse effects occurred in 11.4% of patients with OSE2101 and 35.1% in SoC (P = 0.002).
    In HLA-A2-positive patients with advanced NSCLC and secondary resistance to immunotherapy, OSE2101 increased survival with better safety compared to CT. Further evaluation in this population is warranted.
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  • 文章类型: Journal Article
    B细胞淋巴瘤-超大(Bcl-XL)蛋白在癌细胞抵抗凋亡中起重要作用。临床前研究表明,用Bcl-XL衍生肽接种可以诱导肿瘤特异性T细胞反应,从而消除癌细胞。此外,新型佐剂CAF®09b的临床前研究表明,腹膜内(IP)注射该佐剂可以改善免疫系统的激活。在这项研究中,激素敏感性前列腺癌(PC)患者接受了由Bcl-XL肽组成的疫苗,CAF®09b作为佐剂.主要目的是评估IP和肌内(IM)给药的耐受性和安全性,确定最佳给药途径,并表征疫苗的免疫原性。
    纳入20例患者。总共安排了6次疫苗接种:A组(IM到IP注射),十名患者每两周接受三次疫苗IM;经过三周的停顿,患者随后每两周接受3种疫苗IP接种.在组B(IP到IM注入)中,10名患者首先接种了IP疫苗,随后在类似的疫苗接种时间表下进行IM。根据不良事件通用术语标准(CTCAEv.4.0),通过记录和评估不良事件(AE)来评估安全性。通过酶联免疫斑点和流式细胞术分析疫苗诱导的免疫应答。
    未报告严重的不良事件。尽管在所有患者中发现针对Bcl-XL肽的T细胞应答增加,与A组患者相比,B组中更多的患者对疫苗表现出更早和更强的免疫反应。我们证明了疫苗诱导的针对Bcl-XL肽中嵌入的患者特异性CD4和CD8T细胞表位的免疫,以及疫苗接种后CD4和CD8T细胞活化标志物CD107a和CD137的增加.中位随访21个月,没有患者出现有临床意义的疾病进展.
    Bcl-XL-肽-CAF®09b疫苗在l激素敏感型PC患者中是可行且安全的。此外,该疫苗具有免疫原性,能够引发CD4和CD8T细胞应答,初次IP给药可在更多og患者中引发早期和高水平的疫苗特异性应答.
    https://clinicaltrials.gov,标识符NCT03412786。
    The B-cell lymphoma-extra-large (Bcl-XL) protein plays an important role in cancer cells\' resistance to apoptosis. Pre-clinical studies have shown that vaccination with Bcl-XL-derived peptides can induce tumor-specific T cell responses that may lead to the elimination of cancer cells. Furthermore, pre-clinical studies of the novel adjuvant CAF®09b have shown that intraperitoneal (IP) injections of this adjuvant can improve the activation of the immune system. In this study, patients with hormone-sensitive prostate cancer (PC) received a vaccine consisting of Bcl-XL-peptide with CAF®09b as an adjuvant. The primary aim was to evaluate the tolerability and safety of IP and intramuscular (IM) administration, determine the optimal route of administration, and characterize vaccine immunogenicity.
    Twenty patients were included. A total of six vaccinations were scheduled: in Group A (IM to IP injections), ten patients received three vaccines IM biweekly; after a three-week pause, patients then received three vaccines IP biweekly. In Group B (IP to IM injections), ten patients received IP vaccines first, followed by IM under a similar vaccination schedule. Safety was assessed by logging and evaluating adverse events (AE) according to Common Terminology Criteria for Adverse Events (CTCAE v. 4.0). Vaccines-induced immune responses were analyzed by Enzyme-Linked Immunospot and flow cytometry.
    No serious AEs were reported. Although an increase in T cell response against the Bcl-XL-peptide was found in all patients, a larger proportion of patients in group B demonstrated earlier and stronger immune responses to the vaccine compared to patients in group A. Further, we demonstrated vaccine-induced immunity towards patient-specific CD4, and CD8 T cell epitopes embedded in Bcl-XL-peptide and an increase in CD4 and CD8 T cell activation markers CD107a and CD137 following vaccination. At a median follow-up of 21 months, no patients had experienced clinically significant disease progression.
    The Bcl-XL-peptide-CAF®09b vaccination was feasible and safe in patients with l hormone-sensitive PC. In addition, the vaccine was immunogenic and able to elicit CD4 and CD8 T cell responses with initial IP administration eliciting early and high levels of vaccine-specific responses in a higher number og patients.
    https://clinicaltrials.gov, identifier NCT03412786.
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  • 文章类型: Clinical Trial, Phase I
    我们对通过微流体挤压(CellSqueeze®技术)加载HPV16E6和E7抗原(SQZ-PBMC-HPV)的自体PBMC进行了剂量递增1期研究,HLA-A*02+晚期/转移性HPV16+癌症患者。在小鼠模型的临床前研究表明,这些细胞导致抗原特异性CD8+细胞的刺激和增殖,并证明了抗肿瘤活性。每3周给予SQZ-PBMC-HPV。注册遵循修改后的3+3设计,主要目标是定义安全性,耐受性,和推荐的2期剂量。次要和探索性目标是抗肿瘤活性,制造可行性,和免疫反应的药效学评价。18名患者以0.5×106至5.0×106活细胞/kg的剂量登记。制造证明是可行的,并且在1-2周的整体静脉到静脉时间内需要<24小时;在最高剂量下,中位给药剂量为4次.没有观察到DLT。大多数相关TEAE为1-2级,并报告了1例2级细胞因子释放综合征SAE。3例患者的肿瘤活检显示CD8+组织浸润淋巴细胞增加2至8倍,包括表现出MHC-I+和PD-L1+细胞密度增加和HPV+细胞数量减少的病例。记录了后一种情况的临床益处。SQZ-PBMC-HPV具有良好的耐受性;选择具有双重引发的5.0×106活细胞/kg作为推荐的2期剂量。多个参与者表现出与免疫反应一致的药效学变化,支持SQZ-PBMC-HPV的拟议作用机制,包括以前对检查点抑制剂难以治疗的患者。
    We conducted a dose escalation Phase 1 study of autologous PBMCs loaded by microfluidic squeezing (Cell Squeeze® technology) with HPV16 E6 and E7 antigens (SQZ-PBMC-HPV), in HLA-A*02+ patients with advanced/metastatic HPV16+ cancers. Preclinical studies in murine models had shown such cells resulted in stimulation and proliferation of antigen specific CD8+ cells, and demonstrated antitumor activity. Administration of SQZ-PBMC-HPV was every 3 weeks. Enrollment followed a modified 3+3 design with primary objectives to define safety, tolerability, and the recommended Phase 2 dose. Secondary and exploratory objectives were antitumor activity, manufacturing feasibility, and pharmacodynamic evaluation of immune responses. Eighteen patients were enrolled at doses ranging from 0.5 × 106 to 5.0 × 106 live cells/kg. Manufacture proved feasible and required < 24 h within the overall vein-to-vein time of 1 - 2 weeks; at the highest dose, a median of 4 doses were administered. No DLTs were observed. Most related TEAEs were Grade 1 - 2, and one Grade 2 cytokine release syndrome SAE was reported. Tumor biopsies in three patients showed 2 to 8-fold increases in CD8+ tissue infiltrating lymphocytes, including a case that exhibited increased MHC-I+ and PD-L1+ cell densities and reduced numbers of HPV+ cells. Clinical benefit was documented for the latter case. SQZ-PBMC-HPV was well tolerated; 5.0 × 106 live cells/kg with double priming was chosen as the recommended Phase 2 dose. Multiple participants exhibited pharmacodynamic changes consistent with immune responses supporting the proposed mechanism of action for SQZ-PBMC-HPV, including patients previously refractory to checkpoint inhibitors.
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  • 文章类型: Journal Article
    近年来,用于癌症治疗的免疫疗法获得了越来越多的关注。最近,我们研究小组报告了一例胶质母细胞瘤患者,该患者接受了基于树突状细胞的疫苗接种,并经历了强烈的Th1免疫应答,同时肿瘤几乎完全缓解.在这里,我们报告了I/II期前瞻性的结果,非对照临床试验37例患者有胶质母细胞瘤或4级星形细胞瘤。手术后第一次复发时,患者开始接受每月皮内注射同种异体DC-自体肿瘤细胞杂交瘤.总生存率,生活质量,和免疫学特征进行了前瞻性评估。与基因组数据共享数据库中的患者相比,接种疫苗的胶质母细胞瘤患者的总生存期为27.6±2.4个月(vs.16.3±0.7,对数秩p<0.001,危险比0.53,95CI0.36-0.78,p<0.01),接种疫苗的星形细胞瘤4级患者为59.5±15.9(vs.19.8±2.5,对数秩p<0.05,风险比0.18,95CI0.05-0.62,p<0.01)。此外,7名接种疫苗的患者(2名IDH-1突变和5名野生型)在本报告时仍然存活(总生存期47.9个月,SD21.1,范围:诊断后25.4-78.6个月;复发后34.2个月,范围:17.8至40.7,SD21.3)。我们认为,本文报道的数据可以促进基于细胞免疫疗法的高级别神经胶质瘤治疗方案的改进。
    Immunotherapy for cancer treatment has gained increased attention in recent years. Recently, our group reported the case of a patient with glioblastoma who underwent vaccination based on dendritic cells and experienced a strong Th1 immune response together with near-complete tumor remission. Here we report the results of a phase I/II prospective, non-controlled clinical trial with 37 patients harboring glioblastoma or grade 4 astrocytomas. At the time of first recurrence after surgery, patients began receiving monthly intradermal injections of allogenic DC-autologous tumor cell hybridomas. Overall survival, quality of life, and immunological profiles were assessed prospectively. Compared with patients in the Genomic Data Commons data bank, overall survival for vaccinated patients with glioblastoma was 27.6 ± 2.4 months (vs. 16.3 ± 0.7, log-rank p < 0.001, hazard ratio 0.53, 95%CI 0.36-0.78, p < 0.01), and it was 59.5 ± 15.9 for vaccinated astrocytoma grade 4 patients (vs. 19.8 ± 2.5, log-rank p < 0.05, hazard ratio 0.18, 95%CI 0.05-0.62, p < 0.01). Furthermore, seven vaccinated patients (two IDH-1-mutated and five wild type) remain alive at the time of this report (overall survival 47.9 months, SD 21.1, range: 25.4-78.6 months since diagnosis; and 34.2 months since recurrence, range: 17.8 to 40.7, SD 21.3). We believe that the data reported here can foster the improvement of treatment protocols for high-grade gliomas based on cellular immunotherapy.
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  • 文章类型: Randomized Controlled Trial
    背景:随机,双盲,肿瘤裂解物的安慰剂对照2b期试验,粒子加载,在切除的III/IV期黑色素瘤患者中进行了树突状细胞(TLPLDC)疫苗。在有和没有粒细胞集落刺激因子(G-CSF)的情况下收获树突状细胞(DC)。该分析调查了DC收获方法之间的临床结果和RNA基因表达的差异。
    方法:TLPLDC疫苗是通过将自体肿瘤裂解物装载到酵母细胞壁颗粒(YCWPs)中并将其暴露于DCs的吞噬作用而创建的。对于DC收获,患者直接抽血或在抽血前接受G-CSF预处理.患者以2:1随机分配接受TLPLDC或安慰剂。评估无病生存期(DFS)和总生存期(OS)的差异。对TLPLDC+G和TLPLDC疫苗的总RNA进行RNA-seq分析以比较组间的基因表达。
    结果:144名患者被随机分组:103名TLPLDC(47名TLPLDC/56名TLPLDC+G)和41名安慰剂(19名安慰剂/22名安慰剂+G)。中位随访时间为27.0个月。两个36个月的DFS(55.8%与24.4%vs.30.0%,p=0.010)和OS(94.2%vs.69.8%与70.9%,p=0.024)与TLPLDCG或安慰剂相比,TLPLDC有所改善,分别。与TLPLDC+G疫苗相比,来自TLPLDC疫苗的RNA-seq显示与DC成熟相关的基因上调和与DC抑制或不成熟相关的基因下调。
    结论:接受无G-CSF的TLPLDC疫苗的患者OS和DFS改善。结果在接受TLPLDC+G和安慰剂的患者之间仍然相似。没有G-CSF的直接DC收获具有更高的与DC成熟相关的基因表达,可能提高临床疗效。
    BACKGROUND: A randomized, double-blind, placebo-controlled phase 2b trial of the tumor lysate, particle-loaded, dendritic cell (TLPLDC) vaccine was conducted in patients with resected stage III/IV melanoma. Dendritic cells (DCs) were harvested with and without granulocyte-colony stimulating factor (G-CSF). This analysis investigates differences in clinical outcomes and RNA gene expression between DC harvest methods.
    METHODS: The TLPLDC vaccine is created by loading autologous tumor lysate into yeast cell wall particles (YCWPs) and exposing them to phagocytosis by DCs. For DC harvest, patients had a direct blood draw or were pretreated with G-CSF before blood draw. Patients were randomized 2:1 to receive TLPLDC or placebo. Differences in disease-free survival (DFS) and overall survival (OS) were evaluated. RNA-seq analysis was performed on the total RNA of TLPLDC + G and TLPLDC vaccines to compare gene expression between groups.
    RESULTS: 144 patients were randomized: 103 TLPLDC (47 TLPLDC/56 TLPLDC + G) and 41 placebo (19 placebo/22 placebo + G). Median follow-up was 27.0 months. Both 36-month DFS (55.8% vs. 24.4% vs. 30.0%, p = 0.010) and OS (94.2% vs. 69.8% vs. 70.9%, p = 0.024) were improved in TLPLDC compared to TLPLDC + G or placebo, respectively. When compared to TLPLDC + G vaccine, RNA-seq from TLPLDC vaccine showed upregulation of genes associated with DC maturation and downregulation of genes associated with DC suppression or immaturity.
    CONCLUSIONS: Patients receiving TLPLDC vaccine without G-CSF had improved OS and DFS. Outcomes remained similar between patients receiving TLPLDC + G and placebo. Direct DC harvest without G-CSF had higher expression of genes linked to DC maturation, likely improving clinical efficacy.
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  • 文章类型: Journal Article
    尽管努力开发新的治疗策略,人和犬骨肉瘤的预后仍然较差,总生存期有限。这项临床试验的目的是测试在接受标准护理(SOC)的非转移性阑尾骨肉瘤犬中多次皮肤施用基于肽的抗癌疫苗的抗肿瘤效果和安全性。包括截肢和辅助化疗。通过打开Cx43半通道,诱导沙门氏菌感染的犬骨肉瘤细胞在细胞外空间释放免疫原性肽;收集分泌组并构成疫苗。患有非转移性阑尾骨肉瘤的狗有资格招募。截肢和卡铂辅助治疗后,狗每月接种6次疫苗,并随访连续胸片.在疫苗可用之前经历SOC治疗(截肢和佐剂卡铂)的狗群体用作对照。主要终点是转移时间(TTM)和肿瘤特异性存活(TSS)。次要终点是可行性,毒性,T细胞和体液免疫应答。总共20只狗与SOC一起接种疫苗,34只仅接受SOC。观察到疫苗特异性体液和T细胞反应;它们的幅度与TSS相关。未记录疫苗相关毒性。与未接种疫苗的狗相比,接种疫苗的狗的TTM和TSS明显更长(TTM:308vs.240天,分别;p=0.010;TSS:621vs.278天,分别为;p=0.002)。在患有非转移性骨肉瘤的狗中,增加基于细菌的疫苗接种策略增加了TTM,从而延长生存期,同时保持安全的个人资料。此外,接种疫苗的狗产生了长期的肿瘤特异性反应,随着时间的推移,这些患者的免疫监测记录。这些结果为犬骨肉瘤的未来管理提供了希望。
    Despite efforts to develop novel treatment strategies, human and canine osteosarcomas continue to have poor prognosis and limited overall survival. The aim of this clinical trial was to test the antitumor effect and safety of multiple dermal administrations of a peptide-based anticancer vaccine in dogs with non-metastatic appendicular osteosarcoma undergoing standard of care (SOC), consisting of limb amputation and adjuvant chemotherapy. Salmonella-infected canine osteosarcoma cells were induced to release immunogenic peptides in the extracellular space via Cx43 hemichannels opening; the secretome was collected and constituted the vaccine. Dogs with non-metastatic appendicular osteosarcoma were eligible for recruitment. Following limb amputation and adjuvant carboplatin, dogs were vaccinated on a monthly basis for six times and followed up with serial thoracic radiographs. A population of dogs undergoing SOC treatment (amputation and adjuvant carboplatin) before the vaccine was available served as controls. Primary endpoints were time to metastasis (TTM) and tumor-specific survival (TSS). Secondary endpoints were feasibility, toxicity, T-cell and humoral immune responses. A total of 20 dogs were vaccinated along with SOC and 34 received SOC only. Vaccine-specific humoral and T-cell responses were observed; their amplitude correlated with TSS. Vaccine-associated toxicity was not recorded. TTM and TSS were significantly longer in vaccinated versus unvaccinated dogs (TTM: 308 vs. 240 days, respectively; p = 0.010; TSS: 621 vs. 278 days, respectively; p = 0.002). In dogs with non-metastatic osteosarcoma undergoing SOC, the addition of a bacteria-based vaccination strategy increased TTM, thereby prolonging survival, while maintaining a safe profile. Additionally, vaccinated dogs developed a long-term tumor-specific response, as documented by the immunomonitoring of these patients over time. These results hold promise for future management of canine osteosarcoma.
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