Vaccination with irradiated autologous tumor cells engineered to secrete granulocyte-macrophage colony-stimulating factor augments antitumor immunity in some patients with metastatic non-small-cell lung carcinoma

被引:216
作者
Salgia, R
Lynch, T
Skarin, A
Lucca, J
Lynch, C
Jung, K
Hodi, FS
Jaklitsck, M
Mentzer, S
Swanson, S
Lukanich, J
Buena, R
Wain, J
Mathisen, D
Wright, C
Fidias, P
Donahue, D
Clift, S
Hardy, S
Neuberg, D
Mulligan, R
Webb, I
Sugarbaker, D
Mihm, M
Dranoff, G
机构
[1] Dana Farber Canc Inst, Dept Adult Oncol, Boston, MA 02115 USA
[2] Dana Farber Canc Inst, Dept Surg, Boston, MA 02115 USA
[3] Dana Farber Canc Inst, Dept Biostat, Boston, MA 02115 USA
[4] Brigham & Womens Hosp, Dept Adult Oncol, Boston, MA 02115 USA
[5] Brigham & Womens Hosp, Dept Surg, Boston, MA 02115 USA
[6] Harvard Univ, Sch Med, Div Hematol Oncol, Dept Adult Oncol, Boston, MA 02115 USA
[7] Harvard Univ, Sch Med, Div Hematol Oncol, Dept Surg, Boston, MA 02115 USA
[8] Harvard Univ, Sch Med, Div Hematol Oncol, Dept Biostat, Boston, MA 02115 USA
[9] Harvard Univ, Sch Med, Div Hematol Oncol, Dept Genet, Boston, MA 02115 USA
[10] Harvard Univ, Sch Med, Div Hematol Oncol, Dept Pathol, Boston, MA 02115 USA
[11] Harvard Univ, Sch Med, Div Hematol Oncol, Dept Med, Boston, MA 02115 USA
[12] Harvard Univ, Sch Med, Childrens Hosp, Boston, MA 02115 USA
[13] Massachusetts Gen Hosp, Div Hematol Oncol, Dept Surg, Boston, MA 02114 USA
[14] Massachusetts Gen Hosp, Div Hematol Oncol, Dept Med, Boston, MA 02114 USA
[15] Massachusetts Gen Hosp, Div Hematol Oncol, Dept Pathol, Boston, MA 02114 USA
[16] Cell Genesys, Foster City, CA USA
关键词
D O I
10.1200/JCO.2003.03.091
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Puspose : We demonstrated that vaccination with irradiated tumor cells engineered to secrete granulocyte-macrophage colony-stimulating factor (GM-CSF) stimulates potent, specific, and long-lasting antitumor immunity in multiple murine models and patients with metastatic melanoma. To test whether this vaccination strategy enhances antitumor immunity in patients with metastatic non-small-cell lung cancer (NSCLC), we conducted a phase I clinical trial. Patients and Methods: Resected metastases were processed to single-cell suspension, infected with a replication-defective adenoviral vector encoding GM-CSF, irradiated, and cryopreserved. Individual vaccines consisted of 1 x 10(6), 4 x 10(6), or 1 x 10(7) cells, depending on overall yield, and were administered intradermally and subcutaneously at weekly and biweekly intervals. Results: Vaccines were successfully manufactured for 34 (97%) of 35 patients. The average GM-CSF secretion was 513 ng/ 10(6) cells/24 h. Toxicities were restricted to grade 1 to 2 local skin reactions. Nine patients were withdrawn early because of rapid disease progression. Vaccination elicited dendritic cell, macrophage, granulocyte, and lymphocyte infiltrates in 18 of 25 assessable patients. Immunization stimulated the development of delayed-type hypersensitivity reactions to irradiated, dissociated, autologous, nontransfected tumor cells in 18 of 22 patients. Metastatic lesions resected after vaccination showed T lymphocyte and plasma cell infiltrates with tumor necrosis in three of six patients. Two patients surgically rendered as having no evidence of disease at enrollment remain free of disease at 43 and 42 months. Five patients showed stable disease durations of 33, 19, 12, 10, and 3 months. One mixed response was observed. Conclusion: Vaccination with irradiated autologous NSCLC cells engineered to secrete GM-CSF enhances antitumor immunity in some patients with metastatic NSCLC.
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收藏
页码:624 / 630
页数:7
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