A phase i clinical study of immunotherapy for advanced colorectal cancers using carcinoembryonic antigen-pulsed dendritic cells mixed with tetanus toxoid and subsequent IL-2 treatment John T Kung
Journal
Journal of Biomedical Science
Journal Volume
23
Journal Issue
1
Date Issued
2016
Author(s)
Liu K.-J.
Chao T.-Y.
Chang J.-Y.
Ch'Ang H.-J.
Kao W.-Y.
Wu Y.-C.
Yu W.-L.
Chung T.-R.
Whang-Peng J.
Abstract
Background: To better evaluate and improve the efficacy of dendritic cell (DC)-based cancer immunotherapy, we conducted a clinical study of patients with advanced colorectal cancer using carcinoembryonic antigen (CEA)-pulsed DCs mixed with tetanus toxoid and subsequent interleukin-2 treatment. The tetanus toxoid in the vaccine preparation serves as an adjuvant and provides a non-tumor specific immune response to enhance vaccine efficacy. The aims of this study were to (1) evaluate the toxicity of this treatment, (2) observe the clinical responses of vaccinated patients, and (3) investigate the immune responses of patients against CEA before and after treatment. Methods: Twelve patients were recruited and treated in this phase I clinical study. These patients all had metastatic colorectal cancer and failed standard chemotherapy. We first subcutaneously immunized patients with metastatic colorectal cancer with 1 × 106 CEA-pulsed DCs mixed with tetanus toxoid as an adjuvant. Patients received 3 successive injections with 1 × 106 CEA-pulsed DCs alone. Low-dose interleukin-2 was administered subcutaneously following the final DC vaccination to boost the growth of T cells. Patients were evaluated for adverse event and clinical status. Blood samples collected before, during, and after treatment were analyzed for T cell proliferation responses against CEA. Results: No severe treatment-related side effects or toxicity was observed in patients who received the regular 4 DC vaccine injections. Two patients had stable disease and 10 patients showed disease progression. A statistically significant increase in proliferation against CEA by T cells collected after vaccination was observed in 2 of 9 patients. Conclusions: The results of this study indicate that it is feasible and safe to treat colorectal cancer patients using this protocol. An increase in the anti-CEA immune response and a clinical benefit was observed in a small fraction of patients. This treatment protocol should be further evaluated in additional colorectal cancer patients with modifications to enhance T cell responses. Trial registration: ClinicalTrials.gov (identifier NCT00154713), September 8, 2005 ? 2016 The Author(s).
Subjects
Carcinoembryonic antigen; Colorectal cancer; Dendritic cell; Interleukin-2; Tetanus toxoid
SDGs
Other Subjects
alanine aminotransferase; aspartate aminotransferase; bilirubin; carcinoembryonic antigen; creatinine; dendritic cell vaccine; interleukin 2; rheumatoid factor; tetanus toxoid; thyroglobulin antibody; cancer vaccine; carcinoembryonic antigen; interleukin 2; tetanus toxoid; adult; advanced cancer; aged; allergy; anemia; Article; bleeding; cancer adjuvant therapy; cancer chemotherapy; cancer immunotherapy; cell growth; chill; clinical article; colorectal cancer; controlled clinical trial; controlled study; diarrhea; disease course; drug safety; dyspnea; feasibility study; female; fever; human; immune response; leg edema; low drug dose; lymphocyte proliferation; male; metastasis; middle aged; mucosa inflammation; myalgia; pain; phase 1 clinical trial; priority journal; pruritus; rash; side effect; skin exfoliation; sweating; swelling; T lymphocyte; vaccination; very elderly; clinical trial; Colorectal Neoplasms; dendritic cell; immunology; immunotherapy; treatment outcome; Aged; Aged, 80 and over; Cancer Vaccines; Carcinoembryonic Antigen; Colorectal Neoplasms; Dendritic Cells; Female; Humans; Immunotherapy; Interleukin-2; Male; Middle Aged; Tetanus Toxoid; Treatment Outcome
Publisher
BioMed Central Ltd.
Type
journal article