The first clinical use of a live-attenuated Listeria monocytogenes vaccine: a Phase I safety study of Lm-LLO-E7 in patients with advanced carcinoma of the cervix

Vaccine. 2009 Jun 19;27(30):3975-83. doi: 10.1016/j.vaccine.2009.04.041. Epub 2009 May 3.


Invasive carcinoma of the cervix (ICC) is the second most common cancer in women worldwide. Lm-LLO-E7 vaccine is a live-attenuated Listeria monocytogenes (Lm) that secretes the HPV-16 E7 antigen fused to a non-hemolytic fragment of the Lm protein listeriolysin O (LLO). In this Phase I trial, the safety of Lm-LLO-E7 was assessed in 15 patients with previously treated metastatic, refractory or recurrent ICC. Patients received 1 of 3 dose levels of Lm-LLO-E7 (1 x 10(9)CFU, 3.3 x 10(9)CFU or 1 x 10(10)CFU) as an intravenous infusion, followed by a second dose 3 weeks later. All patients experienced a flu-like syndrome which responded to non-prescription symptomatic treatment. Severe (grade 3) adverse events related to Lm-LLO-E7 were reported in 6 patients (40%), but no grade 4 adverse events were observed. At the highest dose some patients had severe fever and dose limiting hypotension. By the end of the study protocol, 2 patients had died, 5 had progressed, 7 had stable disease and 1 qualified as a partial responder. This study shows for the first time that a live-attenuated Lm is safe to be administered to late stage ICC patients.

Publication types

  • Clinical Trial, Phase I
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Genetic Vectors*
  • Humans
  • Listeria monocytogenes / genetics*
  • Middle Aged
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Vaccines / adverse effects
  • Papillomavirus Vaccines / immunology*
  • Uterine Cervical Neoplasms / immunology*
  • Uterine Cervical Neoplasms / pathology*
  • Vaccines, Attenuated / adverse effects
  • Vaccines, Attenuated / immunology


  • Papillomavirus Vaccines
  • Vaccines, Attenuated