Pitfalls of vaccinations with WT1-, Proteinase3- and MUC1-derived peptides in combination with MontanideISA51 and CpG7909

Cancer Immunol Immunother. 2011 Feb;60(2):161-71. doi: 10.1007/s00262-010-0929-7. Epub 2010 Oct 21.

Abstract

T cells with specificity for antigens derived from Wilms Tumor gene (WT1), Proteinase3 (Pr3), and mucin1 (MUC1) have been demonstrated to lyse acute myeloid leukemia (AML) blasts and multiple-myeloma (MM) cells, and strategies to enhance or induce such tumor-specific T cells by vaccination are currently being explored in multiple clinical trials. To test safety and immunogenicity of a vaccine composed of WT1-, Pr3-, and MUC1-derived Class I-restricted peptides and the pan HLA-DR T helper cell epitope (PADRE) or MUC1-helper epitopes in combination with CpG7909 and MontanideISA51, four patients with AML and five with MM were repetitively vaccinated. No clinical responses were observed. Neither pre-existing nor naive WT1-/Pr3-/MUC1-specific CD8+ T cells expanded in vivo by vaccination. In contrast, a significant decline in vaccine-specific CD8+ T cells was observed. An increase in PADRE-specific CD4+ T helper cells was observed after vaccination but these appeared unable to produce IL2, and CD4+ T cells with a regulatory phenotype increased. Taken into considerations that multiple clinical trials with identical antigens but different adjuvants induced vaccine-specific T cell responses, our data caution that a vaccination with leukemia-associated antigens can be detrimental when combined with MontanideISA51 and CpG7909. Reflecting the time-consuming efforts of clinical trials and the fact that 1/3 of ongoing peptide vaccination trails use CpG and/or Montanide, our data need to be taken into consideration.

Publication types

  • Controlled Clinical Trial
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antigens, Neoplasm / chemistry
  • Antigens, Neoplasm / immunology*
  • CD4-Positive T-Lymphocytes / immunology
  • CD8-Positive T-Lymphocytes / immunology
  • Cancer Vaccines / adverse effects
  • Cancer Vaccines / immunology
  • Cancer Vaccines / therapeutic use*
  • Female
  • Humans
  • Leukemia, Myeloid, Acute / immunology
  • Leukemia, Myeloid, Acute / pathology
  • Leukemia, Myeloid, Acute / therapy*
  • Male
  • Mannitol / adverse effects
  • Mannitol / analogs & derivatives*
  • Mucin-1 / adverse effects
  • Mucin-1 / chemistry
  • Mucin-1 / immunology
  • Multiple Myeloma / immunology
  • Multiple Myeloma / pathology
  • Multiple Myeloma / therapy*
  • Myeloblastin / adverse effects
  • Myeloblastin / chemistry
  • Myeloblastin / immunology
  • Neoplasm Staging
  • Neoplasm, Residual / immunology
  • Neoplasm, Residual / pathology
  • Neoplasm, Residual / therapy
  • Oleic Acids* / adverse effects
  • Oligodeoxyribonucleotides* / adverse effects
  • Oligodeoxyribonucleotides* / immunology
  • Peptides / adverse effects
  • Peptides / immunology
  • Peptides / therapeutic use*
  • Pilot Projects
  • Treatment Outcome
  • WT1 Proteins / adverse effects
  • WT1 Proteins / chemistry
  • WT1 Proteins / immunology

Substances

  • Antigens, Neoplasm
  • Cancer Vaccines
  • Mucin-1
  • Oleic Acids
  • Oligodeoxyribonucleotides
  • Peptides
  • ProMune
  • WT1 Proteins
  • montanide ISA 51
  • Mannitol
  • Myeloblastin