Multipeptide Immune Response to Cancer Vaccine IMA901 After Single-Dose Cyclophosphamide Associates With Longer Patient Survival

Nat Med. 2012 Aug;18(8):1254-61. doi: 10.1038/nm.2883. Epub 2012 Jul 29.

Abstract

IMA901 is the first therapeutic vaccine for renal cell cancer (RCC) consisting of multiple tumor-associated peptides (TUMAPs) confirmed to be naturally presented in human cancer tissue. We treated a total of 96 human leukocyte antigen A (HLA-A)*02(+) subjects with advanced RCC with IMA901 in two consecutive studies. In the phase 1 study, the T cell responses of the patients to multiple TUMAPs were associated with better disease control and lower numbers of prevaccine forkhead box P3 (FOXP3)(+) regulatory T (T(reg)) cells. The randomized phase 2 trial showed that a single dose of cyclophosphamide reduced the number of T(reg) cells and confirmed that immune responses to multiple TUMAPs were associated with longer overall survival. Furthermore, among six predefined populations of myeloid-derived suppressor cells, two were prognostic for overall survival, and among over 300 serum biomarkers, we identified apolipoprotein A-I (APOA1) and chemokine (C-C motif) ligand 17 (CCL17) as being predictive for both immune response to IMA901 and overall survival. A randomized phase 3 study to determine the clinical benefit of treatment with IMA901 is ongoing.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigens, Neoplasm / immunology
  • Apolipoprotein A-I / blood
  • Biomarkers
  • CD8-Positive T-Lymphocytes / immunology
  • Cancer Vaccines / therapeutic use*
  • Carcinoma, Renal Cell / blood
  • Carcinoma, Renal Cell / drug therapy
  • Carcinoma, Renal Cell / immunology
  • Carcinoma, Renal Cell / therapy*
  • Chemokine CCL17 / blood
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / pharmacology
  • Cyclophosphamide / therapeutic use*
  • Female
  • Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use
  • HLA-A2 Antigen / immunology
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / pharmacology
  • Immunosuppressive Agents / therapeutic use*
  • Immunotherapy, Active*
  • Kaplan-Meier Estimate
  • Kidney Neoplasms / blood
  • Kidney Neoplasms / drug therapy
  • Kidney Neoplasms / immunology
  • Kidney Neoplasms / therapy*
  • Lymphocyte Depletion
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • T-Lymphocytes, Regulatory / drug effects
  • T-Lymphocytes, Regulatory / immunology*
  • Treatment Outcome
  • Vaccines, Subunit / therapeutic use*

Substances

  • APOA1 protein, human
  • Antigens, Neoplasm
  • Apolipoprotein A-I
  • Biomarkers
  • CCL17 protein, human
  • Cancer Vaccines
  • Chemokine CCL17
  • HLA-A*02 antigen
  • HLA-A2 Antigen
  • IMA901 vaccine
  • Immunosuppressive Agents
  • Vaccines, Subunit
  • Granulocyte-Macrophage Colony-Stimulating Factor
  • Cyclophosphamide