Abstract P5-01-05: Personalized peptide vaccines in combination with conventional chemo- or endocrine therapy for metastatic breast cancer: A single-arm phase II study

Background: Immunotherapy using multiple personalized peptide vaccines (PPV) has been reported to be effective for boosting anticancer immunity in patients (pts) with advanced prostate cancer and glioblastoma. The PPVs binding HLA-A2, A24, A3 family and A26 molecules were selected from 31 candidate peptides derived from various tumor associated antigens. Currently, we performed a phase II trial to evaluate the benefit of the PPVs in combination with conventional chemo-or endocrine therapy for pretreated metastatic breast cancer (MBC). Methods: Seventy-one pretreated pts had histologically confirmed measurable MBC and their HLA A molecules matched each of HLA-A2, A24, A26 and A3 family. Pre-vaccination plasma was measured for their IgG levels reactive to each of 31 peptides followed by administration subcutaneously of the four peptides at maximum showing higher levels of IgG in order with schedule of every 1-2 week. The concurrent conventional chemotherapy or endocrine therapy was available for the combination of PPVs. The primary endpoint was anti-tumor immunologic effect and safety, and the secondary endpoints were clinical responses and survival. Levels of IgG reactive to each of the 31 peptides in the pre- and post-treatment plasma at every 6 times of vaccination were measured using LUMNEX system. The CTL responses were simultaneously evaluated using ELISPOT method. Clinical response was evaluated by RECIST criteria. Results: Between May 2009 and December 2012, a total of 71 pts (Luminal-Her2- cases: 39; Her2+cases: 18; Triple negative(TN) cases:14) were enrolled in this study. The median duration of follow-up was 20.7 months. Concurrent chemotherapies (capecitabine, gemcitabine, eribulin, vinorelbine etc.) and endocrine therapies (aromatase inhibitor, toremifen or fulvestrant) were administered to 36 and 24 pts, respectively. Trastuzumab, Laptinib or Bevacizumab was simultaneously used for 13 pts. After 6th vaccination, the IgG reaction and CTL response were identified in 53 of 71 (74.6%) pts and 33 of 63 (52.3%) pts. There were no significant differences between TN cases and the other cases of MBC with regard to immunological humoral and/or cellular responses. No vaccine-related severe adverse events were observed. Clinical response rate of assessable 61 pts was 14.8% (CR 3, PR 6, SD 24, PD 28). The median PFS and OS were 7.6 m and 20.7 m, respectively. In contrast, the PFS and OS of luminal type, Her2 type or TN type were 12, 4.6 or 8.3 m and 24, 15 or 12 m. Conclusions: The phase II PPVs study for MBC demonstrated the promising response and safety, and further studies are essential to identify the clinical benefits of this novel therapy. Clinical trial information: UMIN000001482.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-01-05.

Spatiotemporal structures of edge limit-cycle oscillation before L-to-H transition in the JFT-2M tokamak

In this Letter, we report analyses of spatiotemporal dynamics of turbulence and structure in the limit-cycle oscillation (LCO) that precedes an L-to-H transition. Zonal flows are not observed during LCO, and the oscillation is the periodic generations or decays of barrier with edge-localized mean flow. Oscillatory Reynolds stress is found to be too small to accelerate the LCO flow, by considering the dielectric constant in magnetized toroidal plasmas. Propagation of changes of the density gradient and turbulence amplitude into the core is also observed.

Dynamics of low-intermediate-high-confinement transitions in toroidal plasmas

The dynamic features of the low-intermediate-high-(L-I-H) confinement transitions on HL-2A tokamak are presented. Here we report the discovery of two types of limit cycles (dubbed type-Y and type-J), which show opposite temporal ordering between the radial electric field and turbulence intensity. In type-Y, which appears first after an L-I transition, the turbulence grows first, followed by the localized electric field. In contrast, the electric field leads type-J. The turbulence-induced zonal flow and pressure-gradient-induced drift play essential roles in the two types of limit cycles, respectively. The condition of transition between types-Y and -J is studied in terms of the normalized radial electric field. An I-H transition is demonstrated to occur only from type-J.

One-bottle silane coupling agent containing 4-META

The effectiveness of commercial and experimental silane coupling agents was evaluated by measuring their shear bond strengths to a ceramic disk. Experimental one-bottle silane coupling agents were prepared using 3-MPTS, 4-META, and resin monomers. The surfaces of two ceramic disks (IPS e-max, Ivoclar Vivadent AG, Schaan, Lichtenstein) were treated by a silane coupling agent to bond them to each other; this bonding was mediated by a commercial flowable resin composite (Clearfil Majesty LV, Kuraray, Tokyo, Japan). A commercial silane coupling agent (Clearfil Porcelain Bond Activator, Kuraray, Tokyo, Japan) modified by adding 4-META exhibited a significantly higher bond strength than the unmodified commercial one-bottle silane coupling agent. Among the tested materials, two experimental one-bottle silane coupling agents composed of 5% 4-META, 45% 3-MPTS, and 50% resin monomers exhibited statistically highest bond strengths.

Diagnostic accuracy of lymph node metastasis depends on metabolic activity of the primary lesion in thoracic squamous esophageal cancer

The metabolic activity of the primary tumor is an important variable in (18)F-FDG PET interpretation for presurgical staging, because this activity is likely to affect the possibility of detection of malignant involvement in lymph nodes (LNs). The purpose of this study was to reevaluate the diagnostic accuracy of (18)F-FDG PET/CT for the presurgical staging of esophageal squamous cell carcinoma (SCC) in correlation with the (18)F-FDG avidity of the primary lesions.

METHODS

One hundred fifty-six patients (mean age ± SD, 61.4 ± 8.0 y) underwent (18)F-FDG PET/CT before surgical esophagectomy and LN dissection. LN metastasis was identified using the fusion of PET and CT images with increased (18)F-FDG uptake greater than the background activity of the adjacent structures. The results of the patients' (18)F-FDG PET/CT examinations for LN involvement were compared with the histopathologic results to investigate the diagnostic accuracy of (18)F-FDG PET/CT for tumor staging. In addition, we examined the correlation between the diagnostic accuracy of (18)F-FDG PET/CT for LN involvement and the (18)F-FDG avidity of the primary lesions, to investigate the effect of tumor aggressiveness on the diagnosis of LN metastasis.

RESULTS

The diagnostic accuracy of (18)F-FDG PET/CT for LN metastasis showed a low sensitivity, ranging from 29.3% to 53.3%, whereas the specificity was higher than 89.8% in regional thoracic nodes and in remote areas of the cervical and abdominal regions. The (18)F-FDG uptake of the primary lesions positively correlated with that of the metastatic LNs in the thoracic field (R = 0.52, P < 0.05). As a result, our receiver-operating-characteristic analyses demonstrated an area under the curve value of 0.73, with the optimal cutoff value at a maximum standardized uptake value of 3.3 in patients with mid to high (18)F-FDG avidity in the primary lesions (maximum standardized uptake value ≥ 5).

CONCLUSION

This study showed that the avidity of the primary esophageal SCCs affected the detectability of lymph nodal metastases. If primary lesions of esophageal SCC present with a low (18)F-FDG uptake, PET/CT may have a limited role for initial staging because of low sensitivity to detect lymph node metastases.

Collective excitation of an electric dipole on a molecular dimer in an organic dimer-Mott insulator

The terahertz response in 10-100 cm(-1) was investigated in an organic dimer-Mott (DM) insulator κ-(ET)(2)Cu(2)(CN)(3) that exhibits a relaxorlike dielectric anomaly. An ~30 cm(-1) band in the optical conductivity was attributable to collective excitation of the fluctuating intradimer electric dipoles that are formed by an electron correlation. We succeeded in observing photoinduced enhancement of this ~30 cm(-1) band, reflecting the growth of the electric dipole cluster in the DM phase. Such optical responses in κ-(ET)(2)Cu(2)(CN)(3) reflect an instability near the boundary between the DM-ferroelectric charge ordered phases.

Observation of long-distance radial correlation in toroidal plasma turbulence

This Letter presents the discovery of macroscale electron temperature fluctuations with a long radial correlation length comparable to the plasma minor radius in a toroidal plasma. Their spatiotemporal structure is characterized by a low frequency of ∼1-3  kHz, ballistic radial propagation, a poloidal or toroidal mode number of m/n=1/1 (or 2/1), and an amplitude of ∼2% at maximum. Nonlinear coupling between the long-range fluctuations and the microscopic fluctuations is identified. A change of the amplitude of the long-range fluctuation is transmitted across the plasma radius at the velocity which is of the order of the drift velocity.

Uneven distribution of the luxS gene within the genus Campylobacter

Polymerase chain reaction (PCR) amplification was performed on 20 isolates of five Campylobacter species using a degenerate primer pair designed in silico to generate a product of the luxS gene or its homologue from Campylobacter organisms. Although the primer pair successfully amplified products of approximately 500 base pairs (bp) with the eight isolates of C. jejuni and C. coli and some of C. upsaliensis and C. fetus, it failed to amplify fragments with all four isolates of C. lari (two urease-negative C. lari; two urease-positive thermophilic campylobacters). When Southern blot hybridisation analysis was carried using the mixed luxS gene fragments prepared from the C. jejuni, C. coli, C. upsaliensis and C. fetus strains as a probe, all C. jejuni, C. coli, C. upsaliensis and C. fetus isolates gave positive signals, but no positive signal was detected with any C. lari isolate. These results clearly indicate that C. jejuni, C. coli, C. upsaliensis and C. fetus carry the luxS gene or its homologue. However, no luxS gene or its homologue was identified to occur in the C. lari genome. Although autoinducer-2 assays were positive in C. jejuni, C. coli, C. upsaliensis and C. fetus isolates, it was negative with all the C. lari isolates examined. In addition, a biofilm formation assay demonstrated that biofilm formation in the C. lari species does not appear to correlate with the occurrence of the luxS gene because biofilm formation occurred among some isolates of C. lari.