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Dosset M, Castro A, Carter H, Zanetti M. Telomerase and CD4 T Cell Immunity in Cancer. Cancers (Basel) 2020; 12:cancers12061687. [PMID: 32630460 PMCID: PMC7352225 DOI: 10.3390/cancers12061687] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 12/13/2022] Open
Abstract
Telomerase reverse transcriptase (TERT) is a conserved self-tumor antigen which is overexpressed in most tumors and plays a critical role in tumor formation and progression. As such, TERT is an antigen of great relevance to develop widely applicable immunotherapies. CD4 T cells play a major role in the anti-cancer response alone or with other effector cells such as CD8 T cells and NK cells. To date, efforts have been made to identify TERT peptides capable of stimulating CD4 T cells that are also able to bind diverse MHC-II alleles to ease immune status monitoring and immunotherapies. Here, we review the current status of TERT biology, TERT/MHC-II immunobiology, and past and current vaccine clinical trials. We propose that monitoring CD4 T cell immunity against TERT is a simple and direct way to assess immune surveillance in cancer patients and a new way to predict the response to immune checkpoint inhibitors (ICPi). Finally, we present the initial results of a systematic discovery of TERT peptides able to bind the most common HLA Class II alleles worldwide and show that the repertoire of MHC-II TERT peptides is wider than currently appreciated.
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Affiliation(s)
- Magalie Dosset
- The Laboratory of Immunology, Department of Medicine and Moores Cancer Center, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-081, USA;
| | - Andrea Castro
- Division of Medical Genetics, Department of Medicine and Bioinformatics and Systems Biology Program, University of California San Diego, La Jolla, CA 92093, USA; (A.C.); (H.C.)
- Health Science, Department of Biomedical Informatics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Hannah Carter
- Division of Medical Genetics, Department of Medicine and Bioinformatics and Systems Biology Program, University of California San Diego, La Jolla, CA 92093, USA; (A.C.); (H.C.)
| | - Maurizio Zanetti
- The Laboratory of Immunology, Department of Medicine and Moores Cancer Center, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-081, USA;
- Correspondence:
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Teixeira L, Medioni J, Garibal J, Adotevi O, Doucet L, Durey MAD, Ghrieb Z, Kiladjian JJ, Brizard M, Laheurte C, Wehbe M, Pliquet E, Escande M, Defrance R, Culine S, Oudard S, Wain-Hobson S, Doppler V, Huet T, Langlade-Demoyen P. A First-in-Human Phase I Study of INVAC-1, an Optimized Human Telomerase DNA Vaccine in Patients with Advanced Solid Tumors. Clin Cancer Res 2019; 26:588-597. [PMID: 31558479 DOI: 10.1158/1078-0432.ccr-19-1614] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/24/2019] [Accepted: 09/23/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Human telomerase reverse transcriptase (hTERT) is highly expressed in >85% of human tumors and is thus considered as a good tumor-associated antigen candidate for vaccine development. We conducted a phase I study to investigate the safety, tolerability, clinical response, and immunogenicity of INVAC-1, a DNA plasmid encoding a modified hTERT protein in patients with relapsed or refractory solid tumors. PATIENTS AND METHODS INVAC-1 was either administered by intradermal route followed by electroporation or by Tropis, a needle-free injection system. Safety and tolerability were monitored by clinical and laboratory assessments. Progression-free survival and overall survival were reported using Kaplan-Meier survival analysis. Immunogenicity was studied by ELISpot, Luminex, and Flow Cytometry. RESULTS Twenty-six patients were treated with INVAC-1 administered at three dose levels (100, 400, and 800 μg). Vaccination was well tolerated and no dose-limiting toxicity was reported. One treatment-related grade 3 SAE was reported. Fifty-eight percent of patients experienced disease stabilization. PFS was 2.7 months, median OS was 15 months, and 1-year survival was reached for 65% of patients. INVAC-1 vaccination stimulated specific anti-hTERT CD4 T-cell response as well as cytotoxic CD8 T-cell response. No evidence of peripheral vaccine-induced immunosuppression was observed. CONCLUSIONS INVAC-1 vaccination was safe, well tolerated, and immunogenic when administered intradermally at the three tested doses in patients with relapsed or refractory cancers. Disease stabilization was observed for the majority of patients (58%) during the treatment period and beyond.See related commentary by Slingluff Jr, p. 529.
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Affiliation(s)
- Luis Teixeira
- Breast Diseases Unit, HIPI INSERM U976, AP-HP, Saint Louis Hospital, Paris University, Paris, France
| | - Jacques Medioni
- Center for Early Clinical Trials, Medical Oncology Department (CEPEC), Georges Pompidou Hospital, Paris Descartes University, Paris, France
| | | | - Olivier Adotevi
- University of Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Biomonitoring Platform, Besançon, France
| | - Ludovic Doucet
- Breast Diseases Unit, HIPI INSERM U976, AP-HP, Saint Louis Hospital, Paris University, Paris, France
| | | | - Zineb Ghrieb
- Breast Diseases Unit, HIPI INSERM U976, AP-HP, Saint Louis Hospital, Paris University, Paris, France
| | - Jean-Jacques Kiladjian
- Breast Diseases Unit, HIPI INSERM U976, AP-HP, Saint Louis Hospital, Paris University, Paris, France
| | - Mara Brizard
- Center for Early Clinical Trials, Medical Oncology Department (CEPEC), Georges Pompidou Hospital, Paris Descartes University, Paris, France
| | - Caroline Laheurte
- University of Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Biomonitoring Platform, Besançon, France
| | | | | | | | | | - Stephane Culine
- Breast Diseases Unit, HIPI INSERM U976, AP-HP, Saint Louis Hospital, Paris University, Paris, France
| | - Stephane Oudard
- Center for Early Clinical Trials, Medical Oncology Department (CEPEC), Georges Pompidou Hospital, Paris Descartes University, Paris, France
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Thalmensi J, Pliquet E, Liard C, Chamel G, Kreuz C, Bestetti T, Escande M, Kostrzak A, Pailhes-Jimenez AS, Bourges E, Julithe M, Bourre L, Keravel O, Clayette P, Huet T, Wain-Hobson S, Langlade-Demoyen P. A DNA telomerase vaccine for canine cancer immunotherapy. Oncotarget 2019; 10:3361-3372. [PMID: 31164958 PMCID: PMC6534364 DOI: 10.18632/oncotarget.26927] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 04/29/2019] [Indexed: 12/23/2022] Open
Abstract
Telomerase reverse transcriptase (TERT) is highly expressed in more than 90% of canine cancer cells and low to absent in normal cells. Given that immune tolerance to telomerase is easily broken both naturally and experimentally, telomerase is an attractive tumor associated antigen for cancer immunotherapy. Indeed, therapeutic trials using human telomerase peptides have been performed. We have developed an immunogenic yet catalytically inactive human telomerase DNA construct that is in clinical trials with patients presenting solid tumors. Paralleling this human construct, we have developed a canine telomerase DNA vaccine, called pDUV5. When administered intradermally to mice combined with electrogene transfer, pDUV5 induced canine TERT specific cytotoxic T-cells as measured by IFN-γ ELISpot assay. Intradermal vaccination of healthy dogs with 400 μg of pDUV5 generated strong, broad and long lasting TERT specific cellular immune responses. In vitro immunization with cTERT peptides revealed the maintenance of cTERT specific T-cells in PBMCs from tumor bearing dogs showing that this repertoire was not depleted. This study highlights the potential of pDUV5 as a cancer vaccine and supports its evaluation for the treatment of spontaneous canine tumors.
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Affiliation(s)
| | | | | | | | - Christine Kreuz
- ImmunoPharmacology and Biosafety Lab, Bertin Pharma/CEA, Fontenay-aux-Roses 92265, France
| | | | | | | | | | | | | | | | | | - Pascal Clayette
- ImmunoPharmacology and Biosafety Lab, Bertin Pharma/CEA, Fontenay-aux-Roses 92265, France
| | | | - Simon Wain-Hobson
- Invectys, Paris BioPark, Paris 75013, France.,Molecular Retrovirology Unit, Institut Pasteur, CNRS-URA 3015, Paris 75015, France
| | - Pierre Langlade-Demoyen
- Invectys, Paris BioPark, Paris 75013, France.,Molecular Retrovirology Unit, Institut Pasteur, CNRS-URA 3015, Paris 75015, France
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Thalmensi J, Pliquet E, Liard C, Escande M, Bestetti T, Julithe M, Kostrzak A, Pailhes-Jimenez AS, Bourges E, Loustau M, Caumartin J, Lachgar A, Huet T, Wain-Hobson S, Langlade-Demoyen P. Anticancer DNA vaccine based on human telomerase reverse transcriptase generates a strong and specific T cell immune response. Oncoimmunology 2015; 5:e1083670. [PMID: 27141336 DOI: 10.1080/2162402x.2015.1083670] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 08/07/2015] [Accepted: 08/11/2015] [Indexed: 12/21/2022] Open
Abstract
Human telomerase reverse transcriptase (hTERT) is overexpressed in more than 85% of human cancers regardless of their cellular origin. As immunological tolerance to hTERT can be overcome not only spontaneously but also by vaccination, it represents a relevant universal tumor associated antigen (TAA). Indeed, hTERT specific cytotoxic T lymphocyte (CTL) precursors are present within the peripheral T-cell repertoire. Consequently, hTERT vaccine represents an attractive candidate for antitumor immunotherapy. Here, an optimized DNA plasmid encoding an inactivated form of hTERT, named INVAC-1, was designed in order to trigger cellular immunity against tumors. Intradermal injection of INVAC-1 followed by electrogene transfer (EGT) in a variety of mouse models elicited broad hTERT specific cellular immune responses including high CD4+ Th1 effector and memory CD8+ T‑cells. Furthermore, therapeutic INVAC‑1 immunization in a HLA-A2 spontaneous and aggressive mouse sarcoma model slows tumor growth and increases survival rate of 50% of tumor-bearing mice. These results emphasize that INVAC-1 based immunotherapy represents a relevant cancer vaccine candidate.
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Affiliation(s)
| | - Elodie Pliquet
- Invectys, Pasteur BioTop, Paris, France; Molecular Retrovirology Unit, CNRS-URA 3015, Institut Pasteur, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | - Simon Wain-Hobson
- Invectys, Pasteur BioTop, Paris, France; Molecular Retrovirology Unit, CNRS-URA 3015, Institut Pasteur, Paris, France
| | - Pierre Langlade-Demoyen
- Invectys, Pasteur BioTop, Paris, France; Molecular Retrovirology Unit, CNRS-URA 3015, Institut Pasteur, Paris, France
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Identification of immunogenic peptides of the self-tumor antigen: our experience with telomerase reverse transcriptase. Methods Mol Biol 2010. [PMID: 20686968 DOI: 10.1007/978-1-60761-786-0_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
Abstract
The general approach, termed reverse immunology, to predict and identify immunogenic peptides from the sequence of a gene product of interest has been postulated to be a particularly efficient, high-throughput approach to discover tumor antigens. This laboratory has successfully identified immunogenic peptides of the human telomerase reverse transcriptase (hTERT), a self-tumor antigen, by using a multi-step approach. These steps include the following: the use of predictive bioinformatics algorithms, molecular methods to identify tumor-specific transcripts, prediction of proteasomal cleavage sites, peptide-binding prediction to HLA molecules and experimental validation, assessment of the in vitro and in vivo immunogenic potential of selected peptide antigens, isolation of specific cytolytic T lymphocyte clones, and final validation in functional assays of tumor cell recognition. This laboratory, and others have used similar methods to identify immunogenic peptides of self-tumor antigens, and many of those peptides are included in vaccines currently tested in clinical trials.
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Presentation of Telomerase Reverse Transcriptase, a Self-Tumor Antigen, is Down-regulated by Histone Deacetylase Inhibition. Cancer Res 2008; 68:8085-93. [DOI: 10.1158/0008-5472.can-08-1014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cortez-Gonzalez X, Zanetti M. Telomerase immunity from bench to bedside: round one. J Transl Med 2007; 5:12. [PMID: 17324292 PMCID: PMC1839079 DOI: 10.1186/1479-5876-5-12] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2006] [Accepted: 02/26/2007] [Indexed: 11/10/2022] Open
Abstract
Telomerase, a reverse transcriptase primarily devoted to the elongation of telomeres in mammalian cells, is also the first bona fide common tumor antigen. In fact, telomerase is over-expressed in > 85% of tumor cells irrespective of origin and histological type. In the past seven years, there has been considerable interest in assessing telomerase as substrate for vaccination in cancer patients to induce CD8 T cell responses. Because the activation of T cells is restricted by the MHC molecules on antigen presenting cells or tumor cells, the identification of telomerase peptides immunogenic for humans is tightly linked with HLA types. To date, a handful of peptides have been identified through a variety of screening procedures, including bioinformatics prediction, in vivo immunization of HLA transgenic mice, in vitro immunization of PBMC from normal donors and cancer patients, and processing in human tumor cells. Currently, there exist putative peptides for five major HLA types (A2, A1, A3, A24 and B7). Due to the complexity of the HLA system, trials have been performed focusing on the most prevalent HLA type, HLA-A2. Here, we summarize this collective effort and highlight results obtained in Phase 1 trials including a Phase 1 trial performed at the UCSD Cancer Center.
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Affiliation(s)
- Xochtil Cortez-Gonzalez
- The Laboratory of Immunology, Department of Medicine and Moores Cancer Center, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0837, USA.
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Adotévi O, Mollier K, Neuveut C, Cardinaud S, Boulanger E, Mignen B, Fridman WH, Zanetti M, Charneau P, Tartour E, Lemonnier F, Langlade-Demoyen P. Immunogenic HLA-B*0702-Restricted Epitopes Derived from Human Telomerase Reverse Transcriptase That Elicit Antitumor Cytotoxic T-Cell Responses. Clin Cancer Res 2006; 12:3158-67. [PMID: 16707616 DOI: 10.1158/1078-0432.ccr-05-2647] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The human telomerase reverse transcriptase (hTERT) is considered as a potential target for cancer immunotherapy because it is preferentially expressed in tumor cells. To increase the applicability of hTERT-based immunotherapy, we set out to identify CTL epitopes in hTERT restricted by HLA-B*0702 molecule, a common MHC class I allele. EXPERIMENTAL DESIGN HLA-B*0702-restricted peptides from hTERT were selected by using a method of epitope prediction and tested for their immunogenicity in human (in vitro) and HLA-B*0702 transgenic mice (in vivo). RESULTS All the six hTERT peptides that were predicted to bind to HLA-B*0702 molecule were found to induce primary human CTL responses in vitro. The peptide-specific CD8+ CTL lines were tested against various hTERT+ tumor cells. Although differences were observed according to the tumor origin, only three CTL lines specific for p277, p342, and p351 peptides exhibited cytotoxicity against tumor cells in a HLA-B*0702-restricted manner. In addition, this cytotoxicity was inhibited by the addition of peptide-loaded cold target cells and indicated that these epitopes are naturally processed and presented on the tumor cells. Further, in vivo studies using humanized HLA-B*0702 transgenic mice showed that all the candidate peptides were able to induce CTL responses after peptide immunization. Furthermore, vaccination with a plasmid DNA encoding full-length hTERT elicited peptide-specific CTL responses, indicating that these epitopes are efficiently processed in vivo. CONCLUSIONS Together with previously reported hTERT epitopes, the identification of new CTL epitopes presented by HLA-B*0702 increases the applicability of hTERT-based immunotherapy to treating cancer.
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Affiliation(s)
- Olivier Adotévi
- Institut National de la Sante et de la Recherche Medicale U255, Université René Descartes, Unité d'Immunologie Biologique, Hôpital Européen Georges Pompidou, Assistance-Public Hôpitaux de Paris, France.
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Filaci G, Fravega M, Setti M, Traverso P, Millo E, Fenoglio D, Negrini S, Ferrera F, Romagnoli A, Basso M, Contini P, Rizzi M, Ghio M, Benatti U, Damonte G, Ravetti JL, Carmignani G, Zanetti M, Indiveri F. Frequency of telomerase-specific CD8+ T lymphocytes in patients with cancer. Blood 2006; 107:1505-12. [PMID: 16249379 DOI: 10.1182/blood-2005-01-0258] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Telomerase is considered a universal tumor-associated antigen (TAA) due to its high rate of expression by cancers (≈90%), and clinical trials are in progress to test the immunotherapeutical efficacy of antitelomerase immunization in patients with cancer. However, the data concerning frequency and functional activity of telomerase-specific cytotoxic T lymphocytes (CTLs) in patients with cancer are few and conflicting, although their knowledge would be mandatory to predict the efficacy of telomerase-specific immunotherapy in selected patients. We performed this study to analyze frequency and cytolytic function of circulating CD8+ T lymphocytes specific for the p540 telomerase peptide in a series of human leukocyte antigen (HLA)–A2+ cancer patients. The results show that most patients with cancer have circulating telomerase-specific CD8+ T lymphocytes, but a high frequency of telomerase-specific CTLs are present only in a fraction of them. Furthermore, CTL lines able to kill telomerase-positive tumor cells, including autologous cancer cells, can be expanded ex vivo from some, but not all, patients with cancer. In conclusion, the results of the study support the development of clinical protocols using telomerase peptides as an immunizing agent. However, they underline the necessity to study single patients immunologically before undergoing vaccination, to select the patients adequately, and to eventually adapt the immunization schedule to the patient's immunologic status.
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Affiliation(s)
- Gilberto Filaci
- Department of Internal Medicine and Center of Excellence for Biomedical Research (CEBR), University of Genoa, Viale Benedetto XV no. 6, 16132 Genova, Italy.
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