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Venzel R, Campos MCP, de Oliveira LP, Dan Lins RV, Siena ÁDD, Mesquita KT, Moreira Dos Santos TP, Nohata N, Arruda LCM, Sales-Campos H, Neto MPC. Clinical and molecular overview of immunotherapeutic approaches for malignant skin melanoma: Past, present and future. Crit Rev Oncol Hematol 2023; 186:103988. [PMID: 37086955 DOI: 10.1016/j.critrevonc.2023.103988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/25/2023] [Accepted: 04/11/2023] [Indexed: 04/24/2023] Open
Abstract
Traditional therapeutic approaches for malignant melanoma, have proved to be limited and/or ineffective, especially with respect to their role in improving patient survival and tumor recurrence. In this regard, immunotherapy has been demonstrated to be a promising therapeutic alternative, boosting antitumor responses through the modulation of cell signaling pathways involved in the effector mechanisms of the immune system, particularly, the so-called "immunological checkpoints". Clinical studies on the efficacy and safety of immunotherapeutic regimens, alone or in combination with other antitumor approaches, have increased dramatically in recent decades, with very encouraging results. Hence, this review will discuss the current immunotherapeutic regimens used to treat malignant melanoma, as well as the molecular and cellular mechanisms involved. In addition, current clinical studies that have investigated the use, efficacy, and adverse events of immunotherapy in melanoma will also be discussed.
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Affiliation(s)
- Raphaelly Venzel
- Institute of Health and Biotechnology, Federal University of Amazonas, Coari, Brazil
| | | | | | | | | | | | - Tálita Pollyana Moreira Dos Santos
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA; Head & Neck Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Nijiro Nohata
- Oncology Science Unit, MSD K.K, Chiyoda-ku, Tokyo, Japan
| | | | - Helioswilton Sales-Campos
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, GO, Brazil
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Senzer NN, Kaufman HL, Amatruda T, Nemunaitis M, Reid T, Daniels G, Gonzalez R, Glaspy J, Whitman E, Harrington K, Goldsweig H, Marshall T, Love C, Coffin R, Nemunaitis JJ. Phase II Clinical Trial of a Granulocyte-Macrophage Colony-Stimulating Factor–Encoding, Second-Generation Oncolytic Herpesvirus in Patients With Unresectable Metastatic Melanoma. J Clin Oncol 2009; 27:5763-71. [DOI: 10.1200/jco.2009.24.3675] [Citation(s) in RCA: 472] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PurposeTreatment options for metastatic melanoma are limited. We conducted this phase II trial to assess the efficacy of JS1/34.5-/47-/granulocyte-macrophage colony-stimulating factor (GM-CSF) in stages IIIc and IV disease.Patients and MethodsTreatment involved intratumoral injection of up to 4 mL of 106pfu/mL of JS1/34.5-/47-/GM-CSF followed 3 weeks later by up to 4 mL of 108pfu/mL every 2 weeks for up to 24 treatments. Clinical activity (by RECIST [Response Evaluation Criteria in Solid Tumors]), survival, and safety parameters were monitored.ResultsFifty patients (stages IIIc, n = 10; IVM1a, n = 16; IVM1b, n = 4; IVM1c, n = 20) received a median of six injection sets; 74% of patients had received one or more nonsurgical prior therapies for active disease, including dacarbazine/temozolomide or interleukin-2 (IL-2). Adverse effects were limited primarily to transient flu-like symptoms. The overall response rate by RECIST was 26% (complete response [CR], n = 8; partial response [PR], n = 5), and regression of both injected and distant (including visceral) lesions occurred. Ninety-two percent of the responses had been maintained for 7 to 31 months. Ten additional patients had stable disease (SD) for greater than 3 months, and two additional patients had surgical CR. On an extension protocol, two patients subsequently achieved CR by 24 months (one previously PR, one previously SD), and one achieved surgical CR (previously PR). Overall survival was 58% at 1 year and 52% at 24 months.ConclusionThe 26% response rate, with durability in both injected and uninjected lesions including visceral sites, together with the survival rates, are evidence of systemic effectiveness. This effectiveness, combined with a limited toxicity profile, warrants additional evaluation of JS1/34.5-/47-/GM-CSF in metastatic melanoma. A US Food and Drug Administration–approved phase III investigation is underway.
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Affiliation(s)
- Neil N. Senzer
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Howard L. Kaufman
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Thomas Amatruda
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Mike Nemunaitis
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Tony Reid
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Gregory Daniels
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Rene Gonzalez
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - John Glaspy
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Eric Whitman
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Kevin Harrington
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Howard Goldsweig
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Tracey Marshall
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Colin Love
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Robert Coffin
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - John J. Nemunaitis
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
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Amin A, Benavides LC, Holmes JP, Gates JD, Carmichael MG, Hueman MT, Mittendorf EA, Storrer CE, Jama YH, Craig D, Stojadinovic A, Ponniah S, Peoples GE. Assessment of immunologic response and recurrence patterns among patients with clinical recurrence after vaccination with a preventive HER2/neu peptide vaccine: from US Military Cancer Institute Clinical Trials Group Study I-01 and I-02. Cancer Immunol Immunother 2008; 57:1817-25. [PMID: 18392824 PMCID: PMC11031077 DOI: 10.1007/s00262-008-0509-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Accepted: 03/24/2008] [Indexed: 12/24/2022]
Abstract
BACKGROUND E75, a HER2/neu immunogenic peptide, is expressed in breast cancer (BCa). We have performed clinical trials of E75 + GM-CSF vaccine in disease-free, node-positive and node-negative BCa patients at high recurrence risk and recurrences were noted in both control and vaccine groups. METHODS Among the 186 BCa patients enrolled, 177 completed the study. Patients were HLA typed; the HLA-A2(+)/A3(+) patients were vaccinated; HLA-A2(-)/A3(-) patients were followed as controls. Standard clinicopathological factors, immunologic response to the vaccine, and recurrences were collected and assessed. RESULTS The control group recurrence rate was 14.8 and 8.3% in the vaccinated group (P = 0.17). Comparing the 8 vaccinated recurrences (V-R) to the 88 vaccinated nonrecurrent patients (V-NR), the V-R group had higher nodal stage (> or = N2: 75 vs. 5%, P = 0.0001) and higher grade tumors (%grade 3: 88 vs. 31%, P = 0.003). The V-R group did not fail to respond immunologically as noted by equivalent dimer responses and post-DTH responses. Compared to control recurrent patients (C-R), V-R patients trended toward higher-grade tumors and hormone-receptor negativity. C-R patients had 50% bone-only recurrences, compared to V-R patients with no bone-only recurrences (P = 0.05). Lastly, V-R mortality rate was 12.5% compared with 41.7% for the C-R group (P = 0.3). CONCLUSIONS The vaccinated patients who recurred had more aggressive disease compared to V-NR patients. V-R patients had no difference in immune response to the vaccine either in vitro or in vivo. V-R patients, when compared to C-R patients, trended towards more aggressive disease, decreased recurrence rates, decreased mortality, and no bone-only recurrences.
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MESH Headings
- Adjuvants, Immunologic/administration & dosage
- Breast Neoplasms/immunology
- Breast Neoplasms/pathology
- Breast Neoplasms/prevention & control
- Cancer Vaccines/administration & dosage
- Cancer Vaccines/adverse effects
- Cancer Vaccines/immunology
- Dose-Response Relationship, Drug
- Female
- Granulocyte-Macrophage Colony-Stimulating Factor/administration & dosage
- HLA-A2 Antigen/genetics
- HLA-A2 Antigen/immunology
- HLA-A3 Antigen/genetics
- HLA-A3 Antigen/immunology
- Humans
- Kaplan-Meier Estimate
- Neoplasm Recurrence, Local/immunology
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/prevention & control
- Prognosis
- Receptor, ErbB-2/immunology
- Receptor, ErbB-2/therapeutic use
- Vaccines, Subunit/administration & dosage
- Vaccines, Subunit/adverse effects
- Vaccines, Subunit/immunology
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Affiliation(s)
- Asna Amin
- Department of Surgery, General Surgery Service, Walter Reed Army Medical Center, Washington, DC USA
| | - Linda C. Benavides
- Department of Surgery, General Surgery Service, Brooke Army Medical Center, 3851 Roger Brooke Drive, Ft. Sam Houston, TX 78234 USA
| | - Jarrod P. Holmes
- Department of Medicine, Division of Hematology and Medical Oncology, Naval Medical Center San Diego, San Diego, CA USA
| | - Jeremy D. Gates
- Department of Surgery, General Surgery Service, Brooke Army Medical Center, 3851 Roger Brooke Drive, Ft. Sam Houston, TX 78234 USA
| | - Mark G. Carmichael
- Cancer Vaccine Development Program, Department of Surgery, United States Military Cancer Institute, Uniformed Services University of the Health Sciences, Bethesda, MD USA
| | - Matthew T. Hueman
- Cancer Vaccine Development Program, Department of Surgery, United States Military Cancer Institute, Uniformed Services University of the Health Sciences, Bethesda, MD USA
| | | | - Catherine E. Storrer
- Cancer Vaccine Development Program, Department of Surgery, United States Military Cancer Institute, Uniformed Services University of the Health Sciences, Bethesda, MD USA
| | - Yusuf H. Jama
- Cancer Vaccine Development Program, Department of Surgery, United States Military Cancer Institute, Uniformed Services University of the Health Sciences, Bethesda, MD USA
| | - Dianna Craig
- Joyce Murtha Breast Care Center, Windber Medical Center, Windber, PA USA
| | - Alex Stojadinovic
- Department of Surgery, General Surgery Service, Walter Reed Army Medical Center, Washington, DC USA
| | - Sathibalan Ponniah
- Cancer Vaccine Development Program, Department of Surgery, United States Military Cancer Institute, Uniformed Services University of the Health Sciences, Bethesda, MD USA
| | - George E. Peoples
- Department of Surgery, General Surgery Service, Brooke Army Medical Center, 3851 Roger Brooke Drive, Ft. Sam Houston, TX 78234 USA
- Cancer Vaccine Development Program, Department of Surgery, United States Military Cancer Institute, Uniformed Services University of the Health Sciences, Bethesda, MD USA
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