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Barve M, Bender J, Senzer N, Cunningham C, Greco FA, McCune D, Steis R, Khong H, Richards D, Stephenson J, Ganesa P, Nemunaitis J, Ishioka G, Pappen B, Nemunaitis M, Morse M, Mills B, Maples PB, Sherman J, Nemunaitis JJ. Induction of Immune Responses and Clinical Efficacy in a Phase II Trial of IDM-2101, a 10-Epitope Cytotoxic T-Lymphocyte Vaccine, in Metastatic Non–Small-Cell Lung Cancer. J Clin Oncol 2008; 26:4418-25. [DOI: 10.1200/jco.2008.16.6462] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose Generation of broad cytotoxic T-lymphocyte responses against multiple epitopes and tumor-associated antigens (TAAs) may provide effective immunotherapy in patients with cancer. We evaluated a single-vial peptide vaccine consisting of nine HLA-A2 supertype-binding epitopes (two native and seven analog epitopes modified for optimal HLA binding or T-cell receptor stimulation) covering five TAAs and the universal helper pan-DR epitope, formulated as a stable emulsion with incomplete Freund's adjuvant (Montanide ISA 51; Seppic SA, Paris, France). The clinical efficacy, safety, and multiepitope immunogenicity of IDM-2101 was evaluated in patients with stage IIIB or IV non–small-cell lung cancer (NSCLC). Patients and Methods A total of 63 patients were enrolled who were positive for HLA-A2. End points included survival, safety, and immune response. IDM-2101 (previously EP-2101) was administered every 3 weeks for the first 15 weeks, then every 2 months through year 1, then quarterly through year 2, for a total of 13 doses. Epitope-specific cytotoxic and helper T-lymphocyte immunogenic responses were measured by the interferon gamma enzyme-linked immunosorbent spot assay. Results No significant adverse events were noted. Low-grade erythema and pain at the injection site were the most common adverse effects. One-year survival in the treated patients was 60%, and median survival was 17.3 months. One complete and one partial response were identified. Survival was longer in patients demonstrating an immune response to epitope peptides (P < .001). Conclusion IDM-2101 was well tolerated, and evidence of efficacy was suggested.
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Affiliation(s)
- Minal Barve
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - James Bender
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Neil Senzer
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Casey Cunningham
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - F. Anthony Greco
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - David McCune
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Ronald Steis
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Hung Khong
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Donald Richards
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Joe Stephenson
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Prasanthi Ganesa
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Jackie Nemunaitis
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Glenn Ishioka
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Beena Pappen
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Michael Nemunaitis
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Michael Morse
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Bonnie Mills
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Phillip B. Maples
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - Jeffrey Sherman
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
| | - John J. Nemunaitis
- From the Mary Crowley Cancer Research Centers; Baylor Sammons Cancer Center; Gradalis Inc; and Texas Oncology Physicians Association, Dallas; Tyler Cancer Center, Tyler, TX; IDM Pharma Inc, Irvine; Pharmexa-Epimmune, San Diego, CA; Sarah Cannon Cancer Center, Nashville, TN; Madigan Army Medical Center, Tacoma WA; Atlanta Cancer Care, Roswell, GA; University of South Alabama, Mitchell Cancer Institute, Mobile, AL; Cancer Center of the Carolinas, Greenville, SC; and Duke University Medical Center, Durham, NC
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