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Holmes JP, Everest DJ, Shuttleworth CM. Repeated squirrelpox infection in Welsh red squirrels. Vet Rec 2023; 192:128-129. [PMID: 36734577 DOI: 10.1002/vetr.2709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- J P Holmes
- APHA Shrewsbury, Veterinary Investigation Centre, Harlescott, Shrewsbury, Shropshire, SY14HD
| | - D J Everest
- APHA Weybridge, New Haw, Addlestone, Surrey, KT15 3NB
| | - C M Shuttleworth
- School of Natural Sciences, Bangor University, Bangor, Gwynedd, LL57 2UW
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Fullick E, Bidewell CA, Duff JP, Holmes JP, Howie F, Robinson C, Goodman G, Beckmann KM, Philbey AW, Daunt F. Mass mortality of seabirds in GB. Vet Rec 2022. [PMID: 35119735 DOI: 10.1002/vetr.1462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- E Fullick
- APHA Thirsk, North Yorkshire, YO7 1PZ
| | | | | | | | - F Howie
- SRUC Veterinary Services, Pentlands Science Park, Bush Loan, Penicuik, Midlothian, EH26 0PZ
| | - C Robinson
- SRUC Veterinary Services, Pentlands Science Park, Bush Loan, Penicuik, Midlothian, EH26 0PZ
| | | | | | - A W Philbey
- Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Easter Bush Campus, Midlothian, EH26 9RG
| | - F Daunt
- UK Centre for Ecology & Hydrology, Bush Estate, Penicuik, Midlothian, EH26 0QB
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Affiliation(s)
- J P Duff
- DoWS, APHA Penrith, Cumbria, CA11 9RR
| | | | - J P Holmes
- DoWS, APHA Shrewsbury, Shropshire, SY5 0YG
| | | | | | - Adrian M Whatmore
- Department of Bacteriology, APHA Weybridge, Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB
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Shuttleworth C, Everest D, Wood C, Holmes JP. Sympatric cases of squirrelpox in red and grey squirrels. Vet Rec 2021; 188:358. [PMID: 33960446 DOI: 10.1002/vetr.483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Craig Shuttleworth
- School of Natural Sciences, Bangor University, Bangor, Gwynedd, LL57 2UW
| | | | - C Wood
- APHA Weybridge, New Haw, Addlestone, Surrey, KT15 3NB
| | - J P Holmes
- APHA Shrewsbury, Veterinary Investigation Centre, Harlescott, Shrewsbury, Shropshire, SY1 4HD
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Affiliation(s)
- D J Everest
- APHA Weybridge, Woodham Lane, New Haw, Addlestone, Surrey KT15 3NB
| | - C M Shuttleworth
- School of Natural Sciences, Bangor University, Bangor, Gwynedd LL57 2UW
| | - J P Holmes
- APHA Shrewsbury, Veterinary Investigation Centre, Harlescott, Shrewsbury, Shropshire SY1 4HD
| | - S Bell
- APHA Shrewsbury, Veterinary Investigation Centre, Harlescott, Shrewsbury, Shropshire SY1 4HD
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Duff JP, Richey M, Holmes JP, Bianco C, Duff KP, Lawson B. Suspected collision trauma deaths in pied wagtails. Vet Rec 2020; 186:609-610. [PMID: 32527899 PMCID: PMC7365569 DOI: 10.1136/vr.m2272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
| | - M Richey
- APHA Shrewsbury, Kendal Road, Shrewsbury SY1 4HD
| | - J P Holmes
- APHA Shrewsbury, Kendal Road, Shrewsbury SY1 4HD
| | - C Bianco
- APHA Lasswade, Bush Loan Road, Penicuik, Midlothian EH26 OPZ
| | - K P Duff
- Coventry University, Coventry CV1 2TU
| | - B Lawson
- Institute of Zoology, Zoological Society of London, London NW1 4RY
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Bhattacharya S, Holmes JP, Calfa C, Lukas J, Tan-Chiu E, Clifton GT, Peoples GE, Lacher M, Wiseman CL, Williams WV. Abstract P2-09-09: Initial safety and efficacy of a phase I/IIa trial of a modified whole tumor cell targeted immunotherapy in patients with advanced breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-09-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: SV-BR-1-GM is a GM-CSF transfected breast cancer cell line which expresses HLA class I & II antigens. In a previous clinical trial, a partial response of widely metastatic breast cancer was seen in a patient who matched SV-BR-1-GM at HLA-DRB3*02:02. Here we report the safety and efficacy analysis with immunologic correlates of response in the initial patients in a phase I/IIa trial of SV-BR-1-GM in patients with advanced breast cancer
Methods: This phase I/IIa trial enrolled patients with recurrent and/or metastatic breast cancer refractory to standard chemotherapy/targeted-therapy. Patients received low-dose cyclophosphamide 2-3d prior to intradermal injection of SV-BR-1-GM (20x106 cells divided into 4 sites) and interferon-α into the inoculation sites (10,000 IU/site) ˜2 & 4 days subsequently. Cycles were 2 weeks x3 then q mo x 3. Adverse events (AE) were evaluated after each inoculation and graded via CTCAE v4.03. Immunologic response was measured by delayed type hypersensitivity (DTH) after each inoculation. Disease response was evaluated radiographically q3 mo and as clinically indicated (clinical trial NCT03066947).
Results: To date, twenty-two patients have been enrolled and 17 have been inoculated for a total of 39 SV-BR-1-GM inoculations given. Per inoculation, the maximum related AE was grade 1 in 64%, grade 2 in 7.7%, and grade 3 in 7.7%. There were no related grade >3 or unexpected AE. Efficacy data is available on the first six (Table). Tumor regression was seen in 2 patients. 01-002 presented with liver, bone and 20 classic miliary lung metastases (up to 9mm). This subject previously received 7 chemotherapy regimens. She matched SV-BR-1-GM at Class I & II HLA loci. Imaging at 3 mo showed virtually complete regression of all 20 identifiable lesions in the lungs. This response was maintained at 6 mo but the subject was taken off protocol because of disease progression (liver and bone). 01-005, matching HLA-A*24:02, had notable regression of cutaneous lesions, but progressed in pleural and pericardial effusions, had irreversible cardiac arrest (unlikely related). DTH increased in 01-002 from 4mm (first dose) to 47mm (8th dose). Three of 3 patients evaluated developed antibodies responses (as measured by flow cytometry with SV-BR-1) including 01-002. Interleukin 8 also increased in 01-002.
Conclusions: SV-BR-1-GM in this regimen appears to be safe and well-tolerated. In this initial exploratory analysis, SV-BR-1-GM can produce regression of pre-treated metastatic breast cancer correlating with an immunologic response. HLA matching is being evaluated as a predictor of response.
PatientAgeMetastatic Sites# Prior RegimensHLA Matches# of CyclesTumor Regression?01-00146Pleura, Lymph Nodes7 chemo/bio, 5 hormonalDRB3*02:021No01-00273Lung, Liver, Bone6 chemo, 1 hormonalA*24:02, DRB3*02:028Lungs01-00554Lymph nodes, Pleura, Skin3 chemo/bioA*24:022Skin02-00170Lymph nodes1 chemo/bioNone1No02-00361Bone, Brain3 chemoNone6No02-00474Lymph nodes, Cutaneous3 chemo/bio, 1 hormonalDRB3*02:022Lost to Follow-up
Citation Format: Bhattacharya S, Holmes JP, Calfa C, Lukas J, Tan-Chiu E, Clifton GT, Peoples GE, Lacher M, Wiseman CL, Williams WV. Initial safety and efficacy of a phase I/IIa trial of a modified whole tumor cell targeted immunotherapy in patients with advanced breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-09-09.
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Affiliation(s)
- S Bhattacharya
- Thomas Jefferson University, Philadelphia, PA; Redwood Reg Medcl Grp, Santa Rosa, CA; University of Miami, Miami, FL; The Everett Clinic, Everett, WA; Florida Cancer Specialists and Research Institute, Parkland, FL; Cancer Insight, San Antonio, TX; BriaCell Therapeutics Corporation, Berkeley, CA
| | - JP Holmes
- Thomas Jefferson University, Philadelphia, PA; Redwood Reg Medcl Grp, Santa Rosa, CA; University of Miami, Miami, FL; The Everett Clinic, Everett, WA; Florida Cancer Specialists and Research Institute, Parkland, FL; Cancer Insight, San Antonio, TX; BriaCell Therapeutics Corporation, Berkeley, CA
| | - C Calfa
- Thomas Jefferson University, Philadelphia, PA; Redwood Reg Medcl Grp, Santa Rosa, CA; University of Miami, Miami, FL; The Everett Clinic, Everett, WA; Florida Cancer Specialists and Research Institute, Parkland, FL; Cancer Insight, San Antonio, TX; BriaCell Therapeutics Corporation, Berkeley, CA
| | - J Lukas
- Thomas Jefferson University, Philadelphia, PA; Redwood Reg Medcl Grp, Santa Rosa, CA; University of Miami, Miami, FL; The Everett Clinic, Everett, WA; Florida Cancer Specialists and Research Institute, Parkland, FL; Cancer Insight, San Antonio, TX; BriaCell Therapeutics Corporation, Berkeley, CA
| | - E Tan-Chiu
- Thomas Jefferson University, Philadelphia, PA; Redwood Reg Medcl Grp, Santa Rosa, CA; University of Miami, Miami, FL; The Everett Clinic, Everett, WA; Florida Cancer Specialists and Research Institute, Parkland, FL; Cancer Insight, San Antonio, TX; BriaCell Therapeutics Corporation, Berkeley, CA
| | - GT Clifton
- Thomas Jefferson University, Philadelphia, PA; Redwood Reg Medcl Grp, Santa Rosa, CA; University of Miami, Miami, FL; The Everett Clinic, Everett, WA; Florida Cancer Specialists and Research Institute, Parkland, FL; Cancer Insight, San Antonio, TX; BriaCell Therapeutics Corporation, Berkeley, CA
| | - GE Peoples
- Thomas Jefferson University, Philadelphia, PA; Redwood Reg Medcl Grp, Santa Rosa, CA; University of Miami, Miami, FL; The Everett Clinic, Everett, WA; Florida Cancer Specialists and Research Institute, Parkland, FL; Cancer Insight, San Antonio, TX; BriaCell Therapeutics Corporation, Berkeley, CA
| | - M Lacher
- Thomas Jefferson University, Philadelphia, PA; Redwood Reg Medcl Grp, Santa Rosa, CA; University of Miami, Miami, FL; The Everett Clinic, Everett, WA; Florida Cancer Specialists and Research Institute, Parkland, FL; Cancer Insight, San Antonio, TX; BriaCell Therapeutics Corporation, Berkeley, CA
| | - CL Wiseman
- Thomas Jefferson University, Philadelphia, PA; Redwood Reg Medcl Grp, Santa Rosa, CA; University of Miami, Miami, FL; The Everett Clinic, Everett, WA; Florida Cancer Specialists and Research Institute, Parkland, FL; Cancer Insight, San Antonio, TX; BriaCell Therapeutics Corporation, Berkeley, CA
| | - WV Williams
- Thomas Jefferson University, Philadelphia, PA; Redwood Reg Medcl Grp, Santa Rosa, CA; University of Miami, Miami, FL; The Everett Clinic, Everett, WA; Florida Cancer Specialists and Research Institute, Parkland, FL; Cancer Insight, San Antonio, TX; BriaCell Therapeutics Corporation, Berkeley, CA
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Clifton GT, Kemp Bohan PM, Hale DF, Myers JW, Brown TA, Holmes JP, Vreeland TJ, Litton JK, Murthy RK, Mittendorf EA, Peoples GE. Abstract P2-09-01: Subgroups analysis of a multicenter, prospective, randomized, blinded phase 2b trial of trastuzumab + nelipeptimut-S (NeuVax) vs trastuzumab for prevention of recurrence in breast cancer patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-09-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:HER2 low-expressing (LE) (IHC 1-2+, FISH non-amplified) breast cancer (BC) patients (pts) have not benefited from HER2-directed therapy despite HER2 antigen availability. Triple negative BC (TNBC), in particular, is immunogenic and in need of additional therapeutic options. We have previously shown the HER2-derived nelipeptimut-S (E75) + GM-CSF (NeuVax) to be synergistic with trastuzumab (Tz) in pre-clinical and pilot clinical studies. In a planned interim analysis of a multi-center, prospective, randomized, single-blinded, placebo-controlled phase 2b trial of Tz + NeuVax vs Tz to reduce recurrence in HER2 LE, node-positive (NP) and/or triple negative BC (TNBC) pts, we previously reported that the NeuVax + Tz was safe without added cardiac toxicity and demonstrated a significant reduction of recurrences in TNBC pts. This analysis examines additional subsets in this trial.
Methods:HER2 LE, NP and/or TNBC pts who were clinically disease-free after standard therapy were randomized to receive Tz+NeuVax (vaccine group; VG) or Tz+GM-CSF (control group; CG). All pts received 1 yr of Tz per label. NeuVax or GM-CSF was given every 3 weeks x 6 starting with the 3rdTz dose, and then boosted every 6 months x 4. This pre-specified interim analysis was triggered 6 months after last enrollment. The primary endpoint is intention-to-treat 24 month disease-free survival (DFS) evaluated by log rank.
Results: Of 275 pts randomized in the study (VG n=136, CG n=139), 98 had TNBC (VG=53, CG=45). In the interim analysis, estimated disease-free survival (DFS) was assessed with a median follow up of 18.8 months. No significant clinicopathologic differences were seen between treatment groups. In the TNBC group, estimated DFS was higher overall in VG vs CG (91.9% v 69.9%, p=0.023; hazard ratio [HR] 0.29, 95% confidence interval [CI] 0.09-0.90). On TNBC subgroup analysis, estimated DFS was higher in VG vs CG among pts who received neoadjuvant chemotherapy (VG n=35, CG n=31; HR 0.26, CI 0.07-0.93; p=0.03), HER2 IHC 1+ BC (VG n=34, CG n=28; HR 0.20, CI 0.04-0.96; p=0.03), pts who were AJCC 7thedition stage I/II (VG n=37, CG n=27; HR incalculable, no recurrences in the VG, p=0.008), and pts 351yr of age (VG n=32 & CG n = 26; HR 0.26 CI 0.07,0.94; p=0.009). HRs did not appreciably vary based on the histologic grade or presence of lymphovascular invasion.
Conclusion:Examining the subgroups from the pre-specified interim analysis demonstrates a highly significant clinical benefit in TNBC pts overall. Within the TNBC cohort, specific benefit was seen in pts who received chemotherapy neoadjuvantly, expressed lower HER2, were earlier stage, and were older in age. These factors may help enrich the TNBC population targeted in a definitive Phase 3 study in TNBC patients with residual disease after neoadjuvant chemotherapy.
Citation Format: Clifton GT, Kemp Bohan PM, Hale DF, Myers JW, Brown TA, Holmes JP, Vreeland TJ, Litton JK, Murthy RK, Mittendorf EA, Peoples GE. Subgroups analysis of a multicenter, prospective, randomized, blinded phase 2b trial of trastuzumab + nelipeptimut-S (NeuVax) vs trastuzumab for prevention of recurrence in breast cancer patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-09-01.
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Affiliation(s)
- GT Clifton
- Brooke Army Medical Center, Fort Sam Houston, TX; St. Joseph Hospital, Santa Rosa, CA; MD Anderson Cancer Center, Houston, TX; Brigham and Women's Hospital, Boston, MA; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - PM Kemp Bohan
- Brooke Army Medical Center, Fort Sam Houston, TX; St. Joseph Hospital, Santa Rosa, CA; MD Anderson Cancer Center, Houston, TX; Brigham and Women's Hospital, Boston, MA; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - DF Hale
- Brooke Army Medical Center, Fort Sam Houston, TX; St. Joseph Hospital, Santa Rosa, CA; MD Anderson Cancer Center, Houston, TX; Brigham and Women's Hospital, Boston, MA; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - JW Myers
- Brooke Army Medical Center, Fort Sam Houston, TX; St. Joseph Hospital, Santa Rosa, CA; MD Anderson Cancer Center, Houston, TX; Brigham and Women's Hospital, Boston, MA; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - TA Brown
- Brooke Army Medical Center, Fort Sam Houston, TX; St. Joseph Hospital, Santa Rosa, CA; MD Anderson Cancer Center, Houston, TX; Brigham and Women's Hospital, Boston, MA; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - JP Holmes
- Brooke Army Medical Center, Fort Sam Houston, TX; St. Joseph Hospital, Santa Rosa, CA; MD Anderson Cancer Center, Houston, TX; Brigham and Women's Hospital, Boston, MA; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - TJ Vreeland
- Brooke Army Medical Center, Fort Sam Houston, TX; St. Joseph Hospital, Santa Rosa, CA; MD Anderson Cancer Center, Houston, TX; Brigham and Women's Hospital, Boston, MA; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - JK Litton
- Brooke Army Medical Center, Fort Sam Houston, TX; St. Joseph Hospital, Santa Rosa, CA; MD Anderson Cancer Center, Houston, TX; Brigham and Women's Hospital, Boston, MA; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - RK Murthy
- Brooke Army Medical Center, Fort Sam Houston, TX; St. Joseph Hospital, Santa Rosa, CA; MD Anderson Cancer Center, Houston, TX; Brigham and Women's Hospital, Boston, MA; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - EA Mittendorf
- Brooke Army Medical Center, Fort Sam Houston, TX; St. Joseph Hospital, Santa Rosa, CA; MD Anderson Cancer Center, Houston, TX; Brigham and Women's Hospital, Boston, MA; Uniformed Services University of the Health Sciences, Bethesda, MD
| | - GE Peoples
- Brooke Army Medical Center, Fort Sam Houston, TX; St. Joseph Hospital, Santa Rosa, CA; MD Anderson Cancer Center, Houston, TX; Brigham and Women's Hospital, Boston, MA; Uniformed Services University of the Health Sciences, Bethesda, MD
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Lasater EA, Massi ES, Stecula A, Politi J, Tan SK, Smith CC, Gunthorpe M, Holmes JP, Chehab F, Sali A, Shah NP. Novel TKI-resistant BCR-ABL1 gatekeeper residue mutations retain in vitro sensitivity to axitinib. Leukemia 2015; 30:1405-9. [PMID: 26511402 DOI: 10.1038/leu.2015.303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- E A Lasater
- Division of Hematology/Oncology, University of California, San Francisco, CA, USA
| | - E S Massi
- Division of Hematology/Oncology, University of California, San Francisco, CA, USA
| | - A Stecula
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
| | - J Politi
- Division of Hematology/Oncology, University of California, San Francisco, CA, USA
| | - S K Tan
- Division of Hematology/Oncology, University of California, San Francisco, CA, USA
| | - C C Smith
- Division of Hematology/Oncology, University of California, San Francisco, CA, USA
| | - M Gunthorpe
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - J P Holmes
- Annadel Medical Group, Santa Rosa, CA, USA
| | - F Chehab
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - A Sali
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA.,Department of Pharmaceutical Chemistry, University of California, San Francisco, CA, USA.,California Institute for Quantitative Biosciences, University of California, San Francisco, CA, USA
| | - N P Shah
- Division of Hematology/Oncology, University of California, San Francisco, CA, USA.,Helen Diller Comprehensive Cancer Center, University of California, San Francisco, CA, USA
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Mittendorf EA, Clifton GT, Holmes JP, Schneble E, van Echo D, Ponniah S, Peoples GE. Final report of the phase I/II clinical trial of the E75 (nelipepimut-S) vaccine with booster inoculations to prevent disease recurrence in high-risk breast cancer patients. Ann Oncol 2014; 25:1735-1742. [PMID: 24907636 PMCID: PMC4143091 DOI: 10.1093/annonc/mdu211] [Citation(s) in RCA: 177] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 05/24/2014] [Accepted: 05/27/2014] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND E75 (nelipepimut-S) is a human leukocyte antigen (HLA)-A2/A3-restricted immunogenic peptide derived from the HER2 protein. We have conducted phase I/II clinical trials vaccinating breast cancer patients with nelipepimut-S and granulocyte-macrophage colony-stimulating factor (GM-CSF) in the adjuvant setting to prevent disease recurrence. All patients have completed 60 months follow-up, and here, we report the final analyses. PATIENTS AND METHODS The studies were conducted as dose escalation/schedule optimization trials enrolling node-positive and high-risk node-negative patients with tumors expressing any degree of HER2 (immunohistochemistry 1-3+). HLA-A2/3+ patients were vaccinated; others were followed prospectively as controls. Local and systemic toxicity was monitored. Clinical recurrences were documented, and disease-free survival (DFS) was analyzed by Kaplan-Meier curves; groups were compared using log-rank tests. RESULTS Of 195 enrolled patients, 187 were assessable: 108 (57.8%) in the vaccinated group (VG) and 79 (42.2%) in the control group (CG). The groups were well matched for clinicopathologic characteristics. Toxicities were minimal. Five-year DFS was 89.7% in the VG versus 80.2% in the CG (P = 0.08). Due to trial design, 65% of patients received less than the optimal vaccine dose. Five-year DFS was 94.6% in optimally dosed patients (P = 0.05 versus the CG) and 87.1% in suboptimally dosed patients. A voluntary booster program was initiated, and among the 21 patients that were optimally boosted, there was only one recurrence (DFS = 95.2%). CONCLUSION The E75 vaccine is safe and appears to have clinical efficacy. A phase III trial evaluating the optimal dose and including booster inoculations has been initiated. CLINICAL TRIALS NCT00841399, NCT00584789.
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Affiliation(s)
- E A Mittendorf
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - G T Clifton
- Blanchfield Army Community Hospital, Fort Campbell
| | - J P Holmes
- Redwood Regional Medical Group, Santa Rosa
| | - E Schneble
- Department of Surgery, Brooke Army Medical Center, Ft Sam Houston
| | - D van Echo
- Department of Hematology Oncology, Walter Reed Army Medical Center, Washington
| | - S Ponniah
- Department of Surgery, Cancer Vaccine Development Program, United States Military Cancer Institute, Uniformed Services University of the Health Sciences, Bethesda, USA
| | - G E Peoples
- Department of Surgery, Brooke Army Medical Center, Ft Sam Houston; Department of Surgery, Cancer Vaccine Development Program, United States Military Cancer Institute, Uniformed Services University of the Health Sciences, Bethesda, USA.
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Payne JH, Holmes JP, Hogg RA, van der Burgt GM, Jewell NJ, Welchman DDB. Lead intoxication incidents associated with shot from clay pigeon shooting. Vet Rec 2013; 173:552. [PMID: 24277920 DOI: 10.1136/vr.102120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- J H Payne
- AHVLA Sutton Bonington, College Road, Sutton Bonington, Loughborough, Leicestershire LE12 5RB, UK
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Clifton GT, Sears AK, Patil R, Shumway NM, Carmichael MG, Van Echo DC, Holmes JP, McCall S, Merrill GA, Ponniah S, Peoples GE, Mittendorf EA. Monitoring of circulating tumor cell trends in a prospective, randomized, placebo-controlled HER2 /neu peptide vaccine trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e11126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sears AK, Clifton GT, Patil R, Shumway NM, Carmichael MG, Van Echo DC, Holmes JP, Ponniah S, Mittendorf EA, Peoples GE. Sequential administration of trastuzumab and a CD8 T-cell-eliciting HER2/neu peptide vaccine in patients with breast cancer compared to trastuzumab alone. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Affiliation(s)
- J. P. Duff
- VLA - Penrith; Merrythought, Calthwaite Penrith CA11 9RR
| | - J. P. Holmes
- VLA - Shrewsbury; Kendal Road, Harlescott Shrewsbury SY1 4HD
| | - A. M. Barlow
- VLA - Langford; Langford House Langford, Bristol BS40 5DX
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Clifton GT, Clive KS, Patil R, Holmes JP, Benavides LC, Gates JD, Tyler J, Mittendorf EA, Ponniah S, Peoples GE. Effect of a novel II-key hybrid HER2/neu peptide (AE37) vaccine with GM-CSF as compared to GM-CSF alone on levels of regulatory T-cell (Treg) populations. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.2565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Clive KS, Summers TA, Clifton GT, Patil R, Tyler J, Holmes JP, Mittendorf EA, Stojadinovic A, Ponniah S, Peoples GE. Assessment of circulating tumor cell (CTC) patterns among disease-free breast cancer patients vaccinated with adjuvant HER2/neu-based peptide vaccines. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.2542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Hogg RA, Holmes JP, Ghebrehewet S, Elders K, Hart J, Whiteside C, Willshaw GA, Cheasty T, Kay A, Lynch K, Pritchard GC. Probable zoonotic transmission of verocytotoxigenic Escherichia coli O 157 by dogs. Vet Rec 2009; 164:304-5. [PMID: 19270322 DOI: 10.1136/vr.164.10.304] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- R A Hogg
- VLA - Preston, Barton Hall, Garstang Road, Preston PR3 5HE, UK.
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Gates JD, Benavides LC, Carmichael MG, Hueman MT, Holmes JP, Khoo S, Stojadinovic A, von Hofe E, Ponniah S, Peoples GE. Circulating regulatory (CD4+CD25+FOXP3+) T cells decrease in breast cancer patients after vaccination with an Ii-Key-modified class II HER2/ neu peptide (AE37). Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-3134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #3134
Background: CD4+CD25+FOXP3+ regulatory T cells (Tregs) have been implicated in the suppression of immune responses against various tumors. To monitor the potential induction of Tregs in breast cancer (BrCa) patients receiving a modified HLA Class II HER2/neu peptide (AE37) vaccine in a clinical trial, we have analyzed peripheral blood lymphocytes (PBL) from vaccinated patients for the presence of Tregs and correlated our findings with ex vivo immune assays and in vivo delayed type hypersensitivity (DTH) responses to the vaccine. Methods: Fifteen BrCa patients have completed 6 monthly injections of the AE37+GM-CSF vaccine in a dose escalation safety study. The AE37 peptide consists of a HER2/neu peptide (776-790) linked to the Ii-Key moiety of the HLA Class II-associated invariant chain, which enhances epitope interaction with the Class II molecule. PBL obtained pre- and post-vaccination were stained with anti-CD4/CD25 (n=15) and FOXP3 (n=9) antibodies (PCH101 and 236A/E7) and analyzed by flow cytometry. Cells were also stimulated ex vivo with AE37 peptide to measure IFN-γ ELISPOT, proliferation (3H-thymidine-cpm) and cytokine secretion (TGF-β). DTH responses to the AE37 peptide pre- and post-vaccination were also recorded. Results: The mean CD4+ and CD4+CD25+ T cell populations for all patients (n=15) did not change from pre- to post-vaccination (CD4+ = 52.3+3.3% vs. 50.5+3.9%, p=0.6; CD4+CD25+ = 1.9+0.2% vs. 2.4+0.5%, p=0.2). Tregs (CD4+CD25+FOXP3+) were reduced in all 9 patients tested pre- to post-vaccination for both FOXP3 antibodies (Ab) (FOXP3 Ab1 = 2.1+0.2% vs. 1.1+0.1%, p=0.002; FOXP3 Ab2 = 2.0+0.2% vs. 1.0+0.2%, p=0.0009). There was no difference in pre- to post-vaccination levels of TGF-β (2720+582 pg/ml vs. 3387+848 pg/ml; p=0.9). AE37-specific proliferative responses increased from pre- to post-vaccination (34+23cpm vs. 6427+1431 cpm; p<0.001). ELISPOT demonstrated an increased response from pre- to long term (6-12mo.) post-vaccination (Median – 2 vs. 34 spots/106 cells; p=0.003). DTH responses increased in all patients from pre- to post-vaccination (3.6+1.4 mm vs. 56.0+9.4 mm; p<0.0001), and there appeared to be an inverse relationship between the degree of Treg reduction and the size of DTH response to AE37 (R2=0.83).
 Discussion: The novel AE37 HER2/neu peptide vaccine does not result in increased levels of Tregs. Furthermore, the reduced levels of Tregs in vaccinated patients appear to be associated with more robust responses in ex vivo immune assays and in vivo DTH reactions suggesting that the AE37 vaccine may be clinically useful.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3134.
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Affiliation(s)
- JD Gates
- 1 Dept. of Surgery, Brooke Army Medical Center, Ft. Sam Houston, TX
| | - LC Benavides
- 1 Dept. of Surgery, Brooke Army Medical Center, Ft. Sam Houston, TX
| | - MG Carmichael
- 2 Cancer Vaccine Development Program, USMCI, Dept. of Surgery, USUHS, Bethesda, MD
| | - MT Hueman
- 2 Cancer Vaccine Development Program, USMCI, Dept. of Surgery, USUHS, Bethesda, MD
| | - JP Holmes
- 3 Dept. of Hematology/Oncology, Naval Medical Center San Diego, San Diego, CA
| | - S Khoo
- 2 Cancer Vaccine Development Program, USMCI, Dept. of Surgery, USUHS, Bethesda, MD
| | - A Stojadinovic
- 4 Dept. of Surgery, Walter Reed Army Medical Center, Washington, DC
| | | | - S Ponniah
- 2 Cancer Vaccine Development Program, USMCI, Dept. of Surgery, USUHS, Bethesda, MD
| | - GE Peoples
- 1 Dept. of Surgery, Brooke Army Medical Center, Ft. Sam Houston, TX
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Benavides LC, Gates JD, Holmes JP, Mittendorf EA, Ponniah S, Peoples GE. Optimal method of dosing HER2/ neu peptide vaccines: U.S. Military Cancer Institute Clinical Trials Group Study 1-01, 1-02, 1-03, and 1-04. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-3139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #3139
Background: Our Cancer Vaccine Development Program has performed phase I and II clinical trials using immunogenic peptides from the HER2/neu protein. AE37 (aa:776-790+Ii-Key) is HLA promiscuous whereas E75 (aa:369-377) and GP2 (aa:654-662) are HLA-A2/A3+ restricted. The peptides are located on the intracellular, extracellular, and transmembrane portions of the HER2/neu protein. We evaluate patients who required dose reductions and compare them to those who did not in our three peptide vaccine trials to determine the immunologic and clinical relevance of different responses to the peptide vaccines. Methods: Three vaccine trials were performed separately with similar dose escalation design by varying the amount of AE37, GP2 or E75 peptide and GM-CSF adjuvant. Dose reductions (DR) were made in event of significant toxicity (>100mm local or ≥grade 2 systemic) by decreasing GM-CSF (or peptide if no GM-CSF) by 50% for subsequent inoculations. We compared patients necessitating DR and those who did not. Immune response was measured ex vivo via 3H-thymidine proliferative assays or HLA-A2:Ig dimer assays and in vivo via DTH reactions pre- and post-vaccine. Recurrence and mortality data were available for E75 treated patients at 30-month median follow-up. Results: 132 patients underwent peptide vaccination and 39 patients required DR (Table 1).
 
 No patient had grade 3-5 local or systemic toxicities. DR patients, particularly those reduced for robust local reactions (DR-L), had greater immune responses ex vivo and in vivo. The post-vaccine DTH in DR-L patients compared to all other vaccinated patients was significantly larger in E75 (24.5±4.1mm vs. 12.7±1.3mm; p=0.001) and trended towards significant in AE37 (69.4±10.3mm vs. 35.8±14.9mm; p=0.08) and GP2 (48.9±14.1mm vs. 24.1±3.3mm; p=0.08). No recurrences or deaths were noted in the E75 DR patients; but for patients not requiring dose reductions there were 10 (12.5%) recurrences and 1 (1.25%) death.Discussion: All three peptide vaccines are safe and well-tolerated with minimal toxicity. The safety was partly due to reducing GM-CSF (or peptide if no GM-CSF) by 50% for patients with >100mm local reactions or >grade 2 systemic toxicity. DR patients, particularly DR-L patients, immunological responses were larger. This increased immune response (noted by DTH) suggests improved clinical response as there have been no recurrences or deaths among DR patients. Our analysis indicates that the optimal method of dosing HER2/neu peptide vaccines consists of constant peptide dose with a large enough dose of adjuvant to generate robust local reactions and that when local reactions are >100mm performing DR of adjuvant by 50% for subsequent inoculations.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3139.
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Affiliation(s)
- LC Benavides
- 1 Dept. of Surgery, Brooke Army Medical Center, Ft. Sam Houston, TX
| | - JD Gates
- 1 Dept. of Surgery, Brooke Army Medical Center, Ft. Sam Houston, TX
| | - JP Holmes
- 2 Naval Medical Center, San Diego, CA
| | | | - S Ponniah
- 4 CVDL, Dept. of Surgery, USUHS, Bethesda, MD
| | - GE Peoples
- 1 Dept. of Surgery, Brooke Army Medical Center, Ft. Sam Houston, TX
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Gates JD, Benavides LC, Stojadinovic A, Mittendorf EA, Holmes JP, Carmichael MG, McCall S, Milford AL, Merrill GA, Ponniah S, Peoples GE. Monitoring circulating tumor cells in cancer vaccine trials. Hum Vaccin 2008; 4:389-92. [PMID: 18437056 DOI: 10.4161/hv.4.5.6115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The presence of circulating tumor cells (CTC) from various cancers has provided a wealth of information and possibilities. As the role of CTC detection in the treatment assessment of metastatic breast cancer becomes standard, there is interest in applying this tool in cancer vaccine development and clinical trial monitoring. Since we lack a proven immunologic assay that correlates with clinical response, CTC detection, quantification and phenotypic characterization may be a useful surrogate for clinical outcome. The Cancer Vaccine Development Program is involved in the development of HER2/neu peptide based vaccine development for the prevention of recurrence in HER2/neu expressing cancers like breast cancer. The CellSearch System (Veridex, LLC Warren, NJ) has been used by our lab in conjunction with in vivo and/or in vitro immunologic measurements to define a monitoring tool that could predict clinical response. Once validated, this assay could significantly shorten clinical trials and lead to more efficient assessment of potentially promising cancer vaccines.
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Affiliation(s)
- J D Gates
- Department of Surgery, General Surgery Service, Brooke Army Medical Center, Ft. Sam Houston, Texas 78234, USA
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Phipps LP, Duff JP, Holmes JP, Gough RE, McCracken F, McElhinney LM, Johnson N, Hughes L, Chantrey J, Pennycott T, Murray KO, Brown IH, Fooks AR. Surveillance for West Nile virus in British birds (2001 to 2006). Vet Rec 2008; 162:413-5. [PMID: 18375986 DOI: 10.1136/vr.162.13.413] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- L P Phipps
- Veterinary Laboratories Agency - Weybridge, New Haw, Addlestone, Surrey KT15 3NB, UK
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Gates JD, Benavides LC, Carmichael MG, Holmes JP, Hueman MT, Mittendorf EA, McLeod DG, Ponniah S, Peoples GE. Long-term follow-up assessment of a HER-2/neu peptide (E75) vaccine for the prevention of recurrence in high-risk prostate cancer patients. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.3067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Carmichael MG, Peoples GE, Benevides LC, Gates JD, Patil R, Amin A, Jama YH, Craig D, Ponniah S, Holmes JP. Increased incidence of HLA-DR3+ individuals amongst HER2/neu expressing breast cancer patients. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.22215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Benavides LC, Holmes JP, Gates JD, Carmichael MG, Hueman MT, Mittendorf EA, von Hofe E, Ponniah S, Peoples GE. Results of the first phase I clinical trial of the novel Ii-key hybrid preventive HER2/neu peptide (AE37) vaccine: United States Military Cancer Institute Clinical Trials Group Study I-03. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.3016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Foster AP, Houlihan MG, Holmes JP, Watt EJ, Higgins RJ, Errington J, Ibata G, Wakeley PR. Bovine viral diarrhoea virus infection of alpacas (Vicugna pacos
) in the uk. Vet Rec 2007; 161:94-9. [PMID: 17652435 DOI: 10.1136/vr.161.3.94] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Three alpacas (Vicugna pacos) aged two to 22 months with a history of illthrift and diarrhoea were examined postmortem, and tissues were collected for histology, including immunohistochemical labelling for pestivirus antigen, virus isolation and TaqMan reverse transcriptase-pcr assay. Blood samples from two clinical cases and the remaining herd members were tested for bovine viral diarrhoea virus (bvdv) antibody by serum neutralisation, antigen detection and pcr assay. The three affected alpacas were positive for bvdv by pcr of splenic tissue and/or heparinised blood. Non-cytopathic bvdv was isolated from several tissues and plasma of two of the alpacas. dna sequencing and phylogenetic analysis of the viral genome from the pcr product showed that the bvdv was of subgenotype 1b. Immunohistochemical examination of brain tissue was positive in two cases, consistent with a persistent infection. bvdv antibodies were detected in 16 of 25 clinically unaffected alpacas. There was no evidence of persistent infection in the in-contact animals. The source of the infection was not determined.
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Affiliation(s)
- A P Foster
- Veterinary Laboratories Agency (VLA) - Shrewsbury, Kendal Road, Harlescott, Shrewsbury, Shropshire SY1 4HD
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Amin A, Stojadinovic A, Holmes JP, Storrer CE, Smith AM, Jama YH, Craig D, Ponniah S, Peoples GE. Assessment of circulating tumor cell (CTC) patterns among disease-free breast cancer patients vaccinated with a preventive HER2/neu E75-peptide vaccine. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.3059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3059 Background: The quantity of CTC and post-treatment reduction predict outcome in medically treated metastatic breast cancer patients (BCa); however, the impact on survival of CTC in patients at risk for recurrence rendered free of disease after multimodality treatment is unknown. We conducted a pilot study to assess CTC in clinically disease-free node-positive (NP) BCa patients, and to determine the effect on CTC of vaccination with the immunogenic HER2/neu peptide E75. Methods: The CellSearch System (Veridex, LLC Warren, NJ) was used to enumerate total CTC and HER2/neu+ CTC in 20 ml of blood from selected samples obtained from patients (n=16) throughout and after the E75 vaccination series. Standard prognostic factors were collected on these patients as were measures of their immunologic response to the vaccine. Results: 14/16 patients (88%) had at least 1 CTC and 10/16 (63%) had 2 or more CTC identified. Standard clinical prognostic factors (tumor size, grade, lymph nodes and HER2/neu overexpression) did not correlate with number of CTC. Thus far, 9 patients have had multiple samples collected prior to, during and/or after the vaccine series. Early levels of CTC were significantly higher (mean±SE=5.2±0.5) vs. post-vaccination levels (0.3±0.1, p=0.005). Levels of HER2/neu+ CTC were also significantly different (early 3.4±0.3 vs. post 0.4±0.1, p=0.01). All patients showed a decline in CTC from early to post levels while demonstrating HER2/neu immunity as measured by DTH to the E75 peptide post- vaccination (22.9±1.8 mm vs. control 4±0.9 mm, p=0.006). Conclusions: CTCs are readily demonstrated in clinically disease-free NP BCa patients. Prognostic indicators do not seem to correlate with the number of CTCs. CTCs decline during the course of vaccination. These data suggest a potential role for the CTC assay in assessing response to preventive vaccine-based immunotherapy. The views expressed in this abstract are those of the authors and do not necessarily reflect the official policy or position of the Departments of Army or Navy, Department of Defense or the U.S. Government. No significant financial relationships to disclose.
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Affiliation(s)
- A. Amin
- Cancer Vaccine Development Laboratory, Bethesda, MD; Walter Reed Army Medical Center, Washington, DC; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - A. Stojadinovic
- Cancer Vaccine Development Laboratory, Bethesda, MD; Walter Reed Army Medical Center, Washington, DC; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - J. P. Holmes
- Cancer Vaccine Development Laboratory, Bethesda, MD; Walter Reed Army Medical Center, Washington, DC; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - C. E. Storrer
- Cancer Vaccine Development Laboratory, Bethesda, MD; Walter Reed Army Medical Center, Washington, DC; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - A. M. Smith
- Cancer Vaccine Development Laboratory, Bethesda, MD; Walter Reed Army Medical Center, Washington, DC; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - Y. H. Jama
- Cancer Vaccine Development Laboratory, Bethesda, MD; Walter Reed Army Medical Center, Washington, DC; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - D. Craig
- Cancer Vaccine Development Laboratory, Bethesda, MD; Walter Reed Army Medical Center, Washington, DC; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - S. Ponniah
- Cancer Vaccine Development Laboratory, Bethesda, MD; Walter Reed Army Medical Center, Washington, DC; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - G. E. Peoples
- Cancer Vaccine Development Laboratory, Bethesda, MD; Walter Reed Army Medical Center, Washington, DC; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
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Holmes JP, Amin A, Storrer CE, Smith AM, Jama YH, McNeil A, Craig D, Ponniah S, Peoples GE. Clinical and immunologic effects of a HER2/ neu (E75) peptide vaccine booster in previously vaccinated breast cancer patients. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.3014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3014 Background: We are conducting clinical trials of the HER2/neu E75-peptide vaccine in clinically disease-free breast cancer (BCa) patients. Our Phase I/II trials have shown that the E75+GM-CSF vaccine is safe and effective in stimulating clonal expansion of E75-specific CD8+ T-cells. Since peptide vaccines may not lead to long term immunity, we have assessed the need for and response to a vaccine booster for patients after completion of their primary vaccination series. Methods: BCa patients enrolled in our E75 vaccine trials who were >6 months from the completion of their primary vaccination series were offered a single 1000 mcg dose of E75 peptide with 250 mcg of GM-CSF. Patients were monitored for local and systemic toxicity. E75-specific CD8+ T-cells were quantified using the HLA-A2:IgG dimer before and after booster administration. Results: 19 patients have received the vaccine booster. Median time from primary vaccine series was 12 months (range 6–25) and median residual E75-specific immunity was 0.61% (range 0- 3.43%). Significant residual immunity (SRI=CD8+ E75-specific T-cells >0.5%) was seen in 71% of patients <12 months from primary vaccination vs. 33% of patients ≥12 months. Graded local toxicities were as follows: 18/19 (94.7%) grade 1; 1/19 (5.3%) grade 2. Only 6/19 (31.6%) experienced even grade 1 systemic toxicity. Local reactions were more robust in patients receiving the booster <12 months from primary vaccine compared to those ≥12 months (99±2.8 mm vs. 75±1 mm, p=0.01). In patients lacking SRI, 80% showed increased specific immunity post-vaccination. In these patients, the average CD8+ E75-specific T-cells pre-booster vs. post-booster was 0.37±0.03% vs. 1.06 ± 0.14% (p=0.07). Conclusions: The HER2/neu peptide vaccine E75 stimulates specific immunity in disease-free BCa patients. However, only about half of patients show SRI at median follow-up of 12 months. A vaccine booster is safe and highly effective in stimulating E75-specific immunity especially in those patients without SRI. Initial results suggest that the booster should be given within a year of completion of the initial vaccine series. No significant financial relationships to disclose.
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Affiliation(s)
- J. P. Holmes
- Cancer Vaccine Development Laboratory, Bethesda, MD; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - A. Amin
- Cancer Vaccine Development Laboratory, Bethesda, MD; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - C. E. Storrer
- Cancer Vaccine Development Laboratory, Bethesda, MD; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - A. M. Smith
- Cancer Vaccine Development Laboratory, Bethesda, MD; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - Y. H. Jama
- Cancer Vaccine Development Laboratory, Bethesda, MD; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - A. McNeil
- Cancer Vaccine Development Laboratory, Bethesda, MD; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - D. Craig
- Cancer Vaccine Development Laboratory, Bethesda, MD; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - S. Ponniah
- Cancer Vaccine Development Laboratory, Bethesda, MD; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
| | - G. E. Peoples
- Cancer Vaccine Development Laboratory, Bethesda, MD; Windber Medical Center, Windber, PA; Brooke Army Medical Center, Fort Sam Houston, TX
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Holmes JP, Reid TJ. Dramatic response of metastatic peripheral nerve sheath sarcoma to cetuximab combined with doxorubicin-based chemotherapy: Report of a case. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.19503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
19503 Background: Soft tissue sarcomas are aggressive tumors that often show poor response to conventional chemotherapy agents. Some of these tumors over express epidermal growth factor receptor (EGFR) which is thought to promote tumor growth. Cetuximab, a monoclonal antibody to EGFR, is FDA approved for use in colon cancer. We report a case here of use in a patient with an aggressive soft tissue sarcoma. Case Report: A 32 yr male presented in April 2005 for routine follow up three months after completing adjuvant radiotherapy for retroperitoneal soft tissue sarcoma. At this time the patient was found to have recurrence of disease on routine surveillance scans. During workup of the recurrent masses, he developed acute bowel obstruction and went emergently to the OR. Multiple masses were removed and he was rendered grossly disease free. Adjuvant adriamycin and ifosfamide were planned; however, bulky masses were again noted on a pre-chemo staging study. After a single cycle of chemotherapy, he presented with abdominal pain, and an urgent CT scan ordered showed progressive disease. Immunohistochemical stains demonstrated strong expression of EGFR on his tumor. Cetuximab was added to his chemotherapy regimen. Repeat studies showed dramatic (>30%) decrease in his tumor burden after only two doses. As cycle three began, the patient developed acute abdominal pain and fever; emergent scans showed free air within the abdomen. The majority of his tumor burden had continued to decrease. The perforation could not be surgically managed and the patient was discharged to hospice. He expired ten days after discovery of the perforation. Conclusions: Addition of cetuximab to therapy for an aggressive soft tissue sarcoma which overexpressed EGFR resulted in dramatic decrease in tumor burden. Unfortunately, the patient suffered perforation of abdominal viscera and subsequently expired. Rapid tumor shrinkage likely contributed to the perforation. Use of cetuximab in patients with aggressive tumors expressing EGFR should be explored in the setting of clinical trials. No significant financial relationships to disclose.
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Affiliation(s)
- J. P. Holmes
- National Naval Medical Center, Bethesda, MD; Walter Reed Army Medical Center, Washington, DC
| | - T. J. Reid
- National Naval Medical Center, Bethesda, MD; Walter Reed Army Medical Center, Washington, DC
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Holmes JP, Jones JR, Gough RE, Welchman DDB, Wessels ME, Jones EL. Goose parvovirus in England and Wales. Vet Rec 2004; 155:127. [PMID: 15328745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Holmes JP, Gulabivala K, van der Stelt PF. Detection of simulated internal tooth resorption using conventional radiography and subtraction imaging. Dentomaxillofac Radiol 2001; 30:249-54. [PMID: 11571543 DOI: 10.1038/sj/dmfr/4600626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2000] [Accepted: 04/25/2001] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To compare the diagnostic accuracy of conventional radiography with digital subtraction imaging in the detection of simulated internal resorption. METHODS Simulated resorption cavities were created by the sequential use of progressively larger round burs (ISO size range 006-016) in the labial wall of the coronal or apical thirds of the pulp chamber of the maxillary incisors of two cadavers. Five viewers examined 120 pairs of radiographs, one of each pair being baseline (no lesion) and the other with or without a lesion. The process was then repeated with subtraction images of the pairs of radiographs. Receiver Operating Characteristic (ROC) analysis was used to compare the diagnostic accuracy of the two imaging modalities. RESULTS Using conventional radiography, the minimum lesion size detectable coronally was in the 'medium' range (ISO size 010 and 012 round burs), but only 'large' lesions (ISO size 014 and 016) could be detected in the apical region. The overall diagnostic accuracy of subtraction imaging was superior to conventional radiography but only significant (P<0.05) for coronal lesions. CONCLUSION Subtraction radiography may be a useful tool for detecting and monitoring the progress of internal root resorption.
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Affiliation(s)
- J P Holmes
- Department of Conservative Dentistry, Eastman Dental Institute for Oral Health Care Sciences, University College London, London, UK
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Holmes JP, Gulabivala K, van der Stelt PF. Detection of simulated internal tooth resorption using conventional radiography and subtraction imaging. Dentomaxillofac Radiol 2001. [DOI: 10.1038/sj.dmfr.4600626] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Holmes JP. Lungworm infection in housed calves. Vet Rec 1999; 145:743-4. [PMID: 10972117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Holmes JP. Funding for wildlife disease research. Vet Rec 1999; 145:56. [PMID: 10458587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Dartnall NA, Holmes JP, Morgan SN, McDougle CJ. Brief report: two-year control of behavioral symptoms with risperidone in two profoundly retarded adults with autism. J Autism Dev Disord 1999; 29:87-91. [PMID: 10097998 DOI: 10.1023/a:1025926817928] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- N A Dartnall
- Connecticut Department of Mental Retardation, South Central Region, Wallingford 06492, USA
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Potenza MN, Holmes JP, Kanes SJ, McDougle CJ. Olanzapine treatment of children, adolescents, and adults with pervasive developmental disorders: an open-label pilot study. J Clin Psychopharmacol 1999; 19:37-44. [PMID: 9934941 DOI: 10.1097/00004714-199902000-00008] [Citation(s) in RCA: 172] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This pilot study examined the efficacy and tolerability of olanzapine in the treatment of children, adolescents, and adults with pervasive developmental disorders (PDDs). Eight patients with principal diagnoses (DSM-IV) of autistic disorder (N = 5) or PDD not otherwise specified (N = 3) were given olanzapine in an open-label, prospective fashion for 12 weeks. Clinical ratings were obtained at baseline and at the end of weeks (EOWs) 4, 8, and 12. Seven of eight patients completed the 12-week trial, and six of the completers were deemed clinical responders as measured by ratings at the EOW 12 of "much improved" or "very much improved" on the global improvement item of the Clinical Global Impression Scale. Significant improvements in overall symptoms of autism, motor restlessness or hyperactivity, social relatedness, affectual reactions, sensory responses, language usage, self-injurious behavior, aggression, irritability or anger, anxiety, and depression were observed. Significant changes in repetitive behaviors were not observed for the group. The EOW 12 mean +/- SD daily dose of olanzapine was 7.8 +/- 4.7 mg/day. The drug was well tolerated with the most significant adverse effects noted to be increased appetite and weight gain in six patients and sedation in three. With respect to weight gain, the mean +/- SD weight for the group increased from 137.50 +/- 55.81 pounds (62.50 +/- 25.37 kilograms) at baseline to 155.94 +/- 55.13 pounds (70.88 +/- 25.06 kilograms) at EOW 12. No evidence of extrapyramidal side effects or liver function abnormalities was seen. These preliminary results suggest that olanzapine may be an effective and well tolerated drug in targeting core and related symptoms of PDDs in children, adolescents, and adults. Further studies, particularly those that are placebo-controlled and double-blinded, are indicated to better define the clinical use of olanzapine in these patient populations.
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Affiliation(s)
- M N Potenza
- Connecticut Mental Health Center, Department of Psychiatry, Yale University School of Medicine, New Haven, USA
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McDougle CJ, Holmes JP, Carlson DC, Pelton GH, Cohen DJ, Price LH. A double-blind, placebo-controlled study of risperidone in adults with autistic disorder and other pervasive developmental disorders. Arch Gen Psychiatry 1998; 55:633-41. [PMID: 9672054 DOI: 10.1001/archpsyc.55.7.633] [Citation(s) in RCA: 221] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Neurobiological research has implicated the dopamine and serotonin systems in the pathogenesis of autism. Open-label reports suggest that the serotonin2A-dopamine D2 antagonist risperidone may be safe and effective in reducing the interfering symptoms of patients with autism. METHODS Thirty-one adults (age [mean+/-SD], 28.1+/-7.3 years) with autistic disorder (n=17) or pervasive developmental disorder not otherwise specified (n=14) participated in a 12-week double-blind, placebo-controlled trial of risperidone. Patients treated with placebo subsequently received a 12-week open-label trial of risperidone. RESULTS For persons completing the study, 8 (57%) of 14 patients treated with risperidone were categorized as responders (daily dose [mean+/-SD], 2.9+/-1.4 mg) compared with none of 16 in the placebo group (P<.002). Risperidone was superior to placebo in reducing repetitive behavior (P<.001), aggression (P<.001), anxiety or nervousness (P<.02), depression (P<.03), irritability (P<.01), and the overall behavioral symptoms of autism (P<.02). Objective, measurable change in social behavior and language did not occur. Nine (60%) of 15 patients who received treatment with open-label risperidone following the double-blind placebo phase responded. Other than mild, transient sedation, risperidone was well tolerated, with no evidence of extrapyramidal effects, cardiac events, or seizures. CONCLUSION Risperidone is more effective than placebo in the short-term treatment of symptoms of autism in adults.
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Affiliation(s)
- C J McDougle
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis 46202-5200, USA.
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David GP, Holmes JP, Adams WF. Neurological condition in polled Dorset lambs. Vet Rec 1997; 141:27. [PMID: 9248025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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McDougle CJ, Holmes JP, Bronson MR, Anderson GM, Volkmar FR, Price LH, Cohen DJ. Risperidone treatment of children and adolescents with pervasive developmental disorders: a prospective open-label study. J Am Acad Child Adolesc Psychiatry 1997; 36:685-93. [PMID: 9136504 DOI: 10.1097/00004583-199705000-00020] [Citation(s) in RCA: 169] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To investigate the short-term safety and efficacy of risperidone in the treatment of children and adolescents with pervasive developmental disorders. METHOD This was a 12-week, prospective, systematic, open-label trial that included 18 subjects (15 boys and 3 girls) with a mean age of 10.2 +/- 3.7 years. The sample included 11 subjects with autistic disorder, 3 with Asperger's disorder, 1 with childhood disintegrative disorder, and 3 with pervasive developmental disorder not otherwise specified. Fourteen subjects had comorbid mental retardation. Behavioral ratings were obtained during two baseline visits and again after 12 weeks of risperidone treatment. RESULTS The optimal dose of risperidone for the 18 subjects was 1.8 +/- 1.0 mg/day. On the basis of the global improvement item of the Clinical Global Impression Scale, 12 of 18 subjects were considered responders. Significant improvement was seen in measures of interfering repetitive behavior, aggression and impulsivity, and some elements of impaired social relatedness. The most common side effect was weight gain (range 10 to 35 lb). CONCLUSIONS These preliminary results suggest that risperidone may be effective for improving interfering behavioral symptoms in some children and adolescents with pervasive developmental disorders. Double-blind, placebo-controlled studies are needed before definitive statements of safety and efficacy can be made.
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Affiliation(s)
- C J McDougle
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Cox IS, Lichtiger B, Holmes JP. Recovery of lymphocytes from clotted blood for HLA typing. J Immunol Methods 1978; 22:385-8. [PMID: 681762 DOI: 10.1016/0022-1759(78)90046-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
A method to recover lymphoid cells from clotted blood for the microcytotoxicity test used in HLA typing is described. The procedure consists of disruption of the clotted blood followed by Ficoll-Hypaque gradient purification of the mononuclear cells. The results of HLA typing of lymphocytes from unclotted and clotted blood were identical.
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Holmes JP. Cleaning the Teeth. Dent Regist 1869; 23:361-364. [PMID: 33697499 PMCID: PMC6910486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Holmes JP. Dental Squibs. Dent Regist 1869; 23:188-190. [PMID: 33697458 PMCID: PMC6910313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Holmes JP. Digestion. Dent Regist 1866; 20:121-124. [PMID: 33697611 PMCID: PMC6911420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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