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Sánchez Ramírez J, Morera Díaz Y, Bequet-Romero M, Ayala Ávila M. Potential mechanisms involved on how systemic IgG antibodies specific to vascular endothelial growth factor (VEGF) and induced by active immunotherapy decrease platelet derived free-VEGF. Platelets 2022; 33:964-968. [DOI: 10.1080/09537104.2022.2042235] [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: 10/18/2022]
Affiliation(s)
- Javier Sánchez Ramírez
- Department of Pharmaceuticals, Center of Genetic Engineering and Biotechnology (CIGB), Playa, Cuba
| | - Yanelys Morera Díaz
- Department of Pharmaceuticals, Center of Genetic Engineering and Biotechnology (CIGB), Playa, Cuba
| | - Mónica Bequet-Romero
- Department of Pharmaceuticals, Center of Genetic Engineering and Biotechnology (CIGB), Playa, Cuba
| | - Marta Ayala Ávila
- Department of Pharmaceuticals, Center of Genetic Engineering and Biotechnology (CIGB), Playa, Cuba
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Sánchez Ramírez J, Morera Díaz Y, Bequet-Romero M, Hernández-Bernal F, Martín Bauta Y, Selman-Housein Bernal KH, de la Torre Santos AV, Pérez de la Iglesia M, Trimiño Lorenzo L, Ayala Avila M. Specific humoral response in cancer patients treated with a VEGF-specific active immunotherapy procedure within a compassionate use program. BMC Immunol 2020; 21:12. [PMID: 32171254 PMCID: PMC7071683 DOI: 10.1186/s12865-020-0338-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/14/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND CIGB-247 is a cancer therapeutic vaccine that uses as antigen a variant of human vascular endothelial growth factor (VEGF) mixed with the bacterially-derived adjuvant VSSP. CIGB-247 has been already evaluated in two phase I clinical trials (CENTAURO and CENTAURO-2), showing to be safe and immunogenic in advanced cancer patients selected under well-defined and controlled clinical conditions. Surviving patients were submitted to monthly re-immunizations and some of them showed objective clinical benefits. Based on these results, a compassionate use program (CUP) with CIGB-247 was initiated for patients that did not meet the strict entry criteria applied for the CENTAURO and CENTAURO-2 clinical trials, but could potentially benefit from the application of this cancer therapeutic vaccine. RESULTS Polyclonal IgM, IgA and IgG antibodies specific for VEGF were detected by ELISA in serum samples from patients vaccinated with 400 μg of antigen combined with 200 μg of VSSP. Polyclonal antibody response showed no cross reactivity for other VEGF family member molecules like VEGF-C and VEGF-D. Serum from immunized individuals was able to block the binding of VEGF to its receptors VEGFR2 and VEGFR1. IgG fraction purified from immune sera shared the aforementioned characteristics and also inhibited the interaction between VEGF and the therapeutic recombinant antibody bevacizumab, an anti-angiogenic drug approved for the treatment of different tumors. No serious adverse events attributable to CIGB-247 have been documented yet in participants of the CIGB-247 CUP. The present paper is a first report of our findings concerning the humoral response and safety characteristics in treated CIGB-247 CUP cancer patients. The study has provided the unique opportunity of not only testing CIGB-247 in a broader clinical spectrum sample of Cuban cancer patients, but also within the context of the day-to-day clinical practice and treatment settings for these diseases in Cuban medical institutions. CONCLUSIONS The CIGB-247 CUP has demonstrated that immunization and follow-up of a variety of cancer patients, under day-to-day clinical practice conditions in several Cuban medical institutions, replicate our previous findings in clinical trials: CIGB-247 is safe and immunogenic.
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Affiliation(s)
- Javier Sánchez Ramírez
- Department of Pharmaceuticals, Center of Genetic Engineering and Biotechnology (CIGB), Playa, 10600 Havana, Cuba
| | - Yanelys Morera Díaz
- Department of Pharmaceuticals, Center of Genetic Engineering and Biotechnology (CIGB), Playa, 10600 Havana, Cuba
| | - Mónica Bequet-Romero
- Department of Pharmaceuticals, Center of Genetic Engineering and Biotechnology (CIGB), Playa, 10600 Havana, Cuba
| | | | | | | | | | | | | | - Marta Ayala Avila
- Department of Pharmaceuticals, Center of Genetic Engineering and Biotechnology (CIGB), Playa, 10600 Havana, Cuba
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Sánchez Ramírez J, Bequet-Romero M, Morera Díaz Y, Hernández-Bernal F, Ayala Avila M. Does VEGF-targeted active immunotherapy induce complete abrogation of platelet VEGF levels? BMC Res Notes 2019; 12:323. [PMID: 31182141 PMCID: PMC6558718 DOI: 10.1186/s13104-019-4368-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 06/05/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Vascular endothelial growth factor (VEGF) is involved in physiological angiogenesis, but also is considered one of the key factors that promotes tumor angiogenesis. CIGB-247 is a VEGF-based vaccine that has been evaluated in phase I clinical trial patients with advanced solid tumors. This specific active immunotherapy is able to reduce platelet VEGF levels; however it is unknown whether this effect leads to a decrease in VEGF below the levels that can be observed in healthy individuals. The objective of the present study is to investigate platelet VEGF levels in cancer patients vaccinated with CIGB-247, and then compare these values with those obtained in healthy individuals. To achieve this, platelet VEGF levels of 62 cancer patients and 93 healthy individuals were compared. Cancer patients were those individuals recruited in CENTAURO and CENTAURO-2 clinical trials. RESULTS Before vaccination, platelets of cancer patients carried more VEGF than the levels seen in platelet of healthy individuals. However, after vaccination, cancer patients had platelet VEGF values within the range established by healthy individuals, indicating that the antibody response elicited by CIGB-247 is not able to induce a complete suppression of VEGF. Vaccination with CIGB-247 helps to normalize VEGF levels within platelets.
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Affiliation(s)
- Javier Sánchez Ramírez
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Ave 31 e/158 y 190, Playa, P.O. Box 6162, Havana, Cuba.
| | - Mónica Bequet-Romero
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Ave 31 e/158 y 190, Playa, P.O. Box 6162, Havana, Cuba
| | - Yanelys Morera Díaz
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Ave 31 e/158 y 190, Playa, P.O. Box 6162, Havana, Cuba
| | - Francisco Hernández-Bernal
- Department of Clinical Research, Center for Genetic Engineering and Biotechnology, Ave 31 e/158 y 190, Playa, P.O. Box 6162, Havana, Cuba
| | - Marta Ayala Avila
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Ave 31 e/158 y 190, Playa, P.O. Box 6162, Havana, Cuba
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Sánchez Ramírez J, Bequet-Romero M, Morera Díaz Y, Hernández-Bernal F, de la Torre Santos A, Selman-Housein Bernal KH, Martín Bauta Y, Bermúdez Badell CH, Limonta Fernández M, Ayala Avila M. Evaluation of methodologies to determine the effect of specific active immunotherapy on VEGF levels in phase I clinical trial patients with advanced solid tumors. Heliyon 2018; 4:e00906. [PMID: 30426104 PMCID: PMC6223189 DOI: 10.1016/j.heliyon.2018.e00906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/16/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023] Open
Abstract
Two phase I clinical trials were conducted to evaluate, among other parameters, the humoral response elicited by a vascular endothelial growth factor (VEGF)-based therapeutic vaccine in cancer patients with advanced solid tumors. VEGF reduction was studied using an indirect methodology named as “Platelet VEGF”. This methodology is based on the estimation of VEGF within platelets by subtracting the plasma VEGF level from the serum level and dividing this by the platelet count, and then this latter expression is additionally corrected by the hematocrit. However, there is broad debate, whether serum or plasma VEGF or platelet-derived VEGF measurements is the most appropriate strategy to study the changes that occur on ligand bioavailability when patients are submitted to a VEGF-based immunotherapy. The current research is a retrospective study evaluating the changes on VEGF levels in serum and plasma as well as platelet-derived measurements. Changes in VEGF levels were related with the humoral response seen in cancer patients after an active immunotherapy with a VEGF-based vaccine. The present study indicates that “Platelet VEGF” is the most reliable methodology to investigate the effect of VEGF-based immunotherapies on ligand bioavailability. “Platelet VEGF” was associated with those groups of individuals that exhibited the best specific humoral response and the variation of “Platelet VEGF” showed the strongest negative correlation with VEGF-specific IgG antibody levels. This methodology will be very useful for the investigation of this VEGF-based vaccine in phase II clinical trials and could be applied to immunotherapies directed to other growth factors that are actively sequestered by platelets.
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Affiliation(s)
- Javier Sánchez Ramírez
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Playa, Havana, Cuba
| | - Mónica Bequet-Romero
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Playa, Havana, Cuba
| | - Yanelys Morera Díaz
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Playa, Havana, Cuba
| | | | | | | | - Yenima Martín Bauta
- Department of Clinical Research, Center for Genetic Engineering and Biotechnology, Playa, Havana, Cuba
| | - Cimara H Bermúdez Badell
- Department of Clinical Research, Center for Genetic Engineering and Biotechnology, Playa, Havana, Cuba
| | - Miladys Limonta Fernández
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Playa, Havana, Cuba
| | - Marta Ayala Avila
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology, Playa, Havana, Cuba
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Sánchez Ramírez J, Morera Díaz Y, Bequet-Romero M, Hernández-Bernal F, Selman-Housein Bernal KH, de la Torre Santos A, Santiesteban Álvarez ER, Martín Bauta Y, Bermúdez Badell CH, de la Torre Pupo J, Gavilondo JV, Ayala Avila M. Characteristics of the specific humoral response in patients with advanced solid tumors after active immunotherapy with a VEGF vaccine, at different antigen doses and using two distinct adjuvants. BMC Immunol 2017; 18:39. [PMID: 28747172 PMCID: PMC5530503 DOI: 10.1186/s12865-017-0222-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 07/20/2017] [Indexed: 12/19/2022] Open
Abstract
Background CIGB-247, a VSSP-adjuvanted VEGF-based vaccine, was evaluated in a phase I clinical trial in patients with advanced solid tumors (CENTAURO). Vaccination with the maximum dose of antigen showed an excellent safety profile, exhibited the highest immunogenicity and was the only one showing a reduction on platelet VEGF bioavailability. However, this antigen dose level did not achieve a complete seroconversion rate in vaccinated patients. These clinical results led us to the question whether a “reserve” of untapped immune response potential against VEGF could exist in cancer patients. To address this matter, CENTAURO-2 clinical trial was conducted where antigen and VSSP dose scale up were studied, and also incorporated the exploration of aluminum phosphate as adjuvant. These changes were made with the aim to increase immune response against VEGF. Results The present study reports the characterization of the humoral response elicited by CIGB-247 from the combining of different antigen doses and adjuvants. Cancer patients were immunologically monitored for approximately 1 year. Vaccination with different CIGB-247 formulations exhibited a very positive safety profile. Cancer patients developed IgM, IgG or IgA antibodies specific to VEGF. Elicited polyclonal antibodies had the ability to block the interaction between VEGF and its receptors, VEGFR1 and VEGFR2. The highest humoral response was detected in patients immunized with 800 μg of antigen + 200 μg of VSSP. Off-protocol long-term vaccination did not produce negative changes in humoral response. Conclusions Vaccination with a human VEGF variant molecule as antigen in combination with VSSP or aluminum phosphate is immunogenic. The results of this study could contribute to the investigation of this vaccine therapy in an adequately powered efficacy trial. Trial registration Trial registration number: RPCEC00000155. Cuban Public Clinical Trial Registry. Date of registration: June 06, 2013. Available from: http://registroclinico.sld.cu/. Electronic supplementary material The online version of this article (doi:10.1186/s12865-017-0222-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Javier Sánchez Ramírez
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology (CIGB), P.O. Box 6162, Playa Cubanacán, Havana, 10600, Cuba.
| | - Yanelys Morera Díaz
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology (CIGB), P.O. Box 6162, Playa Cubanacán, Havana, 10600, Cuba
| | - Mónica Bequet-Romero
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology (CIGB), P.O. Box 6162, Playa Cubanacán, Havana, 10600, Cuba
| | | | | | | | | | - Yenima Martín Bauta
- Department of Clinical Research, CIGB, P.O. Box 6162, Playa Cubanacán, Havana, 10600, Cuba
| | | | | | - Jorge V Gavilondo
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology (CIGB), P.O. Box 6162, Playa Cubanacán, Havana, 10600, Cuba
| | | | - Marta Ayala Avila
- Department of Pharmaceuticals, Center for Genetic Engineering and Biotechnology (CIGB), P.O. Box 6162, Playa Cubanacán, Havana, 10600, Cuba
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Sánchez Ramírez J, Morera Díaz Y, Musacchio Lasa A, Bequet-Romero M, Muñoz Pozo Y, Pérez Sánchez L, Hernández-Bernal F, Mendoza Fuentes O, Selman-Housein KH, Gavilondo Cowley JV, Ayala Avila M. Indirect and competitive enzyme-linked immunosorbent assays for monitoring the humoral response against human VEGF. J Immunoassay Immunochem 2016; 37:636-58. [PMID: 27143151 DOI: 10.1080/15321819.2016.1184164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
CIGB-247, a VEGF-based vaccine, was studied in a clinical trial. This advance demands the refinement of the methodologies for assessment of vaccine immune responses. This study aimed to improve the performance of ELISAs for detecting IgG antibodies against human VEGF and the blocking activity of the serum to inhibit the VEGF/VEGFR2 interaction. The best experimental conditions were established through the evaluation of several blocking buffers, immobilization surfaces, and plate suppliers using human sera as test samples. As a result, two controlled ELISAs were used in testing of elicited immune response against VEGF in patients immunized with CIGB-247.
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Affiliation(s)
- Javier Sánchez Ramírez
- a Department of Pharmaceuticals , Center for Genetic Engineering and Biotechnology (CIGB) , Playa Cubanacán, Havana , Cuba
| | - Yanelys Morera Díaz
- a Department of Pharmaceuticals , Center for Genetic Engineering and Biotechnology (CIGB) , Playa Cubanacán, Havana , Cuba
| | - Alexis Musacchio Lasa
- b Department of Bioinformatics , Center for Genetic Engineering and Biotechnology (CIGB) , Playa Cubanacán, Havana , Cuba
| | - Mónica Bequet-Romero
- a Department of Pharmaceuticals , Center for Genetic Engineering and Biotechnology (CIGB) , Playa Cubanacán, Havana , Cuba
| | - Yasmiana Muñoz Pozo
- a Department of Pharmaceuticals , Center for Genetic Engineering and Biotechnology (CIGB) , Playa Cubanacán, Havana , Cuba
| | - Lincidio Pérez Sánchez
- a Department of Pharmaceuticals , Center for Genetic Engineering and Biotechnology (CIGB) , Playa Cubanacán, Havana , Cuba
| | - Francisco Hernández-Bernal
- c Department of Clinical Research , Center for Genetic Engineering and Biotechnology (CIGB) , Playa Cubanacán, Havana , Cuba
| | - Osmany Mendoza Fuentes
- d Animal Facility , Center for Genetic Engineering and Biotechnology (CIGB) , Playa Cubanacán, Havana , Cuba
| | | | - Jorge Víctor Gavilondo Cowley
- a Department of Pharmaceuticals , Center for Genetic Engineering and Biotechnology (CIGB) , Playa Cubanacán, Havana , Cuba
| | - Marta Ayala Avila
- a Department of Pharmaceuticals , Center for Genetic Engineering and Biotechnology (CIGB) , Playa Cubanacán, Havana , Cuba
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Pérez Sánchez L, Morera Díaz Y, Bequet-Romero M, Ramses Hernández G, Rodríguez Y, Castro Velazco J, Puente Pérez P, Ayala Avila M, Gavilondo JV. Experimental studies of a vaccine formulation of recombinant human VEGF antigen with aluminum phosphate. Hum Vaccin Immunother 2016; 11:2030-7. [PMID: 25891359 DOI: 10.1080/21645515.2015.1029213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
CIGB-247 is a cancer vaccine that is a formulation of a recombinant protein antigen representative of the human vascular endothelial growth factor (VEGF) with a bacterially-derived adjuvant (VSSP). The vaccine has shown an excellent safety profile in mice, rats, rabbits, not-human primates and in recent clinical trials in cancer patients. Response to the vaccine is characterized by specific antibody titers that neutralize VEGF/VEGFR2 binding and a cytotoxic tumor-specific response. To expand our present anti-VEGF active immunotherapy strategies, we have now studied in mice and non-human primates the effects of vaccination with a formulation of our recombinant VEGF antigen and aluminum phosphate adjuvant (hereafter denominated CIGB-247-A). Administered bi-weekly, CIGB-247-A produces high titers of anti-VEGF IgG blocking antibodies in 2 mice strains. Particularly in BALB/c, the treatment impaired subcutaneous F3II mammary tumor growth and reduced the number of spontaneous lung macro metastases, increasing animals' survival. Spleen cells from specifically immunized mice directly killed F3II tumor cells in vitro. CIGB-247-A also showed to be immunogenic in non-human primates, which developed anti-VEGF blocking antibodies and the ability for specific direct cell cytotoxic responses, all without impairing the healing of deep skin wounds or other side effect. Our results support consideration of aluminum phosphate as a suitable adjuvant for the development of new vaccine formulations using VEGF as antigen.
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Key Words
- ANOVA, Analysis of Variance
- Aluminum phosphate
- CFSE, Carboxyfluorescein succinimidyl ester
- CTL, Cytotoxic T lymphocyte
- ELISA, Enzyme-linked immune-sorbent assay
- FACS, Fluorescence-activated cell sorting
- GST, Glutathione S-transferase
- HPLC, High-performance liquid chromatography
- KDR, kinase domain receptor
- Ni-NTA, nickel-nitrilotriacetic acid
- PBMC, Peripheral blood mononuclear cells
- VEGF
- VEGF, vascular endothelial growth factor
- VEGFR2, vascular endothelial growth factor receptor 2
- VSSP, very small sized proteoliposomes
- adjuvant
- antibodies
- cancer therapeutic vaccine
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Affiliation(s)
- Lincidio Pérez Sánchez
- a Cancer Immunotherapy Laboratory; Department of Pharmaceuticals; Center for Genetic Engineering and Biotechnology (CIGB) ; Playa Cubanacan , Havana , Cuba
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