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J Clin Oncol ; 27(31): 5270-7, 2009 Nov 01.
Article in English | MEDLINE | ID: mdl-19752336

ABSTRACT

PURPOSE To evaluate the maximum-tolerated dose (MTD), safety profile, and immunogenicity of two chimeric, B-cell epitopes derived from the human epidermal growth factor receptor (HER2) extracellular domain in a combination vaccine with a promiscuous T-cell epitope (ie, MVF) and nor-muramyl-dipeptide as adjuvant emulsified in SEPPIC ISA 720. PATIENTS AND METHODS Eligible patients with metastatic and/or recurrent solid tumors received three inoculations on days 1, 22, and 43 at doses of total peptide that ranged from 0.5 to 3.0 mg. Immunogenicity was evaluated by enzyme-linked immunosorbent assay, flow cytometry, and HER2 signaling assays. Results Twenty-four patients received three inoculations at the intended dose levels, which elicited antibodies able to recognize native HER2 receptor and inhibited both the proliferation of HER2-expressing cell lines and phosphorylation of the HER2 protein. The MTD was determined to be the highest dose level of 3.0 mg of the combination vaccine. There was a significant increase from dose level 1 (0.5 mg) to dose level 4 (3.0 mg) in HER2-specific antibodies. Four patients (one each with adrenal, colon, ovarian, and squamous cell carcinoma of unknown primary) were judged to have stable disease; two patients (one each with endometrial and ovarian cancer) had partial responses; and 11 patients had progressive disease. Patients with stable disease received 6-month boosts, and one patient received a 20-month boost. CONCLUSION The combination vaccines were safe and effective in eliciting antibody responses in a subset of patients (62.5%) and were associated with no serious adverse events, autoimmune disease, or cardiotoxicity. There was preliminary evidence of clinical activity in several patients.


Subject(s)
Cancer Vaccines/immunology , Epitopes, B-Lymphocyte/immunology , Epitopes, T-Lymphocyte/immunology , Immunotherapy/methods , Neoplasms/therapy , Receptor, ErbB-2/immunology , Adjuvants, Immunologic , Adult , Aged , Antigens, Neoplasm/administration & dosage , Antigens, Neoplasm/adverse effects , Antigens, Neoplasm/immunology , Cancer Vaccines/administration & dosage , Cancer Vaccines/adverse effects , Enzyme-Linked Immunosorbent Assay , Epitopes, B-Lymphocyte/administration & dosage , Epitopes, B-Lymphocyte/adverse effects , Epitopes, T-Lymphocyte/administration & dosage , Epitopes, T-Lymphocyte/adverse effects , Female , Flow Cytometry , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Male , Maximum Tolerated Dose , Middle Aged , Receptor, ErbB-2/administration & dosage , Recombinant Fusion Proteins/immunology
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