Chemotherapy enhances vaccine-induced antitumor immunity in melanoma patients

Int J Cancer. 2009 Jan 1;124(1):130-9. doi: 10.1002/ijc.23886.

Abstract

Combination of chemotherapy with cancer vaccines is currently regarded as a potentially valuable therapeutic approach for the treatment of some metastatic tumors, but optimal modalities remain unknown. We designed a phase I/II pilot study for evaluating the effects of dacarbazine (DTIC) on the immune response in HLA-A2(+) disease-free melanoma patients who received anticancer vaccination 1 day following chemotherapy (800 mg/mq i.v.). The vaccine, consisting of a combination of HLA-A2 restricted melanoma antigen A (Melan-A/MART-1) and gp100 analog peptides (250 microg each, i.d.), was administered in combination or not with DTIC to 2 patient groups. The combined treatment is nontoxic. The comparative immune monitoring demonstrates that patients receiving DTIC 1 day before the vaccination have a significantly improved long-lasting memory CD8(+) T cell response. Of relevance, these CD8(+) T cells recognize and lyse HLA-A2(+)/Melan-A(+) tumor cell lines. Global transcriptional analysis of peripheral blood mononuclear cells (PBMC) revealed a DTIC-induced activation of genes involved in cytokine production, leukocyte activation, immune response and cell motility that can favorably condition tumor antigen-specific CD8(+) T cell responses. This study represents a proof in humans of a chemotherapy-induced enhancement of CD8(+) memory T cell response to cancer vaccines, which opens new opportunities to design novel effective combined therapies improving cancer vaccination effectiveness.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antineoplastic Agents / pharmacology*
  • CD8-Positive T-Lymphocytes / metabolism
  • Cancer Vaccines / therapeutic use*
  • Female
  • Humans
  • Immunotherapy / methods
  • Interferon-alpha / metabolism
  • Leukocytes, Mononuclear / metabolism
  • Male
  • Melanoma / drug therapy*
  • Melanoma / immunology*
  • Middle Aged
  • Neoplasm Metastasis
  • Pilot Projects
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Cancer Vaccines
  • Interferon-alpha