Phase II Adjuvant Cancer-specific Vaccine Therapy for Esophageal Cancer Patients Curatively Resected After Preoperative Therapy With Pathologically Positive Nodes; Possible Significance of Tumor Immune Microenvironment in its Clinical Effects
| Autor: | Motohiro Imano, Hiroaki Kato, Osamu Shiraishi, Atsushi Yasuda, Yusuke Nakamura, Yutaka Kimura, Masayuki Shinkai, Mitsuru Iwama, Takao Satou, Kazuyoshi Takeda, Kohei Nishiki, Yoko Hiraki, Yasushi Sukegawa, Yasutaka Chiba, Takushi Yasuda, Hitoshi Shiozaki |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment Gastroenterology Cancer Vaccines Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Antigen Antigens Neoplasm Internal medicine Preoperative Care medicine Tumor Microenvironment Humans Prospective Studies Lung cancer Aged Neoplasm Staging business.industry Cancer Immunotherapy Active Esophageal cancer Middle Aged medicine.disease Vaccine therapy Neoadjuvant Therapy Esophagectomy 030220 oncology & carcinogenesis Lymphatic Metastasis Peptide vaccine 030211 gastroenterology & hepatology Surgery Female Cancer vaccine Lymph Nodes business Adjuvant Follow-Up Studies |
| Zdroj: | Annals of surgery. 275(1) |
| ISSN: | 1528-1140 |
| Popis: | Objectives To elucidate the efficacy of adjuvant vaccine monotherapy using 3 Human Leukocyte Antigen (HLA)-A24-restricted tumor-specific peptide antigens for ESCC, upregulated lung cancer 10, cell division cycle associated 1, and KH domain-containing protein overexpressed in cancer 1. Summary of background data ESCC patients with pathologically positive nodes (pN(+)) have a high risk for postoperative recurrence, despite curative resection after preoperative therapy. Subclinical micrometastases are an appropriate target for cancer vaccine. Methods This is a non-randomized prospective phase II clinical trial (UMIN000003557). ESCC patients curatively resected after preoperative therapy with pN(+) were allocated into the control and vaccine groups (CG and VG) according to the HLA-A status. One mg each of three epitope peptides was postoperatively injected 10 times weekly followed by 10 times biweekly to the VG. The primary and secondary endpoints were relapse-free survival (RFS) and esophageal cancer-specific survival (ECSS), respectively. Results Thirty were in the CG and 33 in the VG. No significant difference was observed in RFS between the CG and VG (5-year RFS: 32.5% vs 45.3%), but the recurrence rate significantly decreased with the number of peptides which induced antigen-specific cytotoxic T lymphocytes. The VG showed a significantly higher 5-year ECSS than the CG (60.0% vs 32.4%, P = 0.045) and this difference was more prominent in patients with CD8 and programmed death-ligand 1 double negative tumor (68.0% vs 17.7%, P = 0.010). Conclusions Our cancer peptide vaccine might improve the survival of ESCC patients, which is warranted to be verified in the phase III randomized controlled study. |
| Databáze: | OpenAIRE |
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