1. A phase I study of multi-HLA-binding peptides derived from heat shock protein 70/glypican-3 and a novel combination adjuvant of hLAG-3Ig and Poly-ICLC for patients with metastatic gastrointestinal cancers: YNP01 trial.
- Author
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Nakajima M, Hazama S, Tamada K, Udaka K, Kouki Y, Uematsu T, Arima H, Saito A, Doi S, Matsui H, Shindo Y, Matsukuma S, Kanekiyo S, Tokumitsu Y, Tomochika S, Iida M, Yoshida S, Nakagami Y, Suzuki N, Takeda S, Yamamoto S, Yoshino S, Ueno T, and Nagano H
- Subjects
- Adjuvants, Immunologic administration & dosage, Adult, Aged, Aged, 80 and over, Carboxymethylcellulose Sodium administration & dosage, Cohort Studies, Female, Follow-Up Studies, Gastrointestinal Neoplasms immunology, Gastrointestinal Neoplasms metabolism, Gastrointestinal Neoplasms pathology, Glypicans metabolism, HLA-A Antigens metabolism, HSP70 Heat-Shock Proteins metabolism, Humans, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Metastasis, Neoplasm Recurrence, Local immunology, Neoplasm Recurrence, Local metabolism, Neoplasm Recurrence, Local pathology, Neoplasm Recurrence, Local therapy, Peptide Fragments immunology, Peptide Fragments metabolism, Polylysine administration & dosage, Prognosis, Survival Rate, Carboxymethylcellulose Sodium analogs & derivatives, Gastrointestinal Neoplasms therapy, Glypicans immunology, HLA-A Antigens immunology, HLA-G Antigens administration & dosage, HSP70 Heat-Shock Proteins immunology, Peptide Fragments administration & dosage, Poly I-C administration & dosage, Polylysine analogs & derivatives
- Abstract
Background: This phase I study aimed to evaluate the safety, peptide-specific immune responses, and anti-tumor effects of a novel vaccination therapy comprising multi-HLA-binding heat shock protein (HSP) 70/glypican-3 (GPC3) peptides and a novel adjuvant combination of hLAG-3Ig and Poly-ICLC against metastatic gastrointestinal cancers., Methods: HSP70/GPC3 peptides with high binding affinities for three HLA types (A*24:02, A*02:01, and A*02:06) were identified with our peptide prediction system. The peptides were intradermally administered with combined adjuvants on a weekly basis. This study was a phase I dose escalation clinical trial, which was carried out in a three patients' cohort; in total, 11 patients were enrolled for the recommended dose., Results: Seventeen patients received this vaccination therapy without dose-limiting toxicity. All treatment-related adverse events were of grades 1 to 2. Peptide-specific CTL induction by HSP70 and GPC3 proteins was observed in 11 (64.7%) and 13 (76.5%) cases, respectively, regardless of the HLA type. Serum tumor marker levels were decreased in 10 cases (58.8%). Immunological analysis using PBMCs indicated that patients receiving dose level 3 presented with significantly reduced T cell immunoglobulin and mucin-domain containing-3 (TIM3)-expressing CD4 + T cells after one course of treatment. PD-1 or TIM3-expressing CD4 + T cells and T cell immunoreceptor with immunoglobulin and ITIM domains (TIGIT)-expressing CD8 + T cells in PBMCs before vaccination were negative predictive factors for survival., Conclusions: This novel peptide vaccination therapy was safe for patients with metastatic gastrointestinal cancers.
- Published
- 2020
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