lipid-a and Carcinoma--Transitional-Cell

Treatments with cancer vaccines may be delivered as combination therapies for better efficacy. Addition of intravesical immunostimulation with bacteria promotes vaccine-specific T cells in the bladder and tumor-regression in murine bladder cancer models. Here, we determined whether an adjuvanted cancer vaccine can be safely administered with concomitant standard intravesical Bacillus-Calmette-Guérin (BCG) therapy and how vaccine-specific immune responses may be modulated in patients with non-muscle-invasive bladder cancer (NMIBC).. In a nonrandomized phase I open-label exploratory study, 24 NMIBC patients, apportioned in three groups, received 5 injections of a subunit cancer vaccine (recMAGE-A3 protein+AS15) alone or in two combinations of intravesical BCG-instillations. Safety profiles were compared between the three treatment groups, considering single vaccine injections or BCG instillations and concomitant interventions. Immune responses in blood and urine were compared between treatment groups and upon BCG instillations.. The mild adverse events (AE) experienced by all the patients were similar to AE previously reported for this vaccine and standard BCG treatment. AEs were not increased by the double interventions, suggesting that BCG did not exacerbate the AE caused by the MAGE-A3 vaccine and vice-versa. All patients seroconverted after MAGE-A3 vaccination. In half of the patients, vaccine-specific T cells were induced in blood, irrespective of BCG treatment. Interestingly, such T cells were only detected in urine upon BCG-induced T-cell infiltration.. Cancer vaccines, including strong adjuvants, can be safely combined with intravesical BCG therapy. The increase of vaccine-specific T cells in the bladder upon BCG provides proof-of-principle evidence that cancer vaccines with local immunostimulation may be beneficial. Clin Cancer Res; 23(3); 717-25. ©2016 AACR.

Topics: Adjuvants, Immunologic; Administration, Intravesical; Antigens, Neoplasm; BCG Vaccine; Cancer Vaccines; Carcinoma, Transitional Cell; Combined Modality Therapy; Cystectomy; Cytokines; Dose-Response Relationship, Immunologic; Humans; Immunization Schedule; Immunotherapy; Injections, Intramuscular; Lipid A; Lymphocytes, Tumor-Infiltrating; Neoplasm Proteins; Oligodeoxyribonucleotides; Plant Extracts; Quillaja; Recombinant Proteins; Urinary Bladder Neoplasms

Fifty-seven patients with MAGE-3-positive measurable metastatic cancer, most of them with melanoma, were vaccinated with escalating doses of a recombinant MAGE-3 protein combined with a fixed dose of the immunological adjuvant SBAS-2, which contained MPL and QS21. The immunisation schedule included 4 intramuscular (i.m.) injections at 3-week intervals. Patients whose tumour stabilised or regressed after 4 vaccinations received 2 additional vaccinations at 6-week intervals. The vaccine was generally well tolerated. Among the 33 melanoma patients who were evaluable for tumour response, we observed 2 partial responses, 2 mixed responses and 1 stabilisation. Time to progression in these 5 patients varied from 4 to 29 months. In addition, a partial response lasting 10 months was observed in 1 of the 3 metastatic bladder cancer patients included. None of the tumour responses described above involved visceral metastases. Immunological responses to the vaccine will be reported separately.

Topics: Adjuvants, Immunologic; Adult; Aged; Antigens, Neoplasm; Antineoplastic Combined Chemotherapy Protocols; Cancer Vaccines; Carcinoma, Non-Small-Cell Lung; Carcinoma, Transitional Cell; Female; Humans; Immunization; Lipid A; Lung Neoplasms; Male; Melanoma; Middle Aged; Neoplasm Metastasis; Neoplasm Proteins; Neoplasms; Recombinant Proteins; Saponins; Skin Neoplasms; Survival Analysis; Treatment Outcome; Urinary Bladder Neoplasms