Immunological evaluation of individualized peptide vaccination with a low dose of estramustine for HLA-A24+ HRPC patients.

Abstract

BACKGROUND:

The safety, toxicity, and immunological response of individualized peptide vaccination or human leukocyte antigen (HLA)-A24+ hormone refractory prostate cancer (HRPC) patients in combination with a low dose of estramustine were evaluated.

METHODS:

Sixteen patients with HLA-A24+ HRPC were enrolled in the phase I/II study. Conducted immune monitorings for those patients were peptide-specific cytotoxic T lymphocyte (CTL) precursor analysis by interferon-gamma production and peptide-reactive immunoglobulin G (IgG) by an enzyme-linked immunosorbent assay. Clinical responses and quality of life (QOL) outcomes using a self-reported patient questionnaire were also evaluated.

RESULTS:

Vaccinations were well tolerated, but all patients developed grade 1 or 2 local redness and swelling at the injection site. There was no significant immunosuppression in most cases when the peptide and a half dose (280 mg/day) of estramustine were administrated. Augmentation of peptide-specific CTL precursors or peptide-specific IgG was observed in 10 of 14 or 7 of 14 patients at 12 weeks (peptide vaccination alone), and in 6 of 8 or 10 of 12 patients at 24 weeks (during the combination therapy), respectively. All 13 patients treated, with the combination therapy, showed a decrease of serum prostate-specific antigen (PSA) level from the baseline, including six patients with a serum PSA level decrease of >or=50%. QOL outcomes were not deteriorated during the treatment.

CONCLUSION:

These results might encourage the further evaluation of the combination of peptide vaccination and a low dose of estramustine phosphate for HLA-A24+ HRPC patients.

• Authors: Masanori Noguchi, Kyogo Itoh, Akihisa Yao, Takashi Mine, Akira Yamada, Yayoi Obata, Masatoshi Furuta, Mamoru Harada, Shigetaka Suekane, Kei Matsuoka
• Journal: The Prostate (Prostate) Vol. 63 Issue 1 Pg. 1-12 (Apr 01 2005) ISSN: 0270-4137 [Print] United States
• PMID: 15378520 (Publication Type: Clinical Trial, Clinical Trial, Phase I, Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright (c) 2004 Wiley-Liss, Inc.

Chemical References

• Antineoplastic Agents, Alkylating
• HLA-A Antigens
• HLA-A24 Antigen
• Vaccines, Subunit
• Estramustine

Topics

• Aged
• Antineoplastic Agents, Alkylating (administration & dosage)
• Combined Modality Therapy
• Estramustine (administration & dosage)
• Follow-Up Studies
• HLA-A Antigens (immunology)
• HLA-A24 Antigen
• Humans
• Immunotherapy
• Male
• Middle Aged
• Prostatic Neoplasms (drug therapy, mortality)
• Quality of Life
• Treatment Outcome
• Vaccines, Subunit (administration & dosage)