A Neoantigen-Based Peptide Vaccine for Patients With Advanced Pancreatic Cancer Refractory to Standard Treatment.

Abstract

Background:

Neoantigens are critical targets to elicit robust antitumor T-cell responses. Personalized cancer vaccines developed based on neoantigens have shown promising results by prolonging cancer patients' overall survival (OS) for several cancer types. However, the safety and efficacy of these vaccine modalities remains unclear in pancreatic cancer patients.

Methods:

This retrospective study enrolled 7 advanced pancreatic cancer patients. Up to 20 neoantigen peptides per patient identified by our in-house pipeline iNeo-Suite were selected, manufactured and administered to these patients with low tumor mutation burden (TMB) (less than 10 mutations/Mb). Each patient received multiple doses of vaccine depending on the progression of the disease. Peripheral blood samples of each patient were collected pre- and post-vaccination for the analysis of the immunogenicity of iNeo-Vac-P01 through ELISpot assay and flow cytometry.

Results:

No severe vaccine-related adverse effects were witnessed in patients enrolled in this study. The mean OS, OS associated with vaccine treatment and progression free survival (PFS) were reported to be 24.1, 8.3 and 3.1 months, respectively. Higher peripheral IFN-γ titer and CD4+ or CD8+ effector memory T cells count post vaccination were found in patients with relatively long overall survival. Remarkably, for patient P01 who had a 21-month OS associated with vaccine treatment, the abundance of antigen-specific TCR clone drastically increased from 0% to nearly 100%, indicating the potential of iNeo-Vac-P01 in inducing the activation of a specific subset of T cells to kill cancer cells.

Conclusions:

Neoantigen identification and selection were successfully applied to advanced pancreatic cancer patients with low TMB. As one of the earliest studies that addressed an issue in treating pancreatic cancer with personalized vaccines, it has been demonstrated that iNeo-Vac-P01, a personalized neoantigen-based peptide vaccine, could improve the currently limited clinical efficacy of pancreatic cancer.

Clinical Trial Registration:

ClinicalTrials.gov, identifier (NCT03645148).Registered August 24, 2018 - Retrospectively registered.

• Authors: Zheling Chen, Shanshan Zhang, Ning Han, Jiahong Jiang, Yunyun Xu, Dongying Ma, Lantian Lu, Xiaojie Guo, Min Qiu, Qinxue Huang, Huimin Wang, Fan Mo, Shuqing Chen, Liu Yang
• Journal: Frontiers in immunology (Front Immunol) Vol. 12 Pg. 691605 ( 2021) ISSN: 1664-3224 [Electronic] Switzerland
• PMID: 34484187 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 Chen, Zhang, Han, Jiang, Xu, Ma, Lu, Guo, Qiu, Huang, Wang, Mo, Chen and Yang.

Chemical References

• Antigens, Neoplasm
• Cancer Vaccines
• Vaccines, Subunit

Topics

• Antigens, Neoplasm (immunology)
• Cancer Vaccines (adverse effects, therapeutic use)
• Female
• Humans
• Immunotherapy (adverse effects)
• Male
• Middle Aged
• Pancreatic Neoplasms (immunology, mortality, pathology, therapy)
• Precision Medicine
• Retrospective Studies
• Survival Analysis
• T-Lymphocytes (immunology)
• Vaccines, Subunit (adverse effects, therapeutic use)