Abstract
First-generation, E1-deleted adenovirus subtype 5 (Ad5)-based vectors, although promising platforms for use as cancer vaccines, are impeded in activity by naturally occurring or induced Ad-specific neutralizing antibodies. Ad5-based vectors with deletions of the E1 and the E2b regions (Ad5 [E1-, E2b-]), the latter encoding the DNA polymerase and the pre-terminal protein, by virtue of diminished late phase viral protein expression, were hypothesized to avoid immunological clearance and induce more potent immune responses against the encoded tumor antigen transgene in Ad-immune hosts. Indeed, multiple homologous immunizations with Ad5 [E1-, E2b-]-CEA(6D), encoding the tumor antigen carcinoembryonic antigen (CEA), induced CEA-specific cell-mediated immune (CMI) responses with antitumor activity in mice despite the presence of preexisting or induced Ad5-neutralizing antibody. In the present phase I/II study, cohorts of patients with advanced colorectal cancer were immunized with escalating doses of Ad5 [E1-, E2b-]-CEA(6D). CEA-specific CMI responses were observed despite the presence of preexisting Ad5 immunity in a majority (61.3 %) of patients. Importantly, there was minimal toxicity, and overall patient survival (48 % at 12 months) was similar regardless of preexisting Ad5 neutralizing antibody titers. The results demonstrate that, in cancer patients, the novel Ad5 [E1-, E2b-] gene delivery platform generates significant CMI responses to the tumor antigen CEA in the setting of both naturally acquired and immunization-induced Ad5-specific immunity.
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Acknowledgments
This research was supported by SBIR Grants 1R43CA134063 and 2R44CA134063 from the NCI and by SBIR Research Contracts HHSN261200900059C and HHSN261201100097C from the NCI. The authors wish to thank Dr. Bercedis Peterson for statistical analysis and Ms. Carol Jones for her assistance with grants management. The authors would also like to thank the nursing staff at the Duke Comprehensive Cancer Center and Medical Center and Medical Oncology Associates for care of the patients in the phase I/II clinical trial.
Conflict of interest
The following authors declare financial conflict of interest: Elizabeth S. Gabitzsch, Younong Xu, Stephanie Balcaitis, Rajesh Dua, Susan Nguyen, Joseph P. Balint, Jr., Frank R. Jones are employees of Etubics Corporation. All other authors do not have any conflict of interest.
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Morse, M.A., Chaudhry, A., Gabitzsch, E.S. et al. Novel adenoviral vector induces T-cell responses despite anti-adenoviral neutralizing antibodies in colorectal cancer patients. Cancer Immunol Immunother 62, 1293–1301 (2013). https://doi.org/10.1007/s00262-013-1400-3
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DOI: https://doi.org/10.1007/s00262-013-1400-3