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Efficacy of vaccination with recombinant vaccinia and fowlpox vectors expressing NY-ESO-1 antigen in ovarian cancer and melanoma patients

Odunsi, Kunle, Matsuzaki, Junko, Karbach, Julia, Neumann, Antje, Mhawech-Fauceglia, Paulette, Miller, Austin, Beck, Amy, Morrison, Carl D., Ritter, Gerd, Godoy, Heidi, Lele, Shashikant, duPont, Nefertiti, Edwards, Robert, Shrikant, Protul, Old, Lloyd J., Gnjatic, Sacha, Jäger, Elke
Proceedings of the National Academy of Sciences of the United States of America 2012 v.109 no.15 pp. 5797-5802
CD8-positive T-lymphocytes, Poxviridae, animal ovaries, antigens, clinical trials, fowl pox, immune response, melanoma, ovarian neoplasms, patients, risk, secondary immunization, vaccination, vaccines
Recombinant poxviruses (vaccinia and fowlpox) expressing tumor-associated antigens are currently being evaluated in clinical trials as cancer vaccines to induce tumor-specific immune responses that will improve clinical outcome. To test whether a diversified prime and boost regimen targeting NY-ESO-1 will result in clinical benefit, we conducted two parallel phase II clinical trials of recombinant vaccinia-NY-ESO-1 (rV-NY-ESO-1), followed by booster vaccinations with recombinant fowlpox-NY-ESO-1 (rF-NY-ESO-1) in 25 melanoma and 22 epithelial ovarian cancer (EOC) patients with advanced disease who were at high risk for recurrence/progression. Integrated NY-ESO-1-specific antibody and CD4+ and CD8+ T cells were induced in a high proportion of melanoma and EOC patients. In melanoma patients, objective response rate [complete and partial response (CR+PR)] was 14%, mixed response was 5%, and disease stabilization was 52%, amounting to a clinical benefit rate (CBR) of 72% in melanoma patients. The median PFS in the melanoma patients was 9 mo (range, 0–84 mo) and the median OS was 48 mo (range, 3–106 mo). In EOC patients, the median PFS was 21 mo (95% CI, 16–29 mo), and median OS was 48 mo (CI, not estimable). CD8+ T cells derived from vaccinated patients were shown to lyse NY-ESO-1-expressing tumor targets. These data provide preliminary evidence of clinically meaningful benefit for diversified prime and boost recombinant pox-viral-based vaccines in melanoma and ovarian cancer and support further evaluation of this approach in these patient populations.