Langerhans-type dendritic cells electroporated with TRP-2 mRNA stimulate cellular immunity against melanoma: results of a phase I vaccine trial

DJ Chung, RD Carvajal, MA Postow, S Sharma… - …, 2018 - Taylor & Francis
DJ Chung, RD Carvajal, MA Postow, S Sharma, KB Pronschinske, JA Shyer…
Oncoimmunology, 2018Taylor & Francis
Purpose: We conducted a phase I vaccine trial to determine safety, toxicity, and
immunogenicity of autologous Langerhans-type dendritic cells (LCs), electroporated with
murine tyrosinase-related peptide-2 (mTRP2) mRNA in patients with resected AJCC stage
IIB, IIC, III, or IV (MIa) melanoma. Experimental Design: Nine patients received a priming
immunization plus four boosters at three week intervals. Vaccines comprised 10× 106
mRNA-electroporated LCs, based on absolute number of CD83+ CD86brightHLA …
Purpose
We conducted a phase I vaccine trial to determine safety, toxicity, and immunogenicity of autologous Langerhans-type dendritic cells (LCs), electroporated with murine tyrosinase-related peptide-2 (mTRP2) mRNA in patients with resected AJCC stage IIB, IIC, III, or IV (MIa) melanoma. Experimental Design: Nine patients received a priming immunization plus four boosters at three week intervals. Vaccines comprised 10 × 106 mRNA-electroporated LCs, based on absolute number of CD83+CD86brightHLA-DRbrightCD14neg LCs by flow cytometry. Initial vaccines used freshly generated LCs, whereas booster vaccines used viably thawed cells from the cryopreserved initial product. Post-vaccination assessments included evaluation of delayed-type hypersensitivity (DTH) reactions after booster vaccines and immune response assays at one and three months after the final vaccine.
Results
All patients developed mild DTH reactions at injection sites after booster vaccines, but there were no toxicities exceeding grade 1 (CTCAE, v4.0). At one and three months post-vaccination, antigen-specific CD4 and CD8 T cells increased secretion of proinflammatory cytokines (IFN-γ, IL-2, and TNF-α), above pre-vaccine levels, and also upregulated the cytotoxicity marker CD107a. Next-generation deep sequencing of the TCR-V-β CDR3 documented fold-increases in clonality of 2.11 (range 0.85–3.22) for CD4 and 2.94 (range 0.98–9.57) for CD8 T cells at one month post-vaccines. Subset analyses showed overall lower fold-increases in clonality in three patients who relapsed (CD4: 1.83, CD8: 1.54) versus non-relapsed patients (CD4: 2.31, CD8: 3.99).
Conclusions
TRP2 mRNA-electroporated LC vaccines are safe and immunogenic. Responses are antigen-specific in terms of cytokine secretion, cytolytic degranulation, and increased TCR clonality, which correlates with clinical outcomes.
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