1. Encapsulated plasmid DNA treatment for human papillomavirus 16-associated anal dysplasia: a Phase I study of ZYC101.
- Author
-
Klencke B, Matijevic M, Urban RG, Lathey JL, Hedley ML, Berry M, Thatcher J, Weinberg V, Wilson J, Darragh T, Jay N, Da Costa M, and Palefsky JM
- Subjects
- Adult, Aged, Anus Neoplasms drug therapy, Anus Neoplasms virology, DNA, Viral drug effects, DNA, Viral genetics, DNA, Viral metabolism, Dose-Response Relationship, Drug, Erythema chemically induced, Fatigue chemically induced, Female, Fever chemically induced, HLA-A2 Antigen immunology, Headache chemically induced, Humans, Male, Microspheres, Middle Aged, Oncogene Proteins, Viral genetics, Oncogene Proteins, Viral therapeutic use, Pain chemically induced, Papillomaviridae genetics, Papillomaviridae growth & development, Papillomaviridae immunology, Papillomavirus E7 Proteins, Papillomavirus Infections drug therapy, Papillomavirus Infections virology, Peptide Fragments genetics, Peptide Fragments immunology, Peptide Fragments therapeutic use, Plasmids administration & dosage, Plasmids genetics, Time Factors, Treatment Outcome, Tumor Virus Infections diagnosis, Tumor Virus Infections drug therapy, Vaccines, DNA adverse effects, Vaccines, DNA immunology, Vaccines, DNA therapeutic use, Anus Neoplasms immunology, Oncogene Proteins, Viral immunology, Papillomavirus Infections immunology, Tumor Virus Infections immunology
- Abstract
High-grade dysplasia induced by high-risk types of human papillomavirus (HPV) precedes invasive cancer in anal squamous epithelium just as it does in the cervix. A therapeutic HPV vaccine strategy as a potential treatment for anal dysplasia was tested in a standard Phase I dose escalation trial. The primary objective was to evaluate the safety of the agent; additional study aims were to evaluate the histological response, immune response, and effect on anal HPV-16 infection. Each subject was treated with four i.m. injections of 50-400 microg of ZYC101 at 3-week intervals. ZYC101 is composed of plasmid DNA encapsulated in biodegradable polymer microparticles. The plasmid DNA encodes for multiple HLA-A2-restricted epitopes derived from the HPV-16 E7 protein, one of two HPV oncoproteins consistently expressed in neoplastic cells. Fifty-six potential anal dysplasia subjects were screened to identify 12 eligible subjects with HPV-16 anal infection and a HLA-A2 haplotype. The investigational agent was well tolerated in all subjects at all dose levels tested. Three subjects experienced partial histological responses, including one of three subjects receiving the 200-microg dose and two subjects at the 400-microg dose level. Using a direct Elispot, 10 of 12 subjects demonstrated increased immune response to the peptide epitopes encoded within ZYC101; each continued to show elevated immune responses 6 months after the initiation of therapy. These results support the continued investigation of a therapeutic vaccination strategy for anal dysplasia.
- Published
- 2002