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Phase II Adjuvant Cancer-specific Vaccine Therapy for Esophageal Cancer Patients Curatively Resected After Preoperative Therapy With Pathologically Positive Nodes; Possible Significance of Tumor Immune Microenvironment in its Clinical Effects.
- Source :
-
Annals of surgery [Ann Surg] 2022 Jan 01; Vol. 275 (1), pp. e155-e162. - Publication Year :
- 2022
-
Abstract
- Objectives: To elucidate the efficacy of adjuvant vaccine monotherapy using 3 Human Leukocyte Antigen (HLA)-A∗24-restricted tumor-specific peptide antigens for ESCC, upregulated lung cancer 10, cell division cycle associated 1, and KH domain-containing protein overexpressed in cancer 1.<br />Summary of Background Data: ESCC patients with pathologically positive nodes (pN(+)) have a high risk for postoperative recurrence, despite curative resection after preoperative therapy. Subclinical micrometastases are an appropriate target for cancer vaccine.<br />Methods: This is a non-randomized prospective phase II clinical trial (UMIN000003557). ESCC patients curatively resected after preoperative therapy with pN(+) were allocated into the control and vaccine groups (CG and VG) according to the HLA-A status. One mg each of three epitope peptides was postoperatively injected 10 times weekly followed by 10 times biweekly to the VG. The primary and secondary endpoints were relapse-free survival (RFS) and esophageal cancer-specific survival (ECSS), respectively.<br />Results: Thirty were in the CG and 33 in the VG. No significant difference was observed in RFS between the CG and VG (5-year RFS: 32.5% vs 45.3%), but the recurrence rate significantly decreased with the number of peptides which induced antigen-specific cytotoxic T lymphocytes. The VG showed a significantly higher 5-year ECSS than the CG (60.0% vs 32.4%, P = 0.045) and this difference was more prominent in patients with CD8+ and programmed death-ligand 1 double negative tumor (68.0% vs 17.7%, P = 0.010).<br />Conclusions: Our cancer peptide vaccine might improve the survival of ESCC patients, which is warranted to be verified in the phase III randomized controlled study.<br />Competing Interests: The authors report no conflicts of interest.<br /> (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Antigens, Neoplasm immunology
Disease-Free Survival
Esophageal Neoplasms immunology
Esophageal Neoplasms secondary
Female
Follow-Up Studies
Humans
Lymphatic Metastasis
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging methods
Prospective Studies
Cancer Vaccines therapeutic use
Esophageal Neoplasms drug therapy
Esophagectomy
Immunotherapy, Active methods
Lymph Nodes pathology
Preoperative Care methods
Tumor Microenvironment immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1528-1140
- Volume :
- 275
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annals of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 33055588
- Full Text :
- https://doi.org/10.1097/SLA.0000000000003880