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10.1093/annonc/mdu211

http://scihub22266oqcxt.onion/10.1093/annonc/mdu211
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C4143091!4143091 !24907636
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suck abstract from ncbi


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pmid24907636
      Ann+Oncol 2014 ; 25 (9 ): 1735-1742
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  • Final report of the phase I/II clinical trial of the E75 (nelipepimut-S) vaccine with booster inoculations to prevent disease recurrence in high-risk breast cancer patients #MMPMID24907636
  • Mittendorf EA ; Clifton GT ; Holmes JP ; Schneble E ; van Echo D ; Ponniah S ; Peoples GE
  • Ann Oncol 2014[Sep]; 25 (9 ): 1735-1742 PMID24907636 show ga
  • BACKGROUND: E75 (nelipepimut-S) is a human leukocyte antigen (HLA)-A2/A3-restricted immunogenic peptide derived from the HER2 protein. We have conducted phase I/II clinical trials vaccinating breast cancer patients with nelipepimut-S and granulocyte-macrophage colony-stimulating factor (GM-CSF) in the adjuvant setting to prevent disease recurrence. All patients have completed 60 months follow-up, and here, we report the final analyses. PATIENTS AND METHODS: The studies were conducted as dose escalation/schedule optimization trials enrolling node-positive and high-risk node-negative patients with tumors expressing any degree of HER2 (immunohistochemistry 1-3+). HLA-A2/3+ patients were vaccinated; others were followed prospectively as controls. Local and systemic toxicity was monitored. Clinical recurrences were documented, and disease-free survival (DFS) was analyzed by Kaplan-Meier curves; groups were compared using log-rank tests. RESULTS: Of 195 enrolled patients, 187 were assessable: 108 (57.8%) in the vaccinated group (VG) and 79 (42.2%) in the control group (CG). The groups were well matched for clinicopathologic characteristics. Toxicities were minimal. Five-year DFS was 89.7% in the VG versus 80.2% in the CG (P = 0.08). Due to trial design, 65% of patients received less than the optimal vaccine dose. Five-year DFS was 94.6% in optimally dosed patients (P = 0.05 versus the CG) and 87.1% in suboptimally dosed patients. A voluntary booster program was initiated, and among the 21 patients that were optimally boosted, there was only one recurrence (DFS = 95.2%). CONCLUSION: The E75 vaccine is safe and appears to have clinical efficacy. A phase III trial evaluating the optimal dose and including booster inoculations has been initiated. CLINICAL TRIALS: NCT00841399, NCT00584789.
  • |Adjuvants, Immunologic/therapeutic use [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Breast Neoplasms/*immunology [MESH]
  • |Breast/pathology [MESH]
  • |Cancer Vaccines/adverse effects/*therapeutic use [MESH]
  • |Disease-Free Survival [MESH]
  • |Female [MESH]
  • |Granulocyte-Macrophage Colony-Stimulating Factor/administration & dosage/therapeutic use [MESH]
  • |HLA-A2 Antigen/immunology [MESH]
  • |HLA-A3 Antigen/immunology [MESH]
  • |Humans [MESH]
  • |Immunization, Secondary [MESH]
  • |Immunotherapy/*methods [MESH]
  • |Middle Aged [MESH]
  • |Neoplasm Recurrence, Local/*prevention & control [MESH]
  • |Peptide Fragments/administration & dosage/immunology [MESH]
  • |Receptor, ErbB-2/*immunology/metabolism [MESH]


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