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2014 ; 25
(9
): 1735-1742
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
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]