Relapse of renal cell carcinoma with disappearance of HLA class I following hTERT peptide vaccination.
Relapse of renal cell carcinoma with disappearance of HLA class I following hTERT peptide vaccination.
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DOI：
10.1093/annonc/mdq544
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发表时间：
2010-10
期刊：
影响因子：
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通讯作者：
M. Yasukawa;T. Ochi;H. Fujiwara
中科院分区：
文献类型：
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作者：
M. Yasukawa;T. Ochi;H. Fujiwara
一名74岁女性因肾细胞癌（RCC）行右肾切除术，术后5年发现多发肺转移。患者接受干扰素-a治疗，但由于发烧和严重不适，她无法耐受这种治疗。此时，由于分子靶向治疗，如多激酶抑制剂索拉非尼，不可用，患者入组了人类端粒酶逆转录酶（hTERT）肽疫苗接种的I/II期临床研究，由爱媛大学医院机构审查委员会审查和批准。在Montanide ISA51佐剂中注射hTERT324-332 （VYAETKHFL）肽[1]1 mg，每两周注射一次。在接下来的2年中，她共接种了20次hTERT肽疫苗，其中有一些中断。该方案耐受性良好；仅在肽疫苗注射部位出现局部红斑。如图1A所示，在接种hTERT肽2年期间，RCC转移灶的大小没有明显变化。采用酶联免疫斑点法（ELISPOT）检测htert324 - 332特异性CD8 +细胞毒性T淋巴细胞（ctl），结果如图1B所示。hTERT肽特异性ctl在接种hTERT肽前未在患者外周血中检测到，在第五次接种后可检测到。外周血中hTERT肽特异性ctl的频率随着疫苗接种的重复而增加。给《肿瘤学年鉴》编辑的信
A 74-year-old woman who had undergone right nephrectomy due to renal cell carcinoma (RCC) was found to have developed multiple lung metastasis of RCC 5 years after surgery. The patient was treated with interferon-a, but she was unable to tolerate this therapy because of fever and severe malaise. At this time, as molecular-targeted therapy, such as the multikinase inhibitor sorafenib, was not available, the patient was enrolled in a phase I/II clinical study of human telomerase reverse transcriptase (hTERT) peptide vaccination, as reviewed and approved by the Institutional Review Board of Ehime University Hospital. She received s.c. injection of 1 mg hTERT324–332 (VYAETKHFL) peptide [1] in Montanide ISA51 adjuvant biweekly. During the following 2 years, she received hTERT peptide vaccination a total of 20 times with some discontinuations. The protocol was well tolerated; only local erythema occurred at the peptide vaccine injection sites. As shown in Figure 1A, during vaccination with hTERT peptide for 2 years, the sizes of the RCC metastases did not change significantly. The results of enzyme-linked immunospot (ELISPOT) assay for monitoring hTERT324–332-specific CD8 + cytotoxic T lymphocytes (CTLs) in peripheral blood are shown in Figure 1B. The hTERT peptide-specific CTLs were not detectable in peripheral blood of the patient before hTERT peptide vaccination and became detectable after the fifth vaccination. The frequency of hTERT peptide-specific CTLs in peripheral blood appeared to increase as the vaccinations were repeated. letters to the editor Annals of Oncology