P-4: Direct Delivery of Immune-modulating Therapies to the Pancreatic Tumor Site

我们的目标是使用肿瘤特异性免疫调节剂直接将新型免疫调节剂靶向胰腺肿瘤部位。 MUC 1抗体作为载体。这将与MUC 1/KRAS肽组合施用 疫苗和低剂量吉西他滨。MUC 1和Kras在90%的胰腺导管中过表达， 腺癌（PDA），并且长期以来一直是治疗干预的目标。到目前为止，癌症疫苗 在临床上并不像人们所希望的那样成功。疫苗未能产生长期的 免疫记忆对肿瘤抗原，因为肿瘤已采取的方式逃避免疫 承认和杀戮几种可以逆转免疫逃避的新药物已经用温和的 临床反应可能是因为药物是全身给药， 到达肿瘤部位。我们假设，通过将免疫调节剂直接递送至受试者， 胰腺肿瘤部位，并将其与多肽MUC 1/Kras疫苗结合，我们可以产生一种强大的 抗肿瘤反应与强烈的记忆反应。治疗将影响局部和 扩散的肿瘤和强大的记忆反应将防止复发。我们将测试假设在 一个合适的自发性PDA小鼠模型，明显类似于人类疾病。我们的具体 目的是：1）通过固定四种MUC 1/Kras疫苗，在PDA X MUCLTg小鼠中优化MUC 1/Kras疫苗， 通过将免疫调节剂化学缀合至肿瘤特异性免疫调节剂， MUC 1单克隆抗体。这种抗体不仅可以定位于原发性胰腺肿瘤， 过度表达MUC 1的转移性肿瘤部位; 2）为了评估免疫状态和天然存在的MUC 1- 胰腺癌患者的特异性细胞和体液免疫应答。这一目标将提供一个坚实的 关于肿瘤相关耐受性因子和抗MUCI应答在肿瘤中的作用的数据库 进展、转移、存活和预后和3）用于治疗胰腺癌的I期试验。 该试验使用了基于MUC 1肽的疫苗、塞来昔布、吉西他滨和外照射， 局部晚期胰腺癌患者。我们将监测免疫耐受机制， 治疗前、治疗中和治疗后的免疫反应。未来：这项研究可能会导致开发一种 治疗局限性和播散性胰腺肿瘤的新组合方式。

Our goal is to target novel immune-modulating agents directly to the pancreatic tumor site using a tumorspecific MUC1 antibody as a carrier. This will be administered in combination with the MUC1/KRAS peptide vaccine and low-dose gemcitabine. MUC1 and Kras are over expressed in 90% of pancreatic ductal adenocarcinomas (PDA) and have long been targets for therapeutic interventions. Thus far, cancer vaccines have not been clinically as successful as one had hoped for. Vaccines have failed to generate long-term immune memory against the tumor antigens because tumors have adopted ways to escape immune recognition and killing. Several new agents that can reverse immune evasion have been tested with modest clinical responses probably because the agents were administered systemically and may have never reached the tumor site. We hypothesize that by directly delivering the immune modulating agents to the pancreatic tumor site and combining this with a multi-peptide MUC1/Kras vaccine, we can generate a robust anti-tumor response with a strong memory response. The treatment will affect both localized and disseminated tumors, and strong memory responses will prevent recurrence. We will test the hypothesis in an appropriate mouse model of spontaneous PDA that clearly resembles the human disease. Our specific aims are: 1) To optimize a MUC1/Kras-based vaccine in the PDA X MUCLTg mice by immobilizing four immune modulating agents directly to the tumor site by chemically conjugating the agents to a tumor-specific MUC1 monoclonal antibody. This antibody will home not only to the primary pancreas tumor but also to the metastatic tumor sites that over express MUC1; 2) To assess immune status and naturally occurring MUC1 - specific cellular and humoral immune responses in pancreatic cancer patients. This aim will provide a solid database as to the roles of tumor-associated tolerizing factors and anti-MUCI responses in tumor progression, metastasis, survival, and prognosis and 3) A Phase I trial for the treatment of pancreas cancer. This trial utilizes a MUC1-pep1ide based vaccine, celecoxib, gemcitabine, and external beam radiation in patients with locally advanced pancreatic cancer. We will monitor the immune tolerance mechanisms, and the immune responses before, during, and after treatment. Future: This study could lead to development of a new combination modality for the treatment of localized and disseminated pancreas tumors.