Intravenous and intradermal TriMix-dendritic cell therapy results in a broad T-cell response and durable tumor response in a chemorefractory stage IV-M1c melanoma patient

Cancer Immunol Immunother. 2012 Jul;61(7):1033-43. doi: 10.1007/s00262-011-1176-2. Epub 2011 Dec 10.

Abstract

Dendritic cells (DCs) electroporated with mRNA encoding CD70, CD40L and a constitutively active toll-like receptor 4 (TriMix-DC) have an increased T-cell stimulatory capacity. In a prospective phase IB clinical trial, we treated melanoma patients with intradermal and intravenous injections of autologous TriMix-DC co-electroporated with mRNA encoding full-length MAGE-A3, MAGE-C2, tyrosinase and gp100. We report here the immunological and clinical results obtained in one patient with a particularly favorable outcome. This patient had stage IV-M1c melanoma with documented progression during dacarbazine chemotherapy and received 5 TriMix-DC injections. Following DC therapy, a broad CD8(+) T-cell response against multiple epitopes derived from all four treatment antigens was found in the blood and among T cells derived from DTH biopsy. In addition, CD4(+) T cells recognizing different MAGE-A3-derived epitopes were detected in DTH-derived cells. A spontaneous anti-MAGE-C2 CD8(+) T-cell response was present prior to TriMix-DC therapy and increased during treatment. The tumor response was assessed with 18-fluorodeoxyglucose-positron emission/computed tomography. We documented a partial tumor response according to RECIST criteria with a marked reduction in (18)F-FDG-uptake by lung, lymph node and bone metastases. The patient remains free from progression after 12 months of follow-up. This case report indicates that administration of autologous TriMix-DC by the combined intradermal and intravenous route can mediate a durable objective tumor response accompanied by a broad T-cell response in a chemorefractory stage IV-M1c melanoma patient.

Publication types

  • Case Reports
  • Clinical Trial, Phase I
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amino Acid Sequence
  • CD27 Ligand / biosynthesis
  • CD27 Ligand / genetics
  • CD27 Ligand / immunology
  • CD40 Ligand / biosynthesis
  • CD40 Ligand / genetics
  • CD40 Ligand / immunology
  • Dendritic Cells / immunology*
  • Dendritic Cells / pathology
  • Electroporation / methods
  • Helium / administration & dosage*
  • Humans
  • Hypersensitivity, Delayed / immunology
  • Immunotherapy, Adoptive / methods*
  • Male
  • Melanoma / immunology*
  • Melanoma / pathology
  • Melanoma / therapy*
  • Middle Aged
  • Molecular Sequence Data
  • Neoplasm Staging
  • Nitrogen / administration & dosage*
  • Oxygen / administration & dosage*
  • Prospective Studies
  • RNA, Messenger / administration & dosage
  • RNA, Messenger / genetics
  • T-Lymphocytes / immunology*
  • Toll-Like Receptor 4 / biosynthesis
  • Toll-Like Receptor 4 / genetics
  • Toll-Like Receptor 4 / immunology

Substances

  • CD27 Ligand
  • CD70 protein, human
  • RNA, Messenger
  • TLR4 protein, human
  • Toll-Like Receptor 4
  • CD40 Ligand
  • Helium
  • trimix
  • Nitrogen
  • Oxygen