Annals of Surgical Oncology

, Volume 17, Issue 3, pp 718–730 | Cite as

Local and Distant Immunity Induced by Intralesional Vaccination with an Oncolytic Herpes Virus Encoding GM-CSF in Patients with Stage IIIc and IV Melanoma

  • Howard L. Kaufman
  • Dae Won Kim
  • Gail DeRaffele
  • Josephine Mitcham
  • Rob S. Coffin
  • Seunghee Kim-Schulze
Melanomas

Abstract

Background

An oncolytic herpes simplex virus engineered to replicate selectively in tumor cells and to express granulocyte–macrophage colony-stimulating factor (GM-CSF) was tested as a direct intralesional vaccination in melanoma patients. The work reported herein was performed to better characterize the effect of vaccination on local and distant antitumor immunity.

Methods

Metastatic melanoma patients with accessible lesions were enrolled in a multicenter 50-patient phase II clinical trial of an oncolytic herpesvirus encoding GM-CSF (OncovexGM-CSF). An initial priming dose of 106 pfu vaccine was given by intratumoral injection, followed by 108 pfu every 2 weeks to 24 total doses. Peripheral blood and tumor tissue were collected for analysis of effector T cells, CD4+FoxP3+ regulatory T cells (Treg), CD8+FoxP3+ suppressor T cells (Ts), and myeloid-derived suppressive cells (MDSC).

Results

Phenotypic analysis of T cells derived from tumor samples suggested distinct differences from peripheral blood T cells. There was an increase in melanoma-associated antigen recognized by T cells (MART-1)-specific T cells in tumors undergoing regression after vaccination compared with T cells derived from melanoma patients not treated with vaccine. There was also a significant decrease in Treg and Ts cells in injected lesions compared with noninjected lesions in the same and different melanoma patients. Similarly MDSC were increased in melanoma lesions but underwent a significant decrease only in vaccinated lesions.

Conclusions

Melanoma patients present with elevated levels of Tregs, Ts, and MDSC within established tumors. Direct injection of OncovexGM-CSF induces local and systemic antigen-specific T cell responses and decreases Treg, Ts, and MDSC in patients exhibiting therapeutic responses.

References

  1. 1.
    Liu BL, Robinson M, Han ZQ, et al. ICP34.5 deleted herpes simplex virus with enhanced oncolytic, immune stimulating, and anti-tumour properties. Gene Ther. 2003;10(4):292–303.Google Scholar
  2. 2.
    Toda M, Martuza RL, Rabkin SD. Tumor growth inhibition by intratumoral inoculation of defective herpes simplex virus vectors expressing granulocyte-macrophage colony-stimulating factor. Mol Ther. 2000;2(4):324–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Hu JCC, Coffin RS, Davis CJ, et al. A Phase I study of OncoVEXGM-CSF, a second-generation oncolytic herpes simplex virus expressing granulocyte macrophage colony-stimulating factor. Clin Cancer Res. 2006;12(22):6737–47.CrossRefPubMedGoogle Scholar
  4. 4.
    Senzer NN, Kaufman HL, Amatruda T, et al. Phase II clinical trial with a second generation, GM-CSF encoding, oncolytic herpesvirus in unresectable metastatic melanoma. J Clin Oncol. 2008;26:(May 20 suppl; abstr 9008).Google Scholar
  5. 5.
    Curiel TJ, Coukos G, Zou L, et al. Specific recruitment of regulatory T cells in ovarian carcinoma fosters immune privilege and predicts reduced survival. Nat Med. 2004;10(9):942–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Liyanage UK, Moore TT, Joo HG, et al. Prevalence of regulatory T cells is increased in peripheral blood and tumor microenvironment of patients with pancreas or breast adenocarcinoma. J Immunol. 2002;169(5):2756–61.PubMedGoogle Scholar
  7. 7.
    Whiteside TL. The role of immune cells in the tumor microenvironment. Cancer Treat Res. 2006;130:103–24.CrossRefPubMedGoogle Scholar
  8. 8.
    Conejo-Garcia JR, Benencia F, Courreges M-C, et al. Tumor-infiltrating dendritic cell precursors recruited by a [beta]-defensin contribute to vasculogenesis under the influence of Vegf-A. Nat Med. 2004;10(9):950–8.CrossRefPubMedGoogle Scholar
  9. 9.
    Battaglia A, Buzzonetti A, Baranello C, et al. Metastatic tumour cells favour the generation of a tolerogenic milieu in tumour draining lymph node in patients with early cervical cancer. Cancer Immunol Immunother. 2009;58(9):1363–73.Google Scholar
  10. 10.
    Zhang L, Conejo-Garcia JR, Katsaros D, et al. Intratumoral T cells, recurrence, and survival in epithelial ovarian cancer. N Engl J Med. 2003;348(3):203–13.CrossRefPubMedGoogle Scholar
  11. 11.
    Kaufman HL, DeRaffele G, Mitcham J, et al. Targeting the local tumor microenvironment with vaccinia virus expressing B7.1 for the treatment of melanoma. J Clin Invest. 2005;115(7):1903–12.CrossRefPubMedGoogle Scholar
  12. 12.
    Naito Y, Saito K, Shiiba K, et al. CD8+ T cells infiltrated within cancer cell nests as a prognostic factor in human colorectal cancer. Cancer Res. 1998;58(16):3491–4.PubMedGoogle Scholar
  13. 13.
    Nakano O, Sato M, Naito Y, et al. Proliferative activity of intratumoral CD8+ T-lymphocytes as a prognostic factor in human renal cell carcinoma: clinicopathologic demonstration of antitumor immunity. Cancer Res. 2001;61(13):5132–6.PubMedGoogle Scholar
  14. 14.
    Chang CC, Ciubotariu R, Manavalan JS, et al. Tolerization of dendritic cells by T(S) cells: the crucial role of inhibitory receptors ILT3 and ILT4. Nat Immunol. 2002;3(3):237–43.CrossRefPubMedGoogle Scholar
  15. 15.
    Najafian N, Chitnis T, Salama AD, et al. Regulatory functions of CD8+ CD28− T cells in an autoimmune disease model. J Clin Invest. 2003;112(7):1037–48.PubMedGoogle Scholar
  16. 16.
    Rifa’i M, Kawamoto Y, Nakashima I, Suzuki H. Essential roles of CD8+CD122+ regulatory T cells in the maintenance of T cell homeostasis. J Exp Med. 2004;200(9):1123–34.CrossRefPubMedGoogle Scholar
  17. 17.
    Xystrakis E, Dejean AS, Bernard I, et al. Identification of a novel natural regulatory CD8 T-cell subset and analysis of its mechanism of regulation. Blood. 2004;104(10):3294–301.CrossRefPubMedGoogle Scholar
  18. 18.
    Cosmi L, Liotta F, Lazzeri E, et al. Human CD8+CD25+ thymocytes share phenotypic and functional features with CD4+CD25+ regulatory thymocytes. Blood. 2003;102(12):4107–14.CrossRefPubMedGoogle Scholar
  19. 19.
    Liu Z, Tugulea S, Cortesini R, Suciu-Foca N. Specific suppression of T helper alloreactivity by allo-MHC class I-restricted CD8+CD28− T cells. Int Immunol. 1998;10(6):775–83.CrossRefPubMedGoogle Scholar
  20. 20.
    Ciubotariu R, Colovai AI, Pennesi G, et al. Specific suppression of human CD4+ Th cell responses to pig MHC antigens by CD8+CD28− regulatory T cells. J Immunol. 1998;161(10):5193–202.PubMedGoogle Scholar
  21. 21.
    Colovai AI, Liu Z, Ciubotariu R, et al. Induction of xenoreactive CD4+ T-cell anergy by suppressor CD8+ CD28− T cells. Transplantation. 2000;69(7):1304–10.CrossRefPubMedGoogle Scholar
  22. 22.
    Chaput N, Louafi S, Bardier A, et al. Identification of CD8+CD25+FoxP3+ suppressive T cells in colorectal cancer tissue. Gut. 2008:gut.2008.158824.Google Scholar
  23. 23.
    Kiniwa Y, Miyahara Y, Wang HY, et al. CD8+FoxP3+ regulatory T cells mediate immunosuppression in prostate cancer. Clin Cancer Res. 2007;13(23):6947–58.CrossRefPubMedGoogle Scholar
  24. 24.
    Gabrilovich DI, Nagaraj S. Myeloid-derived suppressor cells as regulators of the immune system. Nat Rev Immunol. 2009;9(3):162–74 (advanced online publication).Google Scholar
  25. 25.
    Rodriguez PC, Zea AH, Culotta KS, et al. Regulation of T cell receptor CD3zeta chain expression by L-arginine. J Biol Chem. 2002;277(24):21123–9.CrossRefPubMedGoogle Scholar
  26. 26.
    Zea AH, Rodriguez PC, Atkins MB, et al. Arginase-producing myeloid suppressor cells in renal cell carcinoma patients: a mechanism of tumor evasion. Cancer Res. 2005;65(8):3044–8.PubMedGoogle Scholar
  27. 27.
    Gabrilovich D, Ishida T, Oyama T, et al. Vascular endothelial growth factor inhibits the development of dendritic cells and dramatically affects the differentiation of multiple hematopoietic lineages in vivo. Blood. 1998;92(11):4150–66.PubMedGoogle Scholar
  28. 28.
    Cesana GC, DeRaffele G, Cohen S, et al. Characterization of CD4+CD25+ regulatory T cells in patients treated with high-dose interleukin-2 for metastatic melanoma or renal cell carcinoma. J Clin Oncol. 2006;24(7):1169–77.CrossRefPubMedGoogle Scholar
  29. 29.
    Ahmadzadeh M, Rosenberg SA. IL-2 administration increases CD4+CD25(hi) FoxP3+ regulatory T cells in cancer patients. Blood. 2006;107(6):2409–14.CrossRefPubMedGoogle Scholar
  30. 30.
    Jandus C, Bioley G, Speiser DE, Romero P. Selective accumulation of differentiated FOXP3(+) CD4 (+) T cells in metastatic tumor lesions from melanoma patients compared to peripheral blood. Cancer Immunol Immunother. 2008;57(12):1795–805.CrossRefPubMedGoogle Scholar
  31. 31.
    Filaci G, Fenoglio D, Fravega M, et al. CD8+CD28 T regulatory lymphocytes inhibiting T cell proliferative and cytotoxic functions infiltrate human cancers. J Immunol. 2007;179(7):4323–34.PubMedGoogle Scholar
  32. 32.
    Maynard CL, Hatton RD, Helms WS, et al. Contrasting roles for all-trans retinoic acid in TGF-beta-mediated induction of FoxP3 and Il10 genes in developing regulatory T cells. J Exp Med. 2009;206(2):343–57.CrossRefPubMedGoogle Scholar
  33. 33.
    Strome SE, Dong H, Tamura H, et al. B7-H1 blockade augments adoptive T-cell immunotherapy for squamous cell carcinoma. Cancer Res. 2003;63(19):6501–5.PubMedGoogle Scholar
  34. 34.
    Shibakita M, Tachibana M, Dhar DK, et al. Prognostic significance of Fas and Fas ligand expressions in human esophageal cancer. Clin Cancer Res. 1999;5(9):2464–9.PubMedGoogle Scholar
  35. 35.
    Ohm JE, Gabrilovich DI, Sempowski GD, et al. VEGF inhibits T-cell development and may contribute to tumor-induced immune suppression. Blood. 2003;101(12):4878–86.CrossRefPubMedGoogle Scholar
  36. 36.
    Hori S, Nomura T, Sakaguchi S. Control of regulatory T cell development by the transcription factor FoxP3. Science. 2003;299(5609):1057–61.CrossRefPubMedGoogle Scholar
  37. 37.
    Gavin MA, Rasmussen JP, Fontenot JD, et al. FoxP3-dependent programme of regulatory T-cell differentiation. Nature. 2007;445(7129):771–5.CrossRefPubMedGoogle Scholar
  38. 38.
    Coombes JL, Siddiqui KR, Arancibia-Carcamo CV, et al. A functionally specialized population of mucosal CD103+DCs induces FoxP3+ regulatory T cells via a TGF-beta and retinoic acid-dependent mechanism. J Exp Med. 2007;204(8):1757–64.CrossRefPubMedGoogle Scholar
  39. 39.
    Marigo I, Dolcetti L, Serafini P, et al. Tumor-induced tolerance and immune suppression by myeloid derived suppressor cells. Immunol Rev. 2008;222(1):162–79.CrossRefPubMedGoogle Scholar
  40. 40.
    Kusmartsev S, Gabrilovich DI. Role of immature myeloid cells in mechanisms of immune evasion in cancer. Cancer Immunol Immunother. 2006;55(3):237–45.CrossRefPubMedGoogle Scholar
  41. 41.
    Joetham A, Matsubara S, Okamoto M, et al. Plasticity of regulatory T cells: subversion of suppressive function and conversion to enhancement of lung allergic responses. J Immunol. 2008;180(11):7117–7124.PubMedGoogle Scholar
  42. 42.
    Qin H, Vlad G, Cortesini R, et al. CD8+ suppressor and cytotoxic T cells recognize the same human leukocyte antigen-A2 restricted cytomegalovirus peptide. Hum Immunol. 2008;69(11):776–80.CrossRefPubMedGoogle Scholar

Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Howard L. Kaufman
    • 1
  • Dae Won Kim
    • 1
  • Gail DeRaffele
    • 2
  • Josephine Mitcham
    • 2
  • Rob S. Coffin
    • 3
  • Seunghee Kim-Schulze
    • 2
  1. 1.Department of Surgery, Medicine and ImmunologyRush University Medical CenterChicagoUSA
  2. 2.The Tumor Immunology Laboratory, Department of SurgeryMount Sinai School of MedicineNew YorkUSA
  3. 3.Biovex, Inc.CambridgeUSA

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