Abstract
This study was conducted in prostate cancer patients in biochemical relapse after radical prostatectomy, to assess the feasibility, safety, and immunogenicity of therapeutic vaccination with autologous dendritic cells (DCs) pulsed with human recombinant prostate-specific antigen (PSA) (Dendritophage-rPSA). Twenty-four patients with histologically proven prostate carcinoma and an isolated postoperative rise of serum PSA (>1 ng/ml to 10 ng/ml) after radical prostatectomy were included. The patients received nine administrations of PSA-loaded DCs by combined intravenous, subcutaneous, and intradermal routes over 21 weeks. Postbaseline blood tests were performed at months 1, 3, 6, 9, and 12 (PSA levels), at months 6 and 12 (circulating prostate cancer cells), at month 6 (anti-PSA IgG and IgM antibodies), and at up to eight time points before, during, and after immunization (PSA-specific T cells). Circulating prostate cancer cells detected in six patients at baseline were undetectable at 6 months and remained undetectable at 12 months. Eleven patients had a postbaseline transient PSA decrease on one to three occasions, predominantly occurring at month 1 (7 patients) or month 3 (2 patients). Maximum PSA decrease ranged from 6% to 39%. PSA decrease on at least one occasion was more frequent in patients with low Gleason score (p=0.016) at prostatectomy and with positive skin tests at study baseline (p=0.04). PSA-specific T cells were detected ex vivo by ELISpot for IFN-γ in 7 patients before vaccination and in 11 patients after vaccination. Of the latter 11 patients, 5 had detectable T cells both before and during the vaccination period, 4 only during the vaccination period, while 2 patients could for technical reasons not be assessed prevaccination. No induction of anti-PSA IgG or IgM antibodies was detected. There were no serious adverse events or otherwise severe toxicities observed during the trial. Immunization with Dendritophage-rPSA was feasible and safe in this cohort of patients. An immune response specific for PSA could be detected in some patients. A notable effect was the disappearance of circulating prostate cells in all patients who were RT-PCR positive before vaccination.
Similar content being viewed by others
References
Alexander RB, Brady F, Leffell MS, Tsai V, Celis E (1998) Specific T cell recognition of peptides derived from prostate-specific antigen in patients with prostate cancer. Urology 51:150
Almand B, Resser JR, Lindman B, Nadaf S, Clark JI, Kwon ED, Carbone DP, Gabrilovich DI (2000) Clinical significance of defective dendritic cell differentiation in cancer. Clin Cancer Res 6:1755
Almand B, Clark JI, Nikitina E, van Beynen J, English NR, Knight SC, Carbone DP, Gabrilovich DI. (2001) Increased production of immature myeloid cells in cancer patients: a mechanism of immunosuppression in cancer. J Immunol 166:678
Banchereau J, Briere F, Caux C, Davoust J, Lebecque S, Liu YJ, Pulendran B, Palucka K (2000) Immunobiology of dendritic cells. Ann Rev Immunol 18:767
Belz GT, Heath WR, Carbone FR (2002) The role of dendritic cell subsets in selection between tolerance and immunity. Immunol Cell Biol 80:463
Bercovici N, Duffour MT, Agrawal S, Salcedo M, Abastado JP (2000) New methods for assessing T-cell responses. Clin Diagn Lab Immunol 7:859
Burks DA, Littleton RH (1992) The epidemiology of prostate cancer in black men. Henry Ford Hosp Med J 40:89
Carroll PR, Lee KI, Fuks ZY, Kantoff PW (2001) Cancer of the prostate. In: DeVita VT Jr, Hellman S, Rosenberg SA (eds) Cancer: principles and practice of oncology, vol 1. Lippincott Williams and Wilkins, Philadelphia, p 1418
D’Amico AV, Whittington R, Schultz D, Malkowicz SB, Tomaszewski JE, Wein A (1997) Outcome based staging for clinically localized adenocarcinoma of the prostate. J Urol 158:1422
Epstein JI, Pound CR, Partin AW, Walsh PC (1998) Disease progression following radical prostatectomy in men with Gleason score 7 tumor. J Urol 160:97
Goxe B, Latour N, Chokri M, Abastado JP, Salcedo M (2000) Simplified method to generate large quantities of dendritic cells suitable for clinical applications. Immunol Invest 29:319
Hartgers FC, Figdor CG, Adema GJ (2000) Towards a molecular understanding of dendritic cell immunobiology. Immunol Today 21:542
He L, Feng H, Raymond A, Kreeger M, Zeng Y, Graner M, Whitesell L, Katsanis E (2001) Dendritic-cell-peptide immunization provides immunoprotection against bcr-abl-positive leukemia in mice. Cancer Immunol Immunother 50:31
Herr W, Schneider J, Lohse AW, Meyer zum Buschenfelde KH, Wolfel T (1996) Detection and quantification of blood-derived CD8+ T lymphocytes secreting tumor necrosis factor alpha in response to HLA-A2.1-binding melanoma and viral peptide antigens. J Immunol Methods 191:131
Horoszewicz JS, Leong SS, Kawinski E, Karr JP, Rosenthal H, Chu TM, Mirand EA, Murphy GP (1983) LNCaP model of human prostatic carcinoma. Cancer Res 43:1809
Hsu FJ, Benike C, Fagnoni F, Liles TM, Czerwinski D, Taidi B, Engleman EG, Levy R (1996) Vaccination of patients with B-cell lymphoma using autologous antigen-pulsed dendritic cells. Nat Med 2:52
Kantoff PW, Halabi S, Farmer DA, Hayes DF, Vogelzang NA, Small EJ (2001) Prognostic significance of reverse transcriptase polymerase chain reaction for prostate-specific antigen in men with hormone-refractory prostate cancer. J Clin Oncol 19:3025
Kiertscher SM, Luo J, Dubinett SM, Roth MD (2000) Tumors promote altered maturation and early apoptosis of monocyte-derived dendritic cells. J Immunol 164:1269
Kupelian PA, Katcher J, Levin HS, Klein EA (1997) Stage T1–2 prostate cancer: a multivariate analysis of factors affecting biomedical and clinical failures after radical prostatectomy. Int J Radiat Oncol Biol Phys 37:1043
Lewis DE, Harriman GR (2001) Cells and tissues of the immune system. In: Rich RR, Fleisher TA, Shearer WT, Kotzin BL, Schroeder HW Jr (eds) Clinical immunology, principles and practice, vol 1. Mosby, London, p 21
Loric S, Dumas F, Eschwege P, Blanchet P, Benoit G, Jardin A, Lacour B (1995) Enhanced detection of hematogenous circulating prostatic cells in patients with prostate adenocarcinoma by using nested reverse transcription polymerase chain reaction assay based on prostate-specific membrane antigen. Clin Chem 41:1698
Mathis G, Socquet F, Viguier M, Darbouret B (1997) Homogeneous immunoassays using rare earth cryptates and time resolved fluorescence: principles and specific advantages for tumor markers. Anticancer Res 17:3011
Mayordomo JI, Zorina T, Storkus WJ, Zitvogel L, Celluzzi C, Falo LD, Melief CJ, Ildstad ST, Kast WM, Deleo AB et al (1995) Bone marrow-derived dendritic cells pulsed with synthetic tumour peptides elicit protective and therapeutic antitumour immunity. Nat Med 1:1297
Melief CJ, Schoenberger S, Toes R, Offringa R (1999) Cytotoxic T lymphocyte priming versus cytotoxic T lymphocyte tolerance induction: a delicate balancing act involving dendritic cells. Haematologica 84[Suppl EHA-4]:26
Nestle FO, Banchereau J, Hart D (2001) Dendritic cells: on the move from bench to bedside. Nat Med 7:761
Partin AW, Pound CR, Clemens JQ, Epstein JL, Walsh PC (1993) Serum PSA after anatomic radical prostatectomy: the Johns Hopkins experience after 10 years. Urol Clin North Am 20:713
Partin AW, Piantadosi S, Sanda MG, Epstein JI, Marshall FF, Mohler JL, Brendler CB, Walsh PC, Simons JW (1995) Selection of men at high risk for disease recurrence for experimental adjuvant therapy following radical prostatectomy. Urology 45:831
Pound CR, Partin AW, Epstein JI, Walsh PC (1997) Prostate-specific antigen after anatomic radical retropubic prostatectomy: patterns of recurrence and cancer control. Urol Clin North Am 24:395
Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC (1999) Natural history of progression after PSA elevation following radical prostatectomy. JAMA 281:1591
Rich RR (2001) The human immune response. In: Rich RR, Fleisher TA, Shearer WT, Kotzin BL, Schroeder HW Jr (eds) Clinical immunology, principles and practice, vol 1. Mosby, London, p 11
Romani N, Gruner S, Brang D, Kampgen E, Lenz A, Trockenbacher B, Konwalinka G, Fritsch PO, Steinman RM, Schuler G (1994) Proliferating dendritic cell progenitors in human blood. J Exp Med 180:83
Romani N, Reider D, Heuer M, Ebner S, Kampgen E, Eibl B, Niederwieser D, Schuler G (1996) Generation of mature dendritic cells from human blood: an improved method with special regard to clinical applicability. J Immunol Methods 196:137
Rosenberg SA (2000) Identification of cancer antigens: impact on development of cancer immunotherapies. Cancer J Sci Am 6[Suppl 3]:S200–S207
Salgaller ML, Tjoa BA, Lodge PA, Ragde H, Kenny G, Boynton A, Murphy GP (1998) Dendritic cell-based immunotherapy of prostate cancer. Crit Rev Immunol 18:109
Sallusto F, Lanzavecchia A (1994) Efficient presentation of soluble antigen by cultured human dendritic cells is maintained by granulocyte/macrophage colony-stimulating factor plus interleukin 4 and downregulated by tumor necrosis factor alpha. J Exp Med 179:1109
Scher HI (1999) Management of prostate cancer after prostatectomy: treating the patient, not the PSA. JAMA 281:1642
Schuler G, Steinman RM (1997) Dendritic cells as adjuvants for immune-mediated resistance to tumors. J Exp Med 186:1183
Seiden MV, Kantoff PW, Krithivas K, Propert K, Bryant M, Haltom E, Gaynes L, Kaplan I, Bubley G, DeWolf W, SklarJ (1994) Detection of circulating tumor cells in men with localized prostate cancer. J Clin Oncol 12:2634
Steinman RM, Inaba K, Turley S, Pierre P, Mellman I (1999) Antigen capture, processing, and presentation by dendritic cells: recent cell biological studies. Hum Immunol 60:562
Zagars GK, Pollack A, von Eschenbach AC (1997) Prognostic factors for clinically localized prostate carcinoma: analysis of 938 patients irradiated in the prostate specific antigen era. Cancer 79:1370
Acknowledgements
We thank Dr Nabi Azar and Dr Françoise Norol for assistance with cell freezing, Dr Brailly for analysis of blood PSA levels, Dr S. Loric for RT-PCR analyses, and F. Vernel Pauillac and I. Hamon for assistance with patient immunomonitoring.
Author information
Authors and Affiliations
Corresponding author
Additional information
Scientific correspondence should be addressed to B. Barrou; editorial correspondence to M.L. Ericson.
Rights and permissions
About this article
Cite this article
Barrou, B., Benoît, G., Ouldkaci, M. et al. Vaccination of prostatectomized prostate cancer patients in biochemical relapse, with autologous dendritic cells pulsed with recombinant human PSA. Cancer Immunol Immunother 53, 453–460 (2004). https://doi.org/10.1007/s00262-003-0451-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00262-003-0451-2