journal contribution posted on 2023-03-31, 01:26 authored by Elizabeth A. Reap, Carter M. Suryadevara, Kristen A. Batich, Luis Sanchez-Perez, Gary E. Archer, Robert J. Schmittling, Pamela K. Norberg, James E. Herndon, Patrick Healy, Kendra L. Congdon, Patrick C. Gedeon, Olivia C. Campbell, Adam M. Swartz, Katherine A. Riccione, John S. Yi, Mohammed K. Hossain-Ibrahim, Anirudh Saraswathula, Smita K. Nair, Anastasie M. Dunn-Pirio, Taylor M. Broome, Kent J. Weinhold, Annick Desjardins, Gordana Vlahovic, Roger E. McLendon, Allan H. Friedman, Henry S. Friedman, Darell D. Bigner, Peter E. Fecci, Duane A. Mitchell, John H. Sampson
Patient weight distribution and weight-based ATCT infusion counts.
NIH National Institute of Neurological Disorders and Stroke
Department of Defense
National Brain Tumor Society
American Brain Tumor Association
Accelerate Brain Cancer Cure Foundation Young Investigator's Award
The Kinetics Foundation
Ben and Catherine Ivy Foundation
Duke University's Clinical & Translational Science Awards
ARTICLE ABSTRACTMedian survival for glioblastoma (GBM) remains <15 months. Human cytomegalovirus (CMV) antigens have been identified in GBM but not normal brain, providing an unparalleled opportunity to subvert CMV antigens as tumor-specific immunotherapy targets. A recent trial in recurrent GBM patients demonstrated the potential clinical benefit of adoptive T-cell therapy (ATCT) of CMV phosphoprotein 65 (pp65)–specific T cells. However, ex vivo analyses from this study found no change in the capacity of CMV pp65-specific T cells to gain multiple effector functions or polyfunctionality, which has been associated with superior antitumor efficacy. Previous studies have shown that dendritic cells (DC) could further enhance tumor-specific CD8+ T-cell polyfunctionality in vivo when administered as a vaccine. Therefore, we hypothesized that vaccination with CMV pp65 RNA-loaded DCs would enhance the frequency of polyfunctional CMV pp65-specific CD8+ T cells after ATCT. Here, we report prospective results of a pilot trial in which 22 patients with newly diagnosed GBM were initially enrolled, of which 17 patients were randomized to receive CMV pp65-specific T cells with CMV-DC vaccination (CMV-ATCT-DC) or saline (CMV-ATCT-saline). Patients who received CMV-ATCT-DC vaccination experienced a significant increase in the overall frequencies of IFNγ+, TNFα+, and CCL3+ polyfunctional, CMV-specific CD8+ T cells. These increases in polyfunctional CMV-specific CD8+ T cells correlated (R = 0.7371, P = 0.0369) with overall survival, although we cannot conclude this was causally related. Our data implicate polyfunctional T-cell responses as a potential biomarker for effective antitumor immunotherapy and support a formal assessment of this combination approach in a larger randomized study.Significance: A randomized pilot trial in patients with GBM implicates polyfunctional T-cell responses as a biomarker for effective antitumor immunotherapy. Cancer Res; 78(1); 256–64. ©2017 AACR.