Vaccination against Oncoproteins of HPV16 for Noninvasive Vulvar/Vaginal Lesions: Lesion Clearance Is Related to the Strength of the T-Cell Response.
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van Poelgeest Mariëtte I E, Welters Marij J P, Vermeij Renee, Stynenbosch Linda F M, Loof Nikki M, Berends-van der Meer Dorien M A, Löwik Margriet J G, Hamming Ineke L E, van Esch Edith M G, Hellebrekers Bart W J, van Beurden Marc, Schreuder Henk W, Kagie Marjolein J, Trimbos J Baptist M Z, Fathers Lorraine M, Daemen Toos, Hollema Harry, Valentijn A Rob P M, Oostendorp Jaap, Oude Elberink J Hanneke N G, Fleuren Gertjan J, Bosse Tjalling, Kenter Gemma G, Stijnen Theo, Nijman Hans W, Melief Cornelis J M, van der Burg Sjoerd H
Аннотация
EXPERIMENTAL DESIGN: A multicenter open-label, randomized controlled trial was conducted in patients with HPV16(+) high-grade VIN/VaIN. Patients received ISA101 vaccination with or without application of 5% imiquimod at the vaccine site. The primary objective was the induction of a directly ex vivo detectable HPV16-specific CD8(+) T-cell response. The secondary objectives were clinical responses (lesion size, histology, and virology) and their relation with the strength of vaccination-induced immune responses.
RESULTS: Forty-three patients were assigned to either ISA101 with imiquimod (n = 21) or ISA101 only (n = 22). Imiquimod did not improve the outcomes of vaccination. However, vaccine-induced clinical responses were observed in 18 of 34 (53%; 95% CI, 35.1-70.2) patients at 3 months and in 15 of 29 (52%; 95% CI, 32.5-70.6) patients, 8 of whom displayed a complete histologic response, at 12 months after the last vaccination. All patients displayed vaccine-induced T-cell responses, which were significantly stronger in patients with complete responses. Importantly, viral clearance occurred in all but one of the patients with complete histologic clearance.
CONCLUSIONS: This new study confirms that clinical efficacy of ISA101 vaccination is related to the strength of vaccine-induced HPV16-specific T-cell immunity and is an effective therapy for HPV16-induced high-grade VIN/VaIN. Clin Cancer Res; 22(10); 2342-50. ©2016 AACRSee related commentary by Karaki et al., p. 2317.