Randomized phase II trial of lymphodepletion plus adoptive cell transfer of tumor-infiltrating lymphocytes, with or without dendritic cell vaccination, in patients with metastatic melanoma
Chantal Saberian, Rodabe N Amaria, Amer M Najjar, Laszlo G Radvanyi, Cara L Haymaker, Marie-Andrée Forget, Roland L Bassett, Silvana C Faria, Isabella C Glitza, Enrique Alvarez, Sapna Parshottam, Victor Prieto, Gregory Lizée, Michael K Wong, Jennifer L McQuade, Adi Diab, Cassian Yee, Hussein A Tawbi, Sapna Patel, Elizabeth J Shpall, Michael A Davies, Patrick Hwu, Chantale Bernatchez, Chantal Saberian, Rodabe N Amaria, Amer M Najjar, Laszlo G Radvanyi, Cara L Haymaker, Marie-Andrée Forget, Roland L Bassett, Silvana C Faria, Isabella C Glitza, Enrique Alvarez, Sapna Parshottam, Victor Prieto, Gregory Lizée, Michael K Wong, Jennifer L McQuade, Adi Diab, Cassian Yee, Hussein A Tawbi, Sapna Patel, Elizabeth J Shpall, Michael A Davies, Patrick Hwu, Chantale Bernatchez
Abstract
Background: The adoptive transfer of tumor-infiltrating lymphocytes (TIL) has demonstrated robust efficacy in metastatic melanoma patients. Tumor antigen-loaded dendritic cells (DCs) are believed to optimally activate antigen-specific T lymphocytes. We hypothesized that the combined transfer of TIL, containing a melanoma antigen recognized by T cells 1 (MART-1) specific population, with MART-1-pulsed DC will result in enhanced proliferation and prolonged survival of transferred MART-1 specific T cells in vivo ultimately leading to improved clinical responses.
Design: We tested the combination of TIL and DC in a phase II clinical trial of patients with advanced stage IV melanoma. HLA-A0201 patients whose early TIL cultures demonstrated reactivity to MART-1 peptide were randomly assigned to receive TIL alone or TIL +DC pulsed with MART-1 peptide. The primary endpoint was to evaluate the persistence of MART-1 TIL in the two arms. Secondary endpoints were to evaluate clinical response and survival.
Results: Ten patients were given TIL alone while eight patients received TIL+DC vaccine. Infused MART-1 reactive CD8+ TIL were tracked in the blood over time by flow cytometry and results show good persistence in both arms, with no difference in the persistence of MART-1 between the two arms. The objective response rate was 30% (3/10) in the TIL arm and 50% (4/8) in the TIL+DC arm. All treatments were well tolerated.
Conclusions: The combination of TIL +DC showed no difference in the persistence of MART-1 TIL compared with TIL therapy alone. Although more patients showed a clinical response to TIL+DC therapy, this study was not powered to resolve differences between groups.
Trial registration number: NCT00338377.
Keywords: adaptive immunity; dendritic cells; lymphocytes; melanoma; tumor-infiltrating; vaccination.
Conflict of interest statement
Competing interests: CLH is on the SAB for Briacell. PH consulting agreement with Immatics, Dragonfly, Sanofi, GSK. CB is on the SAB of Myst therapeutics and received research funding from Iovance biotherapeutics.
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.
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