Pilot trial of tumor-specific peptide vaccination and continuous infusion interleukin-2 in patients with recurrent Ewing sarcoma and alveolar rhabdomyosarcoma: An inter-institute NIH study

Ramzi Dagher, Lauren M. Long, Elizabeth J. Read, Susan F. Leitman, Charles S. Carter, Maria Tsokos, Theresa J. Goletz, Nilo Avila, Jay A. Berzofsky, Lee J. Helman, Crystal L. Mackall

Research output: Contribution to journalArticle

Abstract

Background. Patients with recurrent Ewing sarcoma and alveolar rhabdomyosarcoma have poor prognoses and limited therapeutic options. We have investigated the use of peptide pulsed vaccination in an attempt to immunologically target the breakpoint region of tumor specific fusion proteins expressed in these tumors. Procedure. Sixteen patients with recurrent, translocation positive, Ewing sarcoma, and alveolar rhabdomyosarcoma underwent apheresis for collection of peripheral blood mononuclear cells. Following countercurrent centrifugal elutriation, an apheresis product comprised predominantly of monocytes but containing small numbers of circulating immature dendritic cells was pulsed with peptides derived from the breakpoint region of the fusion proteins. Vaccines were administered intravenously concomitant with continuous intravenous rhIL-2 at 9 × 106 IU/m2/day. Results. Toxicity was limited to IL-2 related effects and was generally mild. Following vaccination, all patients showed progressive disease, most in a rapid fashion following the first vaccine. One patient showed evidence of an immunologic response and another showed a mixed clinical response. Patients enrolled on this tumor vaccine trial showed significant immunosuppression and large bulky tumors. Conclusions. Peptide vaccination as administered in this trial did not alter the dismal clinical outcome for patients with recurrent pediatric sarcomas. Future trials of tumor vaccines in this population should target patient populations with improved immune competence and smaller tumor burdens. Furthermore, optimization of the antigen presenting cell populations may be important for inducing immune responses to peptide antigens.

Original languageEnglish (US)
Pages (from-to)158-164
Number of pages7
JournalMedical and Pediatric Oncology
Volume38
Issue number3
DOIs
StatePublished - Jan 1 2002

Keywords

  • Ewing sarcoma
  • IL-2
  • Immunotherapy
  • Rhabdomyosarcoma
  • Translocation
  • Tumor vaccine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Oncology
  • Cancer Research

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    Dagher, R., Long, L. M., Read, E. J., Leitman, S. F., Carter, C. S., Tsokos, M., Goletz, T. J., Avila, N., Berzofsky, J. A., Helman, L. J., & Mackall, C. L. (2002). Pilot trial of tumor-specific peptide vaccination and continuous infusion interleukin-2 in patients with recurrent Ewing sarcoma and alveolar rhabdomyosarcoma: An inter-institute NIH study. Medical and Pediatric Oncology, 38(3), 158-164. https://doi.org/10.1002/mpo.1303