Journal
CANCER SCIENCE
Volume 110, Issue 8, Pages 2378-2385Publisher
WILEY
DOI: 10.1111/cas.14106
Keywords
immunotherapy; interferon beta; pancreatic cancer; peptide vaccination; survivin
Categories
Funding
- Japan Agency for Medical Research and Development [16cm0106309h0001]
- Japan Society for the Promotion of Science [15H04722 17H01540]
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The prognosis of advanced pancreatic adenocarcinoma is still extremely poor. This study sought to determine the efficacy of, and immunological response to, peptide vaccination therapy in patients with this disease. In this multicenter randomized phase II study, patients with advanced pancreatic adenocarcinoma after gemcitabine and/or tegafur/gimeracil/oteracil were randomly assigned to 3 groups that each received a 2-step treatment course. In Step 1, the groups received treatments of: (i) survivin 2B peptide (SVN-2B) plus interferon-beta (IFN beta); (ii) SVN-2B only; or (iii) placebo until the patients show progression. In Step 2, all patients who consented to participate received 4 treatments with SVN-2B plus IFN beta. The primary endpoint was progression-free survival (PFS) after initiation of Step 1 treatment. Secondary endpoints included immunological effects assessed by analysis of PBMCs after Step 1. Eighty-three patients were randomly assigned to receive SVN-2B plus IFN beta (n = 30), SVN-2B (n = 34), or placebo (n = 19). No significant improvement in PFS was observed. Survivin 2B-specific CTLs were found to be increased in the SVN-2B plus IFN beta group by tetramer assay. Among patients who participated in Step 2, those who had received SVN-2B plus IFN beta in Step 1 showed better overall survival compared with those who had received placebo in Step 1. Patients vaccinated with SVN-2B plus IFN beta did not have improved PFS, but showed significant immunological reaction after vaccination. Subgroup analysis suggested that a longer SVN-2B plus IFN beta vaccination protocol might confer survival benefit. (Clinical trial registration number: UMIN 000012146).
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