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Advances in Brief |
Division of Adult Oncology, Dana-Farber Cancer Institute, Department of Medicine, Brigham and Womens Hospital, Boston, Massachusetts 02115 [J. P. E., P. W. K., K. R., G. X., J. B., W. K. O., D. W. K.]; Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center; Dana-Farber/Harvard Cancer Center, Harvard Medical School, Boston, Massachusetts 02115 [J. P. E., G. J. B.]; National Cancer Institute, NIH, Bethesda, Maryland 20892 [P. A., K. Y. T., J. S.]; and Therion Biologics Corporation, Cambridge, Massachusetts 02142 [L. G., G. M., D. P.]
A
recombinant vaccinia virus encoding human prostate-specific antigen
(rV-PSA) was administered as three consecutive monthly doses to 33 men
with rising PSA levels after radical prostatectomy, radiation therapy,
both, or metastatic disease at presentation. Dose levels were 2.65 x 106, 2.65 x 107, and 2.65 x
108 plaque forming units. Ten patients who received the
highest dose also received 250 µg/m2
granulocyte-macrophage colony-stimulating factor (GM-CSF) as an
immunostimulatory adjunct. No patient experienced any virus-related
effects beyond grade I cutaneous toxicity. Pustule formation and/or
erythema occurred after the first dose in all 27 men who received
2.65 x 107 plaque forming units. GM-CSF
administration was associated with fevers and myalgias of grade 2 or
lower in 9 of 10 patients. PSA levels in 14 of 33 men treated with
rV-PSA with or without GM-CSF were stable for at least 6 months after
primary immunization. Nine patients remained stable for 1125 months;
six of these remain progression free with stable PSA levels.
Immunological studies demonstrated a specific T-cell response to PSA-3,
a 9-mer peptide derived from PSA. rV-PSA is safe and can elicit
clinical and immune responses, and certain patients remain without
evidence of clinical progression for up to 21 months or longer.
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