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Mazorra Z, Cáceres-Lavernia HH, Nenínger-Vinageras E, Varona-Rodríguez LM, Viada CE, González Z, Rodríguez-Zhurbenko N, Thierry AC, Suarez-Formigo GM, Ventura-Carmenate Y, Baumgaertner P, Trabanelli S, Jandus C, Crombet T. Treatment of Advanced NSCLC Patients with an Anti-Idiotypic NeuGcGM3-Based Vaccine: Immune Correlates in Long-Term Survivors. Biomedicines 2025; 13:1122. [PMID: 40426949 PMCID: PMC12109512 DOI: 10.3390/biomedicines13051122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2025] [Revised: 03/26/2025] [Accepted: 04/10/2025] [Indexed: 05/29/2025] Open
Abstract
Background: Racotumomab-alum is an anti-idiotype vaccine targeting the NeuGcGM3 tumor-associated ganglioside. Clinical trials in advanced cancer patients have demonstrated low toxicity, high immunogenicity and clinical benefit. The goal of this study was to identify circulating biomarkers of clinical outcome. Methods: Eighteen patients with stage IIIb/IV non-small-cell lung cancer (NSCLC) were injected with racotumomab-alum as switch maintenance therapy after first-line chemotherapy. Treatment was administered until severe performance status worsening or toxicity. The frequencies of innate and adaptive lymphocytes were assessed by flow cytometry. Circulating factors were measured using multi-analyte flow assay kits. Results: The median overall survival was 16.5 months. Twenty-seven percent of patients were classified as long-term survivors. Patients with lower baseline frequencies of CD4+Tregs and central memory (CM) CD8+T cells displayed longer survival rates. Furthermore, higher baseline frequencies of NKT cells and a high CD8+T/CD4+Treg ratio were associated with longer survival. Interestingly, patients with significantly lower levels of effector memory (EM) CD8+T cells survived longer. The levels of NKT cells and terminal effector memory (EMRA) CD8+T cells were higher in long-term survivors in comparison with short-term survivors in post-immune samples. As expected, the ratio of CD8+T/CD4+Tregs showed significantly higher values during treatment in patients with clinical benefits. Regarding serum factors, pro-tumorigenic cytokines significantly increased during treatment in poor survivors. Conclusions: In advanced NSCLC patients receiving racotumomab-alum vaccine, longer survival could be associated with a unique profile of circulating lymphocyte subsets at baseline and during treatment. Additionally, certain pro-tumor-related cytokines increased in short-term survivors. These results should be confirmed in larger randomized clinical trials. This clinical trial was registered in the Cuban Clinical Trials Register (RPCE00000279).
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Affiliation(s)
- Zaima Mazorra
- Center of Molecular Immunology, Havana 11600, Cuba; (C.E.V.); (Z.G.); (N.R.-Z.); (T.C.)
- Department of Immunology, Abu Dhabi Stem Cells Center (ADSCC), Abu Dhabi 23231, United Arab Emirates (Y.V.-C.)
| | - Haslen H. Cáceres-Lavernia
- Clinical Oncology Department, University Hospital “Hermanos Ameijeiras”, Havana 10400, Cuba; (H.H.C.-L.); (E.N.-V.); (L.M.V.-R.)
| | - Elia Nenínger-Vinageras
- Clinical Oncology Department, University Hospital “Hermanos Ameijeiras”, Havana 10400, Cuba; (H.H.C.-L.); (E.N.-V.); (L.M.V.-R.)
| | - Leslie M. Varona-Rodríguez
- Clinical Oncology Department, University Hospital “Hermanos Ameijeiras”, Havana 10400, Cuba; (H.H.C.-L.); (E.N.-V.); (L.M.V.-R.)
| | - Carmen Elena Viada
- Center of Molecular Immunology, Havana 11600, Cuba; (C.E.V.); (Z.G.); (N.R.-Z.); (T.C.)
| | - Zuyen González
- Center of Molecular Immunology, Havana 11600, Cuba; (C.E.V.); (Z.G.); (N.R.-Z.); (T.C.)
| | | | - Anne-Christine Thierry
- Center of Experimental Therapeutics, Department of Oncology, Lausanne University Hospital (CHUV), 1005 Lausanne, Switzerland; (A.-C.T.); (P.B.)
| | - Gisela María Suarez-Formigo
- Department of Immunology, Abu Dhabi Stem Cells Center (ADSCC), Abu Dhabi 23231, United Arab Emirates (Y.V.-C.)
| | - Yendry Ventura-Carmenate
- Department of Immunology, Abu Dhabi Stem Cells Center (ADSCC), Abu Dhabi 23231, United Arab Emirates (Y.V.-C.)
| | - Petra Baumgaertner
- Center of Experimental Therapeutics, Department of Oncology, Lausanne University Hospital (CHUV), 1005 Lausanne, Switzerland; (A.-C.T.); (P.B.)
| | - Sara Trabanelli
- Department of Pathology and Immunology, University of Geneva, 1211 Geneva, Switzerland; (S.T.)
- Ludwig Institute for Cancer Research, Lausanne Branch, 1066 Lausanne, Switzerland
- Geneva Center for Inflammation Research, 1211 Geneva, Switzerland
- Translational Research Center for Oncohematology, Department of Medicine, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Camila Jandus
- Department of Pathology and Immunology, University of Geneva, 1211 Geneva, Switzerland; (S.T.)
- Ludwig Institute for Cancer Research, Lausanne Branch, 1066 Lausanne, Switzerland
- Geneva Center for Inflammation Research, 1211 Geneva, Switzerland
- Translational Research Center for Oncohematology, Department of Medicine, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Tania Crombet
- Center of Molecular Immunology, Havana 11600, Cuba; (C.E.V.); (Z.G.); (N.R.-Z.); (T.C.)
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