1
|
Kreutmair S, Pfeifer D, Waterhouse M, Takács F, Graessel L, Döhner K, Duyster J, Illert AL, Frey AV, Schmitt M, Lübbert M. First-in-human study of WT1 recombinant protein vaccination in elderly patients with AML in remission: a single-center experience. Cancer Immunol Immunother 2022; 71:2913-2928. [PMID: 35476127 PMCID: PMC9588470 DOI: 10.1007/s00262-022-03202-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 04/01/2022] [Indexed: 12/12/2022]
Abstract
Wilms’ tumor 1 (WT1) protein is highly immunogenic and overexpressed in acute myeloid leukemia (AML), consequently ranked as a promising target for novel immunotherapeutic strategies. Here we report our experience of a phase I/II clinical trial (NCT01051063) of a vaccination strategy based on WT1 recombinant protein (WT1-A10) together with vaccine adjuvant AS01B in five elderly AML patients (median age 69 years, range 63–75) receiving a total of 62 vaccinations (median 18, range 3–20) after standard chemotherapy. Clinical benefit was observed in three patients: one patient achieved measurable residual disease clearance during WT1 vaccination therapy, another patient maintained long-term molecular remission over 59 months after the first vaccination cycle. Interestingly, in one case, we observed a complete clonal switch at AML relapse with loss of WT1 expression, proposing suppression of the original AML clone by WT1-based vaccination therapy. Detected humoral and cellular CD4+ T cell immune responses point to efficient immune stimulation post-vaccination, complementing hints for induced conventional T cell infiltration into the bone marrow and a shift from senescent/exhausted to a more activated T cell profile. Overall, the vaccinations with WT1 recombinant protein had an acceptable safety profile and were thus well tolerated. To conclude, our data provide evidence of potential clinical efficacy of WT1 protein-based vaccination therapy in AML patients, warranting further investigations.
Collapse
Affiliation(s)
- Stefanie Kreutmair
- Department of Internal Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, 79106, Freiburg, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner site Freiburg, 69120, Heidelberg, Germany
| | - Dietmar Pfeifer
- Department of Internal Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, 79106, Freiburg, Germany
| | - Miguel Waterhouse
- Department of Internal Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, 79106, Freiburg, Germany
| | - Ferenc Takács
- Center for Pathology, University Medical Center, University of Freiburg, 79106, Freiburg, Germany.,1st Department of Pathology and Experimental Cancer Research, Semmelweis University, 1085, Budapest, Hungary
| | - Linda Graessel
- Department of Internal Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, 79106, Freiburg, Germany
| | - Konstanze Döhner
- Department of Internal Medicine III, University Hospital, 89081, Ulm, Germany
| | - Justus Duyster
- Department of Internal Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, 79106, Freiburg, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner site Freiburg, 69120, Heidelberg, Germany
| | - Anna Lena Illert
- Department of Internal Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, 79106, Freiburg, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner site Freiburg, 69120, Heidelberg, Germany
| | - Anna-Verena Frey
- Center for Pathology, University Medical Center, University of Freiburg, 79106, Freiburg, Germany
| | - Michael Schmitt
- Department of Internal Medicine V, Hematology, Oncology, Rheumatology, University Hospital Heidelberg, 69120, Heidelberg, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Michael Lübbert
- Department of Internal Medicine I, Faculty of Medicine, Medical Center, University of Freiburg, 79106, Freiburg, Germany. .,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner site Freiburg, 69120, Heidelberg, Germany.
| |
Collapse
|
2
|
Münch C, Dragoi D, Frey AV, Thurig K, Lübbert M, Wäsch R, Bogatyreva L, Hauschke D, Lassmann S, Werner M, May AM. Therapeutic polo-like kinase 1 inhibition results in mitotic arrest and subsequent cell death of blasts in the bone marrow of AML patients and has similar effects in non-neoplastic cell lines. Leuk Res 2015; 39:462-70. [PMID: 25697066 DOI: 10.1016/j.leukres.2015.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 01/15/2015] [Accepted: 01/17/2015] [Indexed: 12/14/2022]
Abstract
Polo-like kinase 1 (PLK1) is an important regulator of the cell cycle and is overexpressed in various solid and hematological malignancies. Small molecule inhibitors targeting PLK1, such as BI2536 or BI6727 (Volasertib) are a promising therapeutic approach in such malignancies. Here, we show a loss of specifically localized PLK1 in AML blasts in vivo, accompanied by mitotic arrest with transition into apoptosis, in bone marrow biopsies of AML patients after treatment with BI2536. We verify these results in live cell imaging experiments with the AML cell line HL-60, and demonstrate that non-neoplastic, immortalized lymphoblastoid cells are also sensitive to PLK1 inhibition. It is demonstrated that normal granulopoietic precursors have similar PLK1 expression levels as leukemic blasts. These results are in line with the adverse effects of PLK1 inhibition and underline the great potential of PLK1 inhibitors in the treatment of AML.
Collapse
MESH Headings
- Aged
- Aged, 80 and over
- Antimitotic Agents/pharmacology
- Apoptosis/drug effects
- Blast Crisis/drug therapy
- Blast Crisis/enzymology
- Blast Crisis/pathology
- Blotting, Western
- Bone Marrow/drug effects
- Bone Marrow/enzymology
- Bone Marrow/pathology
- Cell Cycle Proteins/antagonists & inhibitors
- Cell Cycle Proteins/metabolism
- Cell Proliferation/drug effects
- Female
- Humans
- Immunoenzyme Techniques
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/enzymology
- Leukemia, Myeloid, Acute/pathology
- Male
- Mitosis/drug effects
- Protein Serine-Threonine Kinases/antagonists & inhibitors
- Protein Serine-Threonine Kinases/metabolism
- Proto-Oncogene Proteins/antagonists & inhibitors
- Proto-Oncogene Proteins/metabolism
- Pteridines/pharmacology
- RNA, Messenger/genetics
- Real-Time Polymerase Chain Reaction
- Reverse Transcriptase Polymerase Chain Reaction
- Tumor Cells, Cultured
- Polo-Like Kinase 1
Collapse
Affiliation(s)
- Claudia Münch
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany
| | - Diana Dragoi
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany
| | - Anna-Verena Frey
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany
| | - Katja Thurig
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany
| | - Michael Lübbert
- Department of Hematology and Oncology, University Medical Center, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Ralph Wäsch
- Department of Hematology and Oncology, University Medical Center, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Lioudmila Bogatyreva
- Institute of Medical Biometry and Medical Informatics, University Medical Center, Stefan-Meier-Str. 26, 79104 Freiburg, Germany
| | - Dieter Hauschke
- Institute of Medical Biometry and Medical Informatics, University Medical Center, Stefan-Meier-Str. 26, 79104 Freiburg, Germany
| | - Silke Lassmann
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany; BIOSS Centre for Biological Signalling Studies, University of Freiburg, Germany
| | - Martin Werner
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Annette M May
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany.
| |
Collapse
|
3
|
May AM, Frey AV, Bogatyreva L, Benkisser-Petersen M, Hauschke D, Lübbert M, Wäsch R, Werner M, Hasskarl J, Lassmann S. ID2 and ID3 protein expression mirrors granulopoietic maturation and discriminates between acute leukemia subtypes. Histochem Cell Biol 2013; 141:431-40. [PMID: 24292846 DOI: 10.1007/s00418-013-1169-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2013] [Indexed: 01/21/2023]
Abstract
The inhibitors of DNA binding (ID) inhibit basic helix-loop-helix transcription factors and thereby guide cellular differentiation and proliferation. To elucidate the involvement of IDs in hematopoiesis and acute leukemias (AL), we analyzed ID2 and ID3 expression in hematopoiesis and leukemic blasts in bone marrow biopsies (BMB). BMB of healthy stem cell donors (n = 19) and BMB of patients with acute myeloid leukemia (AML) with myelodysplasia-related changes (AML-MD; n = 19), de novo AML (n = 20), B-acute lymphoblastic leukemia (B-ALL) (n = 23), T-ALL (n = 19), were immunohistochemically stained for ID2 and ID3 expression. The expression patterns were evaluated and quantified for each hematopoietic lineage and each leukemia subtype. In normal BMB, immature granulopoiesis showed weak ID2 and strong ID3 expression, which was lost during maturation (p < 0.001). Erythropoiesis remained negative for ID2/3 (p < 0.001). ID2/3 expression differed between immature granulopoiesis and leukemic blasts (p < 0.001). Moreover, differential ID2/3 expression was seen between AL subgroups: AML, especially AML-MD, had more ID2- (p < 0.001) and ID3-positive (p < 0.001) blasts than ALL. We show a comprehensive in situ picture of ID2/3 expression in hematopoiesis and AL. Morphologically, ID2/3 proteins seem to be involved in the granulopoietic maturation. Importantly, the distinct ID2/3 expression patterns in AL indicate a specific deregulation of ID2/3 in the various types of AL and may support subtyping of AL.
Collapse
Affiliation(s)
- Annette M May
- Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106, Freiburg, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|