1
|
Yll-Pico M, Park Y, Martinez J, Iniguez A, Kha M, Kim T, Medrano L, Nguyen VH, Kaltcheva T, Dempsey S, Chiuppesi F, Wussow F, Diamond DJ. Highly stable and immunogenic CMV T cell vaccine candidate developed using a synthetic MVA platform. NPJ Vaccines 2024; 9:68. [PMID: 38555379 PMCID: PMC10981716 DOI: 10.1038/s41541-024-00859-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/12/2024] [Indexed: 04/02/2024] Open
Abstract
Human cytomegalovirus (CMV) is the most common infectious cause of complications post-transplantation, while a CMV vaccine for transplant recipients has yet to be licensed. Triplex, a multiantigen Modified Vaccinia Ankara (MVA)-vectored CMV vaccine candidate based on the immunodominant antigens phosphoprotein 65 (pp65) and immediate-early 1 and 2 (IE1/2), is in an advanced stage of clinical development. However, its limited genetic and expression stability restricts its potential for large-scale production. Using a recently developed fully synthetic MVA (sMVA) platform, we developed a new generation Triplex vaccine candidate, T10-F10, with different sequence modifications for enhanced vaccine stability. T10-F10 demonstrated genetic and expression stability during extensive virus passaging. In addition, we show that T10-F10 confers comparable immunogenicity to the original Triplex vaccine to elicit antigen-specific T cell responses in HLA-transgenic mice. These results demonstrate improvements in translational vaccine properties of an sMVA-based CMV vaccine candidate designed as a therapeutic treatment for transplant recipients.
Collapse
Affiliation(s)
- Marcal Yll-Pico
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA.
| | - Yoonsuh Park
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Joy Martinez
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Angelina Iniguez
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Mindy Kha
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Taehyun Kim
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Leonard Medrano
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Vu H Nguyen
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Teodora Kaltcheva
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Shannon Dempsey
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Flavia Chiuppesi
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Felix Wussow
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Don J Diamond
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, USA
| |
Collapse
|
2
|
La Rosa C, Park Y, Yang D, Zhou Q, Kaltcheva T, Karras N, Cheng J, Sun W, Diamond DJ, Pawlowska A. Cytomegalovirus Triplex vaccine in pediatric hematopoietic stem cell transplant patients at high risk for cytomegalovirus complications: evaluation of vaccine safety, immunogenicity and impact on viremia requiring antivirals. Haematologica 2024. [PMID: 38426277 DOI: 10.3324/haematol.2023.284256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Indexed: 03/02/2024] Open
Abstract
Not available.
Collapse
Affiliation(s)
- Corinna La Rosa
- Department of Hematology and Hematopoietic Cell Transplantation.
| | - Yoonsuh Park
- Department of Hematology and Hematopoietic Cell Transplantation
| | - Dongyun Yang
- Department of Hematology and Hematopoietic Cell Transplantation
| | - Qiao Zhou
- Department of Hematology and Hematopoietic Cell Transplantation
| | | | - Nicole Karras
- Department of Pediatrics, City of Hope National Medical Center, Duarte, CA
| | - Jerry Cheng
- Department of Pediatrics, City of Hope National Medical Center, Duarte, CA
| | - Weili Sun
- The Janssen Pharmaceutical Companies of Johnson and Johnson, Los Angeles, CA
| | - Don J Diamond
- Department of Hematology and Hematopoietic Cell Transplantation
| | - Anna Pawlowska
- Department of Pediatrics, City of Hope National Medical Center, Duarte, CA
| |
Collapse
|
3
|
Chiuppesi F, Zaia JA, Gutierrez-Franco MA, Ortega-Francisco S, Ly M, Kha M, Kim T, Dempsey S, Kar S, Grifoni A, Sette A, Wussow F, Diamond DJ. Synthetic modified vaccinia Ankara vaccines confer cross-reactive and protective immunity against mpox virus. Commun Med (Lond) 2024; 4:19. [PMID: 38366141 PMCID: PMC10873322 DOI: 10.1038/s43856-024-00443-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/23/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Although the mpox global health emergency caused by mpox virus (MPXV) clade IIb.1 has ended, mpox cases are still reported due to low vaccination coverage and waning immunity. COH04S1 is a clinically evaluated, multiantigen COVID-19 vaccine candidate built on a fully synthetic platform of the highly attenuated modified vaccinia Ankara (MVA) vector, representing the only FDA-approved smallpox/mpox vaccine JYNNEOS. Given the potential threat of MPXV resurgence and need for vaccine alternatives, we aimed to assess the capacity COH04S1 and its synthetic MVA (sMVA) backbone to confer MPXV-specific immunity. METHODS We evaluated orthopoxvirus-specific and MPXV cross-reactive immune responses in samples collected during a Phase 1 clinical trial of COH04S1 and in non-human primates (NHP) vaccinated with COH04S1 or its sMVA backbone. MPXV cross-reactive immune responses in COH04S1-vaccinated healthy adults were compared to responses measured in healthy subjects vaccinated with JYNNEOS. Additionally, we evaluated the protective efficacy of COH04S1 and sMVA against mpox in mpox-susceptible CAST/EiJ mice. RESULTS COH04S1-vaccinated individuals develop robust orthopoxvirus-specific humoral and cellular responses, including cross-reactive antibodies to MPXV-specific virion proteins as well as MPXV cross-neutralizing antibodies in 45% of the subjects. In addition, NHP vaccinated with COH04S1 or sMVA show similar MPXV cross-reactive antibody responses. Moreover, MPXV cross-reactive humoral responses elicited by COH04S1 are comparable to those measured in JYNNEOS-vaccinated subjects. Finally, we show that mice vaccinated with COH04S1 or sMVA are protected from lung infection following challenge with MPXV clade IIb.1. CONCLUSIONS These results demonstrate the capacity of sMVA vaccines to elicit cross-reactive and protective orthopox-specific immunity against MPXV, suggesting that COH04S1 and sMVA could be developed as bivalent or monovalent mpox vaccine alternatives against MPXV.
Collapse
Affiliation(s)
- Flavia Chiuppesi
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA, USA.
| | - John A Zaia
- Center for Gene Therapy, City of Hope National Medical Center, Duarte, CA, USA
| | - Miguel-Angel Gutierrez-Franco
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Sandra Ortega-Francisco
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Minh Ly
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Mindy Kha
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Taehyun Kim
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Shannon Dempsey
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | | | - Alba Grifoni
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA, USA
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA, USA
| | - Felix Wussow
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Don J Diamond
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| |
Collapse
|
4
|
Nakamura R, La Rosa C, Yang D, Hill JA, Rashidi A, Choe H, Zhou Q, Lingaraju CR, Kaltcheva T, Longmate J, Drake J, Slape C, Duarte L, Al Malki MM, Pullarkat VA, Aribi A, Devine S, Verneris MR, Miller JS, Forman SJ, Aldoss I, Diamond DJ. A phase II randomized, placebo-controlled, multicenter trial to evaluate the efficacy of cytomegalovirus PepVax vaccine in preventing cytomegalovirus reactivation and disease after allogeneic hematopoietic stem cell transplant. Haematologica 2024. [PMID: 38328852 DOI: 10.3324/haematol.2023.284544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Indexed: 02/09/2024] Open
Abstract
Not available.
Collapse
Affiliation(s)
| | - Corinna La Rosa
- Department of Hematology and Hematopoietic Cell Transplantation
| | - Dongyun Yang
- Department of Computational and Quantitative Medicine, City of Hope National Medical Center, Duarte, CA
| | | | - Armin Rashidi
- Fred Hutchinson Cancer Center, Seattle, WA, USA; Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN
| | - Hannah Choe
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Qiao Zhou
- Department of Hematology and Hematopoietic Cell Transplantation
| | | | | | - Jeffrey Longmate
- Department of Computational and Quantitative Medicine, City of Hope National Medical Center, Duarte, CA
| | | | - Cynthia Slape
- Department of Clinical Research, City of Hope National Medical Center, Duarte, CA
| | - Lupe Duarte
- Department of Hematology and Hematopoietic Cell Transplantation
| | | | | | - Ahmed Aribi
- Department of Hematology and Hematopoietic Cell Transplantation
| | - Steven Devine
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Michael R Verneris
- University of Colorado School of Medicine, Children's Hospital of Colorado, Aurora, CO
| | - Jeffrey S Miller
- Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN
| | | | - Ibrahim Aldoss
- Department of Hematology and Hematopoietic Cell Transplantation
| | - Don J Diamond
- Department of Hematology and Hematopoietic Cell Transplantation.
| |
Collapse
|
5
|
Kos FJ, Frankel P, Cristea M, Eng M, Tinsley R, Dempsey S, Ruel N, Stewart D, Dellinger TH, Diamond DJ. Immunologic Signatures of Peripheral Blood T Cells Reveal the Outcome of p53MVA Vaccine and Pembrolizumab Treatment in Patients with Advanced Ovarian Cancer. Cancer Res Commun 2023; 3:2585-2595. [PMID: 38032111 PMCID: PMC10732002 DOI: 10.1158/2767-9764.crc-23-0394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE Our previous studies indicated that p53-reactive T cells were associated with clinical benefit in patients with advanced ovarian cancer who were treated with p53-expressing modified vaccinia Ankara (p53MVA) vaccine and gemcitabine chemotherapy. To replace chemotherapy with an approach that will enhance vaccine efficacy and antitumor immunity, we treated patients with p53MVA in combination with PD-1 checkpoint blocker, pembrolizumab. We also attempted to further characterize the activation status of T cells prior to vaccination and during treatment. EXPERIMENTAL DESIGN Patients received up to three triweekly vaccinations concurrent with pembrolizumab, followed by pembrolizumab monotherapy at 3-week intervals. Correlative studies analyzed peripheral blood T-cell phenotypes and profiles of immune function gene expression. RESULTS We observed 6/28 (21%) patients with a clinical benefit to therapy, including 3 partial responses (PR) and 3 patients with stable disease (SD) for 6+ months. The median progression-free survival was 1.8 months (95% confidence interval: 1.7-3.8) and median overall survival was 15.1 months (9.4-30.4). Two patients remain progression-free at 28 and 33 months. Of the 18 patients evaluable in correlative studies, 6 were immunologic responders of whom 5 had clinical benefit (3 PR, 2 SD). Immunologic non-responders expressed in pretreatment peripheral blood mononuclear cell samples high levels of mRNA for multiple molecules associated with terminally differentiated T cells. CONCLUSIONS p53MVA/pembrolizumab immunotherapy showed promising antitumor activity in patients who demonstrated functionally competent peripheral blood T cells. Detection of markers of terminally differentiated T cells before treatment may identify patients unlikely to respond to p53MVA/pembrolizumab. SIGNIFICANCE The activity of a combination immunotherapy of p53 vaccine and PD-1 checkpoint blockade in patients with platinum-resistant ovarian cancer was evaluated in a phase II trial. Clinical benefit was correlated with the responsive immune status of patients before and during the treatment, defining potential predictive markers for immune therapy.
Collapse
Affiliation(s)
- Ferdynand J. Kos
- Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute, City of Hope, Duarte, California
| | - Paul Frankel
- Department of Computational and Quantitative Medicine, Beckman Research Institute, Duarte, California
| | - Mihaela Cristea
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, California
| | - Melissa Eng
- Clinical Trials Office, City of Hope National Medical Center, Duarte, California
| | - Raechelle Tinsley
- Clinical Trials Office, City of Hope National Medical Center, Duarte, California
| | - Shannon Dempsey
- Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute, City of Hope, Duarte, California
| | - Nora Ruel
- Department of Computational and Quantitative Medicine, Beckman Research Institute, Duarte, California
| | - Daphne Stewart
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, California
| | - Thanh H. Dellinger
- Department of Surgery, City of Hope National Medical Center, Duarte, California
| | - Don J. Diamond
- Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute, City of Hope, Duarte, California
| |
Collapse
|
6
|
Chiuppesi F, Ortega-Francisco S, Gutierrez MA, Li J, Ly M, Faircloth K, Mack-Onyeike J, La Rosa C, Thomas S, Zhou Q, Drake J, Slape C, Fernando P, Rida W, Kaltcheva T, Grifoni A, Sette A, Patterson A, Dempsey S, Ball B, Ali H, Salhotra A, Stein A, Nathwani N, Rosenzweig M, Nikolaenko L, Al Malki MM, Dickter J, Nanayakkara DD, Puing A, Forman SJ, Taplitz RA, Zaia JA, Nakamura R, Wussow F, Diamond DJ, Dadwal SS. Stimulation of Potent Humoral and Cellular Immunity via Synthetic Dual-Antigen MVA-Based COVID-19 Vaccine COH04S1 in Cancer Patients Post Hematopoietic Cell Transplantation and Cellular Therapy. Vaccines (Basel) 2023; 11:1492. [PMID: 37766168 PMCID: PMC10538048 DOI: 10.3390/vaccines11091492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/05/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Hematopoietic cell transplantation (HCT) and chimeric antigen receptor (CAR)-T cell patients are immunocompromised, remain at high risk following SARS-CoV-2 infection, and are less likely than immunocompetent individuals to respond to vaccination. As part of the safety lead-in portion of a phase 2 clinical trial in patients post HCT/CAR-T for hematological malignancies (HM), we tested the immunogenicity of the synthetic modified vaccinia Ankara-based COVID-19 vaccine COH04S1 co-expressing spike (S) and nucleocapsid (N) antigens. Thirteen patients were vaccinated 3-12 months post HCT/CAR-T with two to four doses of COH04S1. SARS-CoV-2 antigen-specific humoral and cellular immune responses, including neutralizing antibodies to ancestral virus and variants of concern (VOC), were measured up to six months post vaccination and compared to immune responses in historical cohorts of naïve healthy volunteers (HV) vaccinated with COH04S1 and naïve healthcare workers (HCW) vaccinated with the FDA-approved mRNA vaccine Comirnaty® (Pfizer, New York, NY, USA). After one or two COH04S1 vaccine doses, HCT/CAR-T recipients showed a significant increase in S- and N-specific binding antibody titers and neutralizing antibodies with potent activity against SARS-CoV-2 ancestral virus and VOC, including the highly immune evasive Omicron XBB.1.5 variant. Furthermore, vaccination with COH04S1 resulted in a significant increase in S- and N-specific T cells, predominantly CD4+ T lymphocytes. Elevated S- and N-specific immune responses continued to persist at six months post vaccination. Furthermore, both humoral and cellular immune responses in COH04S1-vaccinated HCT/CAR-T patients were superior or comparable to those measured in COH04S1-vaccinated HV or Comirnaty®-vaccinated HCW. These results demonstrate robust stimulation of SARS-CoV-2 S- and N-specific immune responses including cross-reactive neutralizing antibodies by COH04S1 in HM patients post HCT/CAR-T, supporting further testing of COH04S1 in immunocompromised populations.
Collapse
Affiliation(s)
- Flavia Chiuppesi
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Sandra Ortega-Francisco
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Miguel-Angel Gutierrez
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Jing Li
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Minh Ly
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Katelyn Faircloth
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Jada Mack-Onyeike
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Corinna La Rosa
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Sandra Thomas
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Qiao Zhou
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Jennifer Drake
- Clinical Trials Office, City of Hope National Medical Center, Duarte, CA 91010, USA; (J.D.); (C.S.); (P.F.)
| | - Cynthia Slape
- Clinical Trials Office, City of Hope National Medical Center, Duarte, CA 91010, USA; (J.D.); (C.S.); (P.F.)
| | - Paolo Fernando
- Clinical Trials Office, City of Hope National Medical Center, Duarte, CA 91010, USA; (J.D.); (C.S.); (P.F.)
| | - Wasima Rida
- Independent Researcher, Arlington, VA 22205, USA;
| | - Teodora Kaltcheva
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Alba Grifoni
- Division of Vaccine Discovery, La Jolla Institute of Allergy and Immunology, University of California San Diego, La Jolla, CA 92037, USA; (A.G.); (A.S.)
| | - Alessandro Sette
- Division of Vaccine Discovery, La Jolla Institute of Allergy and Immunology, University of California San Diego, La Jolla, CA 92037, USA; (A.G.); (A.S.)
| | - Angela Patterson
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Shannon Dempsey
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Brian Ball
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Haris Ali
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Amandeep Salhotra
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Anthony Stein
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Nitya Nathwani
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Michael Rosenzweig
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Liana Nikolaenko
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Monzr M. Al Malki
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Jana Dickter
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Deepa D. Nanayakkara
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Alfredo Puing
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Stephen J. Forman
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Randy A. Taplitz
- Division of Infectious Diseases, City of Hope National Medical Center, Duarte, CA 91010, USA; (R.A.T.); (S.S.D.)
- Department of Medicine, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - John A. Zaia
- Center for Gene Therapy, City of Hope National Medical Center, Duarte, CA 91010, USA;
| | - Ryotaro Nakamura
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Felix Wussow
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Don J. Diamond
- Department of Hematology and HCT, Hematologic Malignancies Research Institute, City of Hope National Medical Center, Duarte, CA 91010, USA; (F.C.); (S.O.-F.); (M.-A.G.); (J.L.); (K.F.); (J.M.-O.); (C.L.R.); (S.T.); (Q.Z.); (T.K.); (A.P.); (S.D.); (B.B.); (H.A.); (A.S.); (A.S.); (N.N.); (M.R.); (L.N.); (M.M.A.M.); (J.D.); (D.D.N.); (S.J.F.); (R.N.); (F.W.)
| | - Sanjeet S. Dadwal
- Division of Infectious Diseases, City of Hope National Medical Center, Duarte, CA 91010, USA; (R.A.T.); (S.S.D.)
- Department of Medicine, City of Hope National Medical Center, Duarte, CA 91010, USA
| |
Collapse
|
7
|
La Rosa C, Aldoss I, Park Y, Yang D, Zhou Q, Gendzekhadze K, Kaltcheva T, Rida W, Dempsey S, Arslan S, Artz A, Ball B, Nikolaenko L, Pullarkat VA, Nakamura R, Diamond DJ. Hematopoietic stem cell donor vaccination with cytomegalovirus triplex augments frequencies of functional and durable cytomegalovirus-specific T cells in the recipient: A novel strategy to limit antiviral prophylaxis. Am J Hematol 2023; 98:588-597. [PMID: 36594185 PMCID: PMC10294297 DOI: 10.1002/ajh.26824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 01/04/2023]
Abstract
To enhance protective cytomegalovirus (CMV)-specific T cells in immunosuppressed recipients of an allogeneic hematopoietic cell transplant (HCT), we evaluated post-HCT impact of vaccinating healthy HCT donors with Triplex. Triplex is a viral vectored recombinant vaccine expressing three immunodominant CMV antigens. The vector is modified vaccinia Ankara (MVA), an attenuated, non-replicating poxvirus derived from the vaccinia virus strain Ankara. It demonstrated tolerability and immunogenicity in healthy adults and HCT recipients, in whom it also reduced CMV reactivation. Here, we report feasibility, safety, and immunological outcomes of a pilot phase 1 trial (NCT03560752 at ClinicalTrials.gov) including 17 CMV-seropositive recipients who received an HCT from a matched related donor (MRD) vaccinated with 5.1 × 108 pfu/ml of Triplex before cell harvest (median 15, range 11-28 days). Donor and recipient pairs who committed to participation in the trial resulted in exceptional adherence to the protocol. Triplex was well-tolerated with limited adverse events in donors and recipients, who all engrafted with full donor chimerism. On day 28 post-HCT, levels of functional vaccinia- and CMV-specific CD137+ CD8+ T cells were significantly higher (p < .0001 and p = .0174, respectively) in recipients of Triplex vaccinated MRD than unvaccinated MRD (control cohort). Predominantly, central and effector memory CMV-specific T-cell responses continued to steadily expand through 1-year follow-up. CMV viremia requiring antivirals developed in three recipients (18%). In summary, this novel approach represents a promising strategy applicable to different HCT settings for limiting the use of antiviral prophylaxis, which can impair and delay CMV-specific immunity, leading to CMV reactivation requiring treatment.
Collapse
Affiliation(s)
- Corinna La Rosa
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Ibrahim Aldoss
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Yoonsuh Park
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Dongyun Yang
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Qiao Zhou
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Ketevan Gendzekhadze
- Histocompatibility Laboratory, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Teodora Kaltcheva
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | | | - Shannon Dempsey
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Shukaib Arslan
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Andrew Artz
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Brian Ball
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Liana Nikolaenko
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Vinod A Pullarkat
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Ryotaro Nakamura
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Don J. Diamond
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| |
Collapse
|
8
|
Wussow F, Kha M, Kim T, Ly M, Yll-Pico M, Kar S, Lewis MG, Chiuppesi F, Diamond DJ. Synthetic multiantigen MVA vaccine COH04S1 and variant-specific derivatives protect Syrian hamsters from SARS-CoV-2 Omicron subvariants. NPJ Vaccines 2023; 8:41. [PMID: 36928589 PMCID: PMC10018591 DOI: 10.1038/s41541-023-00640-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
Emerging SARS-CoV-2 Omicron subvariants continue to disrupt COVID-19 vaccine efficacy through multiple immune mechanisms including neutralizing antibody evasion. We developed COH04S1, a synthetic modified vaccinia Ankara vector that co-expresses Wuhan-Hu-1-based spike and nucleocapsid antigens. COH04S1 demonstrated efficacy against ancestral virus and Beta and Delta variants in animal models and was safe and immunogenic in a Phase 1 clinical trial. Here, we report efficacy of COH04S1 and analogous Omicron BA.1- and Beta-specific vaccines to protect Syrian hamsters from Omicron subvariants. Despite eliciting strain-specific antibody responses, all three vaccines protect hamsters from weight loss, lower respiratory tract infection, and lung pathology following challenge with Omicron BA.1 or BA.2.12.1. While the BA.1-specifc vaccine affords consistently improved efficacy compared to COH04S1 to protect against homologous challenge with BA.1, all three vaccines confer similar protection against heterologous challenge with BA.2.12.1. These results demonstrate efficacy of COH04S1 and variant-specific derivatives to confer cross-protective immunity against SARS-CoV-2 Omicron subvariants.
Collapse
Affiliation(s)
- Felix Wussow
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA.
| | - Mindy Kha
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Taehyun Kim
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Minh Ly
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Marcal Yll-Pico
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | | | | | - Flavia Chiuppesi
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Don J Diamond
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA.
| |
Collapse
|
9
|
La Rosa C, Chiuppesi F, Park Y, Zhou Q, Yang D, Gendzekhadze K, Ly M, Li J, Kaltcheva T, Ortega Francisco S, Gutierrez MA, Ali H, Otoukesh S, Amanam I, Salhotra A, Pullarkat VA, Aldoss I, Rosenzweig M, Aribi AM, Stein AS, Marcucci G, Dadwal SS, Nakamura R, Forman SJ, Al Malki MM, Diamond DJ. Functional SARS-CoV-2-specific T cells of donor origin in allogeneic stem cell transplant recipients of a T-cell-replete infusion: A prospective observational study. Front Immunol 2023; 14:1114131. [PMID: 36936918 PMCID: PMC10020189 DOI: 10.3389/fimmu.2023.1114131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/17/2023] [Indexed: 03/06/2023] Open
Abstract
In the current post-pandemic era, recipients of an allogeneic hematopoietic stem cell transplant (HCT) deserve special attention. In these vulnerable patients, vaccine effectiveness is reduced by post-transplant immune-suppressive therapy; consequently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) is often associated with elevated morbidity and mortality. Characterizing SARS-CoV-2 adaptive immunity transfer from immune donors to HCT recipients in the context of immunosuppression will help identify optimal timing and vaccination strategies that can provide adequate protection to HCT recipients against infection with evolving SARS-CoV-2 variants. We performed a prospective observational study (NCT04666025 at ClinicalTrials.gov) to longitudinally monitor the transfer of SARS-CoV-2-specific antiviral immunity from HCT donors, who were either vaccinated or had a history of COVID-19, to their recipients via T-cell replete graft. Levels, function, and quality of SARS-CoV-2-specific immune responses were longitudinally analyzed up to 6 months post-HCT in 14 matched unrelated donor/recipients and four haploidentical donor/recipient pairs. A markedly skewed donor-derived SARS-CoV-2 CD4 T-cell response was measurable in 15 (83%) recipients. It showed a polarized Th1 functional profile, with the prevalence of central memory phenotype subsets. SARS-CoV-2-specific IFN-γ was detectable throughout the observation period, including early post-transplant (day +30). Functionally experienced SARS-CoV-2 Th1-type T cells promptly expanded in two recipients at the time of post-HCT vaccination and in two others who were infected and survived post-transplant COVID-19 infection. Our data suggest that donor-derived SARS-CoV-2 T-cell responses are functional in immunosuppressed recipients and may play a critical role in post-HCT vaccine response and protection from the fatal disease. Clinical trial registration clinicaltrials.gov, identifier NCT04666025.
Collapse
Affiliation(s)
- Corinna La Rosa
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Flavia Chiuppesi
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Yoonsuh Park
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Qiao Zhou
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Dongyun Yang
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Ketevan Gendzekhadze
- Histocompatibility Laboratory, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Minh Ly
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Jing Li
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Teodora Kaltcheva
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Sandra Ortega Francisco
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Miguel-Angel Gutierrez
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Haris Ali
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Salman Otoukesh
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Idoroenyi Amanam
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Amandeep Salhotra
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Vinod A. Pullarkat
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Ibrahim Aldoss
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Michael Rosenzweig
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Ahmed M. Aribi
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Anthony S. Stein
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Guido Marcucci
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | | | - Ryotaro Nakamura
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Stephen J. Forman
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Monzr M. Al Malki
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Don J. Diamond
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA, United States
| |
Collapse
|
10
|
Rosa CL, Aldoss I, Park Y, Yang D, Zhou Q, Gendzekhadze K, Kaltcheva T, Rida W, Arslan S, Artz AS, Ball B, Nikolaenko L, Pullarkat V, Nakamura R, Diamond DJ. CMV-MVA Triplex Vaccination of Stem Cell Donors to Enhance CMV Specific Immunity and Prevent CMV Viremia in Recipients after Stem Cell Transplant. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00151-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
11
|
Dona AA, Sanchez JF, Palmer JM, Synold TW, Chiuppesi F, Thomas S, Caserta E, Singer M, Tandoh T, Chowdhury A, Krishnan A, Rosenzweig M, Diamond DJ, Rosen S, Pichiorri F, Dadwal S. Leflunomide Confers Rapid Recovery from COVID-19 and is Coupled with Temporal Immunologic Changes. J Immunological Sci 2023; 7:9-27. [PMID: 36996290 PMCID: PMC10042490 DOI: 10.29245/2578-3009/2023/1.1241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Background: Vaccines for SARS-CoV-2 have been considerably effective in reducing rates of infection and severe COVID-19. However, many patients, especially those who are immunocompromised due to cancer or other factors, as well as individuals who are unable to receive vaccines or are in resource-poor countries, will continue to be at risk for COVID-19. We describe clinical, therapeutic, and immunologic correlatives in two patients with cancer and severe COVID-19 who were treated with leflunomide after failing to respond to standard-of-care comprising remdesivir and dexamethasone. Both patients had breast cancer and were on therapy for the malignancy. Methods: The protocol is designed with the primary objective to assess the safety and tolerability of leflunomide in treating severe COVID-19 in patients with cancer. Leflunomide dosing consisted of a loading dose of 100 mg daily for the first three days, followed by daily dosing, at the assigned dose level (Dose Level 1: 40 mg, Dose Level -1, 20 mg; Dose Level 2, 60 mg), for an additional 11 days. At defined intervals, serial monitoring of blood samples for toxicity, pharmacokinetics, and immunologic correlative studies were performed, as well as nasopharyngeal swabs for PCR analysis of SARS-CoV-2. Results: Preclinically, leflunomide impaired viral RNA replication, and clinically, it led to a rapid improvement in the two patients discussed herein. Both patients completely recovered, with minimal toxicities; all adverse events experienced were considered unrelated to leflunomide. Single-cell mass-cytometry analysis showed that leflunomide increased levels of CD8+ cytotoxic and terminal effector T cells and decreased naïve and memory B cells. Conclusions: With ongoing COVID-19 transmission and occurrence of breakthrough infections in vaccinated individuals, including patients with cancer, therapeutic agents that target both the virus and host inflammatory response would be helpful despite the availability of currently approved anti-viral agents. Furthermore, from an access to care perspective, especially in resource-limited areas, an inexpensive, readily available, effective drug with existing safety data in humans is relevant in the real-world setting.
Collapse
Affiliation(s)
- Ada Alice Dona
- Judy and Bernard Briskin Center for Multiple Myeloma Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
- Department of Hematologic Malignancies Translational Science, Beckman Research Institute, City of Hope, Duarte, CA
| | - James F Sanchez
- Judy and Bernard Briskin Center for Multiple Myeloma Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Joycelynne M Palmer
- Department of Computational and Quantitative Sciences, Beckman Research Institute, City of Hope, Duarte, CA
| | | | - Flavia Chiuppesi
- Department of Experimental Therapeutics, City of Hope, Duarte, CA
| | - Sandra Thomas
- Department of Hematologic Malignancies Translational Science, Beckman Research Institute, City of Hope, Duarte, CA
| | - Enrico Caserta
- Judy and Bernard Briskin Center for Multiple Myeloma Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
- Department of Hematologic Malignancies Translational Science, Beckman Research Institute, City of Hope, Duarte, CA
| | - Mahmoud Singer
- Judy and Bernard Briskin Center for Multiple Myeloma Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
- Department of Hematologic Malignancies Translational Science, Beckman Research Institute, City of Hope, Duarte, CA
| | - Theophilus Tandoh
- Judy and Bernard Briskin Center for Multiple Myeloma Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
- Department of Hematologic Malignancies Translational Science, Beckman Research Institute, City of Hope, Duarte, CA
| | - Arnab Chowdhury
- Department of Computational and Quantitative Sciences, Beckman Research Institute, City of Hope, Duarte, CA
| | - Amrita Krishnan
- Judy and Bernard Briskin Center for Multiple Myeloma Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Michael Rosenzweig
- Judy and Bernard Briskin Center for Multiple Myeloma Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Don J Diamond
- Department of Experimental Therapeutics, City of Hope, Duarte, CA
| | - Steven Rosen
- Judy and Bernard Briskin Center for Multiple Myeloma Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
- Corresponding Authors: Steven Rosen, srosen@coh,org; Sanjeet Dadwal, ; and Flavia Pichiorri,
| | - Flavia Pichiorri
- Judy and Bernard Briskin Center for Multiple Myeloma Research, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
- Department of Hematologic Malignancies Translational Science, Beckman Research Institute, City of Hope, Duarte, CA
- Corresponding Authors: Steven Rosen, srosen@coh,org; Sanjeet Dadwal, ; and Flavia Pichiorri,
| | - Sanjeet Dadwal
- Department of Medicine, Division of Infectious Disease, City of Hope, Duarte, CA USA
- Corresponding Authors: Steven Rosen, srosen@coh,org; Sanjeet Dadwal, ; and Flavia Pichiorri,
| |
Collapse
|
12
|
Phan T, Nguyen VH, Su R, Li Y, Qing Y, Qin H, Cho H, Jiang L, Wu X, Chen J, Fakih M, Diamond DJ, Goel A, Melstrom LG. Targeting fat mass and obesity-associated protein mitigates human colorectal cancer growth in vitro and in a murine model. Front Oncol 2023; 13:1087644. [PMID: 36874096 PMCID: PMC9981948 DOI: 10.3389/fonc.2023.1087644] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/27/2023] [Indexed: 02/19/2023] Open
Abstract
Introduction Colorectal cancer (CRC) remains a significant cause of cancer related mortality. Fat mass and obesity-associated protein (FTO) is a m6A mRNA demethylase that plays an oncogenic role in various malignancies. In this study we evaluated the role of FTO in CRC tumorigenesis. Methods Cell proliferation assays were conducted in 6 CRC cell lines with the FTO inhibitor CS1 (50-3200 nM) (± 5-FU 5-80 mM) and after lentivirus mediated FTO knockdown. Cell cycle and apoptosis assays were conducted in HCT116 cells (24 h and 48 h, 290 nM CS1). Western blot and m6A dot plot assays were performed to assess CS1 inhibition of cell cycle proteins and FTO demethylase activity. Migration and invasion assays of shFTO cells and CS1 treated cells were performed. An in vivo heterotopic model of HCT116 cells treated with CS1 or with FTO knockdown cells was performed. RNA-seq was performed on shFTO cells to assess which molecular and metabolic pathways were impacted. RT-PCR was conducted on select genes down-regulated by FTO knockdown. Results We found that the FTO inhibitor, CS1 suppressed CRC cell proliferation in 6 colorectal cancer cell lines and in the 5-Fluorouracil resistant cell line (HCT116-5FUR). CS1 induced cell cycle arrest in the G2/M phase by down regulation of CDC25C and promoted apoptosis of HCT116 cells. CS1 suppressed in vivo tumor growth in the HCT116 heterotopic model (p< 0.05). Lentivirus knockdown of FTO in HCT116 cells (shFTO) mitigated in vivo tumor proliferation and in vitro demethylase activity, cell growth, migration and invasion compared to shScr controls (p< 0.01). RNA-seq of shFTO cells compared to shScr demonstrated down-regulation of pathways related to oxidative phosphorylation, MYC and Akt/ mTOR signaling pathways. Discussion Further work exploring the targeted pathways will elucidate precise downstream mechanisms that can potentially translate these findings to clinical trials.
Collapse
Affiliation(s)
- Thuy Phan
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, United States
| | - Vu H Nguyen
- Department of Hematology, City of Hope National Medical Center, Duarte, CA, United States
| | - Rui Su
- Beckman Research Institute, Department of Systems Biology, City of Hope National Medical Center, Monrovia, CA, United States
| | - Yangchan Li
- Beckman Research Institute, Department of Systems Biology, City of Hope National Medical Center, Monrovia, CA, United States
| | - Ying Qing
- Beckman Research Institute, Department of Systems Biology, City of Hope National Medical Center, Monrovia, CA, United States
| | - Hanjun Qin
- Beckman Research Institute, The Integrative Genomics Core, City of Hope National Medical Center, Duarte, CA, United States
| | - Hyejin Cho
- Beckman Research Institute, The Integrative Genomics Core, City of Hope National Medical Center, Duarte, CA, United States
| | - Lei Jiang
- Department of Molecular and Cellular Endocrinology, City of Hope National Medical Center, Duarte, CA, United States
| | - Xiwei Wu
- Beckman Research Institute, The Integrative Genomics Core, City of Hope National Medical Center, Duarte, CA, United States
| | - Jianjun Chen
- Beckman Research Institute, Department of Systems Biology, City of Hope National Medical Center, Monrovia, CA, United States
| | - Marwan Fakih
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, United States
| | - Don J Diamond
- Department of Hematology, City of Hope National Medical Center, Duarte, CA, United States
| | - Ajay Goel
- Department of Molecular Diagnostics and Experimental Therapeutics, City of Hope National Medical Center, Monrovia, CA, United States
| | - Laleh G Melstrom
- Department of Surgery, City of Hope National Medical Center, Duarte, CA, United States
| |
Collapse
|
13
|
Rosa CL, Chiuppesi F, Park Y, Gendzekhadze K, Zhou Q, Faircloth K, Kaltcheva T, Johnson D, Francisco SO, Amanam I, Otoukesh S, Pullarkat VA, Nakamura R, Diamond DJ, Forman SJ, Malki MMA. Adoptive transfer of functional SARS-COV-2-specific immunity from donor graft to hematopoietic stem cell transplant recipients. Am J Hematol 2022; 97:E404-E407. [PMID: 36053823 PMCID: PMC9537795 DOI: 10.1002/ajh.26691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 01/28/2023]
Affiliation(s)
- Corinna La Rosa
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Flavia Chiuppesi
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Yoonsuh Park
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Ketevan Gendzekhadze
- Histocompatibility Laboratory, Department of Hematology and HCT, City of Hope National Medical Center, Duarte, CA
| | - Qiao Zhou
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Katelyn Faircloth
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Teodora Kaltcheva
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Daisy Johnson
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Sandra Ortega Francisco
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Idoroenyi Amanam
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Salman Otoukesh
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Vinod A. Pullarkat
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Ryotaro Nakamura
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Don J. Diamond
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA,Corresponding Author: Don J. Diamond, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA 91010; , phone 626-359-3450, fax 626-301-8981
| | - Stephen J. Forman
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Monzr M. Al Malki
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| |
Collapse
|
14
|
Chiuppesi F, Zaia JA, Faircloth K, Johnson D, Ly M, Karpinski V, La Rosa C, Drake J, Marcia J, Acosta AM, Dempsey S, Taplitz RA, Zhou Q, Park Y, Ortega Francisco S, Kaltcheva T, Frankel PH, Rosen S, Wussow F, Dadwal S, Diamond DJ. Vaccine-induced spike- and nucleocapsid-specific cellular responses maintain potent cross-reactivity to SARS-CoV-2 Delta and Omicron variants. iScience 2022; 25:104745. [PMID: 35846380 PMCID: PMC9272674 DOI: 10.1016/j.isci.2022.104745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/22/2022] [Revised: 06/16/2022] [Accepted: 07/06/2022] [Indexed: 01/06/2023] Open
Abstract
Cell-mediated immunity may contribute to providing protection against SARS-CoV-2 and its variants of concern (VOC). We developed COH04S1, a synthetic multiantigen modified vaccinia Ankara (MVA)-based COVID-19 vaccine that stimulated potent spike (S) and nucleocapsid (N) antigen-specific humoral and cellular immunity in a phase 1 clinical trial in healthy adults. Here, we show that individuals vaccinated with COH04S1 or mRNA vaccine BNT162b2 maintain robust cross-reactive cellular immunity for six or more months post-vaccination. Although neutralizing antibodies induced in COH04S1- and BNT162b2-vaccinees showed reduced activity against Delta and Omicron variants compared to ancestral SARS-CoV-2, S-specific T cells elicited in both COH04S1- and BNT162b2-vaccinees and N-specific T cells elicited in COH04S1-vaccinees demonstrated potent and equivalent cross-reactivity against ancestral SARS-CoV-2 and the major VOC. These results suggest that vaccine-induced T cells to S and N antigens may constitute a critical second line of defense to provide long-term protection against SARS-CoV-2 VOC.
Collapse
Affiliation(s)
- Flavia Chiuppesi
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - John A. Zaia
- Center for Gene Therapy, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Katelyn Faircloth
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Daisy Johnson
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Minh Ly
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Veronica Karpinski
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Corinna La Rosa
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Jennifer Drake
- Clinical Trials Office, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Joan Marcia
- Clinical Trials Office, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Ann Marie Acosta
- Clinical Trials Office, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Shannon Dempsey
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Randy A. Taplitz
- Division of Infectious Diseases, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA
- Department of Medicine, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Qiao Zhou
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Yoonsuh Park
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Sandra Ortega Francisco
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Teodora Kaltcheva
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Paul H. Frankel
- Department of Biostatistics, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Steven Rosen
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Felix Wussow
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Sanjeet Dadwal
- Division of Infectious Diseases, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA
- Department of Medicine, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA
| | - Don J. Diamond
- Department of Hematology and HCT and Hematologic Malignancies Research Institute, 1500 E. Duarte Road, Duarte, CA 91010, USA
- Corresponding author
| |
Collapse
|
15
|
Wussow F, Kha M, Faircloth K, Nguyen VH, Iniguez A, Martinez J, Park Y, Nguyen J, Kar S, Andersen H, Lewis MG, Chiuppesi F, Diamond DJ. COH04S1 and beta sequence-modified vaccine protect hamsters from SARS-CoV-2 variants. iScience 2022; 25:104457. [PMID: 35634578 PMCID: PMC9126022 DOI: 10.1016/j.isci.2022.104457] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/12/2022] [Accepted: 05/13/2022] [Indexed: 01/04/2023] Open
Abstract
COVID-19 vaccine efficacy is threatened by emerging SARS-CoV-2 variants of concern (VOC) with the capacity to evade protective neutralizing antibody responses. We recently developed clinical vaccine candidate COH04S1, a synthetic modified vaccinia Ankara vector (sMVA) co-expressing spike and nucleocapsid antigens based on the Wuhan-Hu-1 reference strain that showed potent efficacy to protect against ancestral SARS-CoV-2 in Syrian hamsters and non-human primates and was safe and immunogenic in healthy volunteers. Here, we demonstrate that intramuscular immunization of Syrian hamsters with COH04S1 and an analogous Beta variant-adapted vaccine candidate (COH04S351) elicits potent cross-reactive antibody responses and protects against weight loss, lower respiratory tract infection, and lung pathology following challenge with major SARS-CoV-2 VOC, including Beta and the highly contagious Delta variant. These results demonstrate efficacy of COH04S1 and a variant-adapted vaccine analog to confer cross-protective immunity against SARS-CoV-2 and its emerging VOC, supporting clinical investigation of these sMVA-based COVID-19 vaccine candidates.
Collapse
Affiliation(s)
- Felix Wussow
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Mindy Kha
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Katelyn Faircloth
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Vu H. Nguyen
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Angelina Iniguez
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Joy Martinez
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Yoonsuh Park
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Jenny Nguyen
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA
| | | | | | | | - Flavia Chiuppesi
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Don J. Diamond
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA
| |
Collapse
|
16
|
Rashidi A, La Rosa C, Curtsinger J, Cao Q, Zhou Q, Lingaraju CR, Weisdorf DJ, Cichocki F, Miller JS, Diamond DJ. CMV Triplex Vaccine to Enhance Adaptive NK and T-cell Reconstitution After Autologous Hematopoietic Cell Transplantation. Transplant Cell Ther 2022; 28:343.e1-343.e4. [PMID: 35272066 PMCID: PMC9198005 DOI: 10.1016/j.jtct.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 11/25/2022]
Abstract
Cytomegalovirus (CMV) reactivation after hematopoietic cell transplantation (HCT) augments adaptive (CD56dimNKG2C+CD57+) natural killer (NK) and CMV-specific T cells, with potential antitumor effects. Our recent work found an association between higher abundance of adaptive NK cells after auto-HCT and lower risk of relapse in patients with multiple myeloma. Triplex vaccine is a recombinant modified vaccinia Ankara expressing immunodominant CMV antigens, which significantly enhanced CMV-specific T-cell immune responses in allo-HCT recipients. We evaluated whether 2 doses of the vaccine after auto-HCT in patients with lymphoma or myeloma improves reconstitution of adaptive NK and CMV-specific T cells. The primary endpoint was the number of adaptive NK cells at day 100 (∼1 month after dose 2) relative to day 28 (before dose 1). We conducted a single-arm phase 2 clinical trial of 20 patients with lymphoma or myeloma undergoing auto-HCT. Two doses of the vaccine were given on days 28 and 56. Adaptive NK cells increased in CMV-seronegative patients (P = .02), a rise that was more substantial than in unvaccinated historical CMV-seronegative cohorts (P = .03 comparing the rise between the 2 cohorts). There was also an increase in both CD4+ and CD8+ CMV-specific T cells in CMV-seronegative patients (P = .01) and CMV-specific CD8+ effector T cells in CMV-seropositive patients (P = .03). Triplex vaccine improved reconstitution of adaptive NK and CMV-specific T cells after auto-HCT in patients with lymphoma and myeloma. Further study is needed to determine the clinical impact of this modulation of immune response.
Collapse
Affiliation(s)
- Armin Rashidi
- Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Corinna La Rosa
- City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, California
| | - Julie Curtsinger
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Qing Cao
- Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Qiao Zhou
- City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, California
| | - Chetan Raj Lingaraju
- City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, California
| | - Daniel J Weisdorf
- Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Frank Cichocki
- Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Jeffrey S Miller
- Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
| | - Don J Diamond
- City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, California
| |
Collapse
|
17
|
Wang X, Urak R, Walter M, Guan M, Han T, Vyas V, Chien SH, Gittins B, Clark MC, Mokhtari S, Cardoso A, Diamond DJ, Zaia J, Forman SJ, Nakamura R. Large-scale manufacturing and characterization of CMV-CD19CAR T cells. J Immunother Cancer 2022; 10:jitc-2021-003461. [PMID: 35027426 PMCID: PMC8762141 DOI: 10.1136/jitc-2021-003461] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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] [Accepted: 12/04/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Adoptive transfer of CD19-specific chimeric antigen receptor (CD19CAR) T cells can induce dramatic disease regression in patients with B cell malignancies. CD19CAR T cell therapy may be limited by insufficient engraftment and persistence, resulting in tumor relapse. We previously demonstrated a proof of principle that cytomegalovirus (CMV)-specific T cells can be isolated and enriched prior to CD19CAR transduction to produce CMV-CD19CAR T cells, and that these CMV-CD19CAR T cells can be expanded in vivo through CMV vaccination, resulting in better tumor control in a murine model. Here we developed a clinical platform for generating CMV-CD19CAR T cells. METHODS Peripheral blood mononuclear cells (PBMCs) collected from CMV-seropositive healthy donors were stimulated with a good manufacturing practices-grade PepTivator overlapping CMVpp65 peptide pool and enriched for CMV-responsive interferon γ (IFNγ)+T cells using IFNγ Catchmatrix, within the CliniMACS Prodigy Cytokine Capture System (Miltenyi Biotec). Resulting CMV-specific T cells were transduced with a lentiviral vector encoding a second generation CD19R:CD28:ζ/EGFRt CAR and expanded with interleukin 2 (IL-2) and IL-15 for 15 days before characterization. RESULTS CMV-specific T cells were enriched from 0.8%±0.5 of input PBMC to 76.3%±11.6 in nine full-scale qualification runs (absolute yield of 4.2±3.3×106 IFNγ+T cells from an input of 1×109 PBMCs). Average CD19CAR transduction efficiency of CMV-specific T cells was 27.0%±14.2 in the final products, which underwent rapid expansion, resulting in a total cell dose of 6.2±0.9 × 106 CD19CAR-tranduced T cells with CMV specificity (ie, functionally bispecific). CMV-CD19CAR T cells were polyclonal, expressed memory markers but had low expression of exhaustion markers, responded to both CD19 and CMVpp65 stimulation with rapid proliferation and exhibited antigen-specific effector functions against both CD19-expressing tumors and CMVpp65 antigen. The final products passed release criteria for clinical use. CONCLUSIONS We demonstrated the feasibility of our large-scale platform for generating CMV-CD19CAR T cells for clinical application. We plan to initiate a clinical trial at City of Hope using CMV-CD19CAR T cells for patients with intermediate/high-grade B cell non-Hodgkin's lymphoma immediately after autologous hematopoietic cell transplantation followed by vaccination with a novel CMV vaccine based on Modified Vaccinia Ankara (Triplex) 28 days and 56 days post-T cell infusion.
Collapse
Affiliation(s)
- Xiuli Wang
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Ryan Urak
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Miriam Walter
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Min Guan
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Tianxu Han
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Vibhuti Vyas
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Sheng-Hsuan Chien
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Brenna Gittins
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Mary C Clark
- Department of Clinical Translational Project Development, City of Hope, Duarte, California, USA
| | - Sally Mokhtari
- Department of Clinical Translational Project Development, City of Hope, Duarte, California, USA
| | - Angelo Cardoso
- Center for Gene Therapy, Hematological Malignancy and Stem Cell Transplantation Institute, City of Hope, Duarte, California, USA
| | - Don J Diamond
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - John Zaia
- Center for Gene Therapy, Hematological Malignancy and Stem Cell Transplantation Institute, City of Hope, Duarte, California, USA
| | - Stephen J Forman
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| | - Ryotaro Nakamura
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA
| |
Collapse
|
18
|
Fernández-Alarcón C, Buchholz G, Contreras H, Wussow F, Nguyen J, Diamond DJ, Schleiss MR. Protection against Congenital CMV Infection Conferred by MVA-Vectored Subunit Vaccines Extends to a Second Pregnancy after Maternal Challenge with a Heterologous, Novel Strain Variant. Viruses 2021; 13:v13122551. [PMID: 34960820 PMCID: PMC8703303 DOI: 10.3390/v13122551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/15/2021] [Accepted: 12/15/2021] [Indexed: 11/25/2022] Open
Abstract
Maternal reinfection of immune women with novel human cytomegalovirus (HCMV) strains acquired during pregnancy can result in symptomatic congenital CMV (cCMV) infection. Novel animal model strategies are needed to explore vaccine-mediated protections against maternal reinfection. To investigate this in the guinea pig cytomegalovirus (GPCMV) model, a strictly in vivo-passaged workpool of a novel strain, the CIDMTR strain (dose, 1 × 107 pfu) was used to infect dams that had been challenged in a previous pregnancy with the 22122 strain, following either sham-immunization (vector only) or vaccination with MVA-vectored gB, gH/gL, or pentameric complex (PC) vaccines. Maternal DNAemia cleared by day 21 in the glycoprotein-vaccinated dams, but not in the sham-immunized dams. Mean pup birth weights were 72.85 ± 10.2, 80.0 ± 6.9, 81.4 ± 14.1, and 89.38 ± 8.4 g in sham-immunized, gB, gH/gL, and PC groups, respectively (p < 0.01 for control v. PC). Pup mortality in the sham-immunized group was 6/12 (50%), but reduced to 3/35 (8.6%) in combined vaccine groups (p = 0.0048). Vertical CIDMTR transmission occurred in 6/12 pups (50%) in the sham-vaccinated group, compared to 2/34 pups (6%) in the vaccine groups (p = 0.002). We conclude that guinea pigs immunized with vectored vaccines expressing 22122 strain-specific glycoproteins are protected after a reinfection with a novel, heterologous clinical isolate (CIDMTR) in a second pregnancy.
Collapse
Affiliation(s)
- Claudia Fernández-Alarcón
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (C.F.-A.); (G.B.)
| | - Grace Buchholz
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (C.F.-A.); (G.B.)
| | - Heidi Contreras
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA; (H.C.); (F.W.); (J.N.); (D.J.D.)
| | - Felix Wussow
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA; (H.C.); (F.W.); (J.N.); (D.J.D.)
| | - Jenny Nguyen
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA; (H.C.); (F.W.); (J.N.); (D.J.D.)
| | - Don J. Diamond
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA 91010, USA; (H.C.); (F.W.); (J.N.); (D.J.D.)
| | - Mark R. Schleiss
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, USA; (C.F.-A.); (G.B.)
- Correspondence:
| |
Collapse
|
19
|
Wang X, Diamond DJ, Forman SJ, Nakamura R. Development of CMV-CD19 bi-specific CAR T cells with post-infusion in vivo boost using an anti-CMV vaccine. Int J Hematol 2021; 114:544-553. [PMID: 34561840 PMCID: PMC8475363 DOI: 10.1007/s12185-021-03215-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 05/25/2021] [Revised: 08/21/2021] [Accepted: 09/01/2021] [Indexed: 11/25/2022]
Abstract
Adoptive transfer of in vitro expanded, chimeric antigen receptor (CAR)-redirected CD19-specific T cells can induce dramatic disease regression in patients with leukemia and lymphomas. However, the full potential of this emerging modality is hampered in some cancer settings by a significant rate of therapeutic failure arising from the attenuated engraftment and persistence of CAR-redirected T cells, and tumor relapse following adoptive transfer. Here, we discuss an advanced strategy that facilitates post-infusion in vivo boosting of CAR T cells via CMV vaccination, to mediate durable remission of B cell malignancies by engrafting a CAR molecule onto a CMV-specific T cell. We also discuss a feasible and unique platform for the generation of the CMV-CD19CAR T cells for clinical application. This new approach would overcome multiple challenges in current CAR T cell technology including: short T cell persistence, limited duration of response, and inability to re-stimulate T cells after relapse or persistent disease.
Collapse
Affiliation(s)
- Xiuli Wang
- Department of Hematology/HCT, City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Don J Diamond
- Department of Hematology/HCT, City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Stephen J Forman
- Department of Hematology/HCT, City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, 1500 E. Duarte Road, Duarte, CA, 91010, USA
| | - Ryotaro Nakamura
- Department of Hematology/HCT, City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, 1500 E. Duarte Road, Duarte, CA, 91010, USA.
| |
Collapse
|
20
|
Chiuppesi F, Nguyen VH, Park Y, Contreras H, Karpinski V, Faircloth K, Nguyen J, Kha M, Johnson D, Martinez J, Iniguez A, Zhou Q, Kaltcheva T, Frankel P, Kar S, Sharma A, Andersen H, Lewis MG, Shostak Y, Wussow F, Diamond DJ. Synthetic Multiantigen MVA Vaccine COH04S1 Protects Against SARS-CoV-2 in Syrian Hamsters and Non-Human Primates. bioRxiv 2021. [PMID: 34545366 DOI: 10.1101/2021.09.15.460487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Second-generation COVID-19 vaccines could contribute to establish protective immunity against SARS-CoV-2 and its emerging variants. We developed COH04S1, a synthetic multiantigen Modified Vaccinia Ankara-based SARS-CoV-2 vaccine that co-expresses spike and nucleocapsid antigens. Here, we report COH04S1 vaccine efficacy in animal models. We demonstrate that intramuscular or intranasal vaccination of Syrian hamsters with COH04S1 induces robust Th1-biased antigen-specific humoral immunity and cross-neutralizing antibodies (NAb) and protects against weight loss, lower respiratory tract infection, and lung injury following intranasal SARS-CoV-2 challenge. Moreover, we demonstrate that single-dose or two-dose vaccination of non-human primates with COH04S1 induces robust antigen-specific binding antibodies, NAb, and Th1-biased T cells, protects against both upper and lower respiratory tract infection following intranasal/intratracheal SARS-CoV-2 challenge, and triggers potent post-challenge anamnestic antiviral responses. These results demonstrate COH04S1-mediated vaccine protection in animal models through different vaccination routes and dose regimens, complementing ongoing investigation of this multiantigen SARS-CoV-2 vaccine in clinical trials.
Collapse
|
21
|
Ali A, Chiuppesi F, Nguyen M, Hausner MA, Nguyen J, Kha M, Iniguez A, Wussow F, Diamond DJ, Yang OO. Chimeric Antigen Receptors Targeting Human Cytomegalovirus. J Infect Dis 2021; 222:853-862. [PMID: 32285133 DOI: 10.1093/infdis/jiaa171] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/10/2020] [Indexed: 12/15/2022] Open
Abstract
Human cytomegalovirus (CMV) is a ubiquitous pathogen that causes significant morbidity in some vulnerable populations. Individualized adoptive transfer of ex vivo expanded CMV-specific CD8+ T cells has provided proof-of-concept that immunotherapy can be highly effective, but a chimeric antigen receptor (CAR) approach would provide a feasible method for broad application. We created 8 novel CARs using anti-CMV neutralizing antibody sequences, which were transduced via lentiviral vector into primary CD8+ T cells. All CARs were expressed. Activity against CMV-infected target cells was assessed by release of cytokines (interferon-γ and tumor necrosis factor-α), upregulation of surface CD107a, proliferation, cytolysis of infected cells, and suppression of viral replication. While some CARs showed varying functional activity across these assays, 1 CAR based on antibody 21E9 was consistently superior in all measures. These results support development of a CMV-specific CAR for therapeutic use against CMV and potentially other applications harnessing CMV-driven immunotherapies.
Collapse
Affiliation(s)
- Ayub Ali
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Flavia Chiuppesi
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Minh Nguyen
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Mary Ann Hausner
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Jenny Nguyen
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Mindy Kha
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Angelina Iniguez
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Felix Wussow
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Don J Diamond
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Otto O Yang
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.,Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.,AIDS Healthcare Foundation, Los Angeles, California, USA
| |
Collapse
|
22
|
Abstract
Improving on the limited success of cancer immunotherapy requires new approaches to inhibit immunosuppressive pathways initiated by tumor cells to "escape" protective immunity. One unique approach utilizes Salmonella for systemic delivery of inhibitory RNA, targeting the immunosuppressive molecule Stat3, and a Survivin vaccine to suppress growth of aggressive murine tumors.
Collapse
Affiliation(s)
- Edwin R Manuel
- Division of Translational Vaccine Research; City of Hope; Duarte, CA USA
| | | | | | | |
Collapse
|
23
|
Plotkin SA, Wang D, Oualim A, Diamond DJ, Kotton CN, Mossman S, Carfi A, Anderson D, Dormitzer PR. The Status of Vaccine Development Against the Human Cytomegalovirus. J Infect Dis 2021; 221:S113-S122. [PMID: 32134478 DOI: 10.1093/infdis/jiz447] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Numerous candidate vaccines against cytomegalovirus (CMV) infection and disease are in development. Whereas the previous article [1] provides background and opinions about the issues relating to vaccination, this article provides specifics about the vaccines in active development, as reported at a National Institutes of Health-sponsored meeting in Bethesda on September 4-6, 2018. Here, vaccine developers provide synopses of their candidate vaccines to immunize women to protect against congenital CMV disease and to prevent the consequences of CMV disease in recipients of transplanted organs or hematopoietic stem calls. The projects are presented here roughly in the descending order of their stage of development in the opinion of the first author.
Collapse
Affiliation(s)
- Stanley A Plotkin
- Department of Pediatrics, University of Pennsylvania, Vaxconsult, Doylestown, Pennsylvania, USA
| | - Dai Wang
- Merck & Co., Kenilworth, New Jersey, USA
| | | | - Don J Diamond
- City of Hope National Medical Center, Duarte, California, USA
| | | | | | - Andrea Carfi
- Moderna Therapeutics, Cambridge, Massachusetts, USA
| | | | | |
Collapse
|
24
|
Phan T, Nguyen VH, Buettner R, Morales C, Yang L, Wong P, Tsai W, Salazar MD, Gil Z, Diamond DJ, Rabinowitz JD, Rosen S, Melstrom LG. Inhibition of de novo pyrimidine synthesis augments Gemcitabine induced growth inhibition in an immunocompetent model of pancreatic cancer. Int J Biol Sci 2021; 17:2240-2251. [PMID: 34239352 PMCID: PMC8241727 DOI: 10.7150/ijbs.60473] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/18/2021] [Indexed: 12/13/2022] Open
Abstract
Leflunomide (Lef) is an agent used in autoimmune disorders that interferes with DNA synthesis. De Novo pyrimidine synthesis is a mechanism of Gemcitabine (Gem) resistance in pancreatic cancer. This study aims to assess the efficacy and changes in the tumor microenvironment of Lef monotherapy and in combination with Gem, in a syngeneic mouse model of pancreatic cancer. Methods: MTS proliferation assays were conducted to assess growth inhibition by Gem (0-20 nM), Lef (0-40 uM) and Gem+Lef in KPC (KrasLSL.G12D/+;p53R172H/+; PdxCretg/+) cells in vitro. An in vivo heterotopic KPC model was used and cohorts were treated with: PBS (control), Gem (75 mg/kg/q3d), Lef (40 mg/kg/d), or Gem+Lef. At d28 post-treatment, tumor burden, proliferation index (Ki67), and vascularity (CD31) were measured. Changes in the frequency of peripheral and intratumoral immune cell subsets were evaluated via FACS. Liquid chromatography-mass spectrometry was used for metabolomics profiling. Results: Lef inhibits KPC cell growth and synergizes with Gem in vitro (P<0.05; Combination Index 0.44 (<1 indicates synergy). In vivo, Lef alone and in combination with Gem delays KPC tumor progression (P<0.001). CTLA-4+T cells are also significantly decreased in tumors treated with Lef, Gem or in combination (Gem+Lef) compared to controls (P<0.05). Combination therapy also decreased the Ki67 and vascularity (P<0.01). Leflunomide inhibits de novo pyrimidine synthesis both in vitro (p<0.0001) and in vivo (p<0.05). Conclusions: In this study, we demonstrated that Gem+Lef inhibits pancreatic cancer growth, decrease T cell exhaustion, vascularity and as proof of principle inhibits de novo pyrimidine synthesis. Further characterization of changes in adaptive immunity are necessary to characterize the mechanism of tumor growth inhibition and facilitate translation to a clinical trial.
Collapse
Affiliation(s)
- Thuy Phan
- Department of Surgery, City of Hope National Medical Center, Duarte, CA 91010
| | - Vu H. Nguyen
- Department of Hematology, City of Hope National Medical Center, Duarte, CA 91010
| | - Ralf Buettner
- Department of Hematology, City of Hope National Medical Center, Duarte, CA 91010
| | - Corey Morales
- Department of Hematology, City of Hope National Medical Center, Duarte, CA 91010
| | - Lifeng Yang
- Lewis Sigler Institute for Integrative Genomics and Department of Chemistry, Princeton University, Princeton, NJ 08544
| | - Paul Wong
- Department of Surgery, City of Hope National Medical Center, Duarte, CA 91010
| | - Weiman Tsai
- Department of Hematology, City of Hope National Medical Center, Duarte, CA 91010
| | | | - Ziv Gil
- Rambam Medical Center, Israel
| | - Don J Diamond
- Department of Hematology, City of Hope National Medical Center, Duarte, CA 91010
| | - Joshua D. Rabinowitz
- Lewis Sigler Institute for Integrative Genomics and Department of Chemistry, Princeton University, Princeton, NJ 08544
| | - Steven Rosen
- Department of Hematology, City of Hope National Medical Center, Duarte, CA 91010
| | - Laleh G. Melstrom
- Department of Surgery, City of Hope National Medical Center, Duarte, CA 91010
- ✉ Corresponding author: Laleh Melstrom MD, City of Hope National Medical Center, Department of Surgery and Immuno-oncology, 1500 E Duarte Road, Duarte, CA 91010. E-mail: ; Phone: 626 218 0282; Fax: 626 218 1113
| |
Collapse
|
25
|
Chiuppesi F, Salazar MD, Contreras H, Nguyen VH, Martinez J, Park Y, Nguyen J, Kha M, Iniguez A, Zhou Q, Kaltcheva T, Levytskyy R, Ebelt ND, Kang TH, Wu X, Rogers TF, Manuel ER, Shostak Y, Diamond DJ, Wussow F. Development of a multi-antigenic SARS-CoV-2 vaccine candidate using a synthetic poxvirus platform. Nat Commun 2020; 11:6121. [PMID: 33257686 PMCID: PMC7705736 DOI: 10.1038/s41467-020-19819-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 11/02/2020] [Indexed: 12/14/2022] Open
Abstract
Modified Vaccinia Ankara (MVA) is a highly attenuated poxvirus vector that is widely used to develop vaccines for infectious diseases and cancer. We demonstrate the construction of a vaccine platform based on a unique three-plasmid system to efficiently generate recombinant MVA vectors from chemically synthesized DNA. In response to the ongoing global pandemic caused by SARS coronavirus-2 (SARS-CoV-2), we use this vaccine platform to rapidly produce fully synthetic MVA (sMVA) vectors co-expressing SARS-CoV-2 spike and nucleocapsid antigens, two immunodominant antigens implicated in protective immunity. We show that mice immunized with these sMVA vectors develop robust SARS-CoV-2 antigen-specific humoral and cellular immune responses, including potent neutralizing antibodies. These results demonstrate the potential of a vaccine platform based on synthetic DNA to efficiently generate recombinant MVA vectors and to rapidly develop a multi-antigenic poxvirus-based SARS-CoV-2 vaccine candidate.
Collapse
Affiliation(s)
- Flavia Chiuppesi
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Marcela d'Alincourt Salazar
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Heidi Contreras
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Vu H Nguyen
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Joy Martinez
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Yoonsuh Park
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Jenny Nguyen
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Mindy Kha
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Angelina Iniguez
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Qiao Zhou
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Teodora Kaltcheva
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Roman Levytskyy
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA
| | - Nancy D Ebelt
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte, CA, 91010, USA
| | - Tae Hyuk Kang
- Integrative Genomics Core, Beckman Research Institute of the City of Hope, Duarte, CA, 91010, USA
| | - Xiwei Wu
- Integrative Genomics Core, Beckman Research Institute of the City of Hope, Duarte, CA, 91010, USA
| | - Thomas F Rogers
- Division of Infectious Diseases and Global Public Health, University of California San Diego, School of Medicine, 9500 Gilman Dr, La Jolla, CA, 92093, USA
- Scripps Research, Department of Immunology and Microbiology, 10550N Torrey Pines Rd, La Jolla, CA, 92037, USA
| | - Edwin R Manuel
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte, CA, 91010, USA
| | - Yuriy Shostak
- Research Business Development, City of Hope, Duarte, CA, 91010, USA
| | - Don J Diamond
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA.
| | - Felix Wussow
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte, CA, 91010, USA.
| |
Collapse
|
26
|
Schleiss MR, Diamond DJ. Exciting Times for Cytomegalovirus (CMV) Vaccine Development: Navigating the Pathways toward the Goal of Protecting Infants against Congenital CMV Infection. Vaccines (Basel) 2020; 8:E526. [PMID: 32937764 PMCID: PMC7563117 DOI: 10.3390/vaccines8030526] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 02/07/2023] Open
Abstract
The congenital transmission of cytomegalovirus (cCMV) is the most common infectious cause of disability in children in the developed world, and probably globally [...].
Collapse
Affiliation(s)
- Mark R. Schleiss
- Department of Pediatrics, Medical School Campus, University of Minnesota, Minneapolis, MN 55455, USA
| | - Don J. Diamond
- Department of Hematology/HCT, Beckman Research Institute of the City of Hope, Duarte, CA 91010, USA
| |
Collapse
|
27
|
Abstract
: There is a long history of personal protective equipment (PPE) used by the surgeon to minimize the transmission of various pathogens. In the context of the present coronavirus disease 2019 pandemic there is significant controversy as to what forms of PPE are appropriate or adequate. This review aims to describe the pathogenic mechanism and route of spread of the causative virus, severe acute respiratory syndrome coronavirus, as it pertains to accumulated published data from experienced centers globally. The various forms of PPE that are both available and appropriate are addressed. There are options in the form of eyewear, gloves, masks, respirators, and gowns. The logical and practical utilization of these should be data driven and evolve based on both experience and data. Last, situations specific to surgical populations are addressed. We aim to provide granular collective data that has thus far been published and that can be used as a reference for optimal PPE choices in the perioperative setting for surgical teams.
Collapse
Affiliation(s)
- Camille L Stewart
- Department of Surgery, City of Hope National Medical Center, Duarte, CA
| | | | - Don J Diamond
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Yuman Fong
- Department of Surgery, City of Hope National Medical Center, Duarte, CA
| | - Laleh G Melstrom
- Department of Surgery, City of Hope National Medical Center, Duarte, CA
| |
Collapse
|
28
|
Chiuppesi F, Salazar MD, Contreras H, Nguyen VH, Martinez J, Park S, Nguyen J, Kha M, Iniguez A, Zhou Q, Kaltcheva T, Levytskyy R, Ebelt ND, Kang TH, Wu X, Rogers T, Manuel ER, Shostak Y, Diamond DJ, Wussow F. Development of a Synthetic Poxvirus-Based SARS-CoV-2 Vaccine. bioRxiv 2020:2020.07.01.183236. [PMID: 32637957 PMCID: PMC7337387 DOI: 10.1101/2020.07.01.183236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Modified Vaccinia Ankara (MVA) is a highly attenuated poxvirus vector that is widely used to develop vaccines for infectious diseases and cancer. We developed a novel vaccine platform based on a unique three-plasmid system to efficiently generate recombinant MVA vectors from chemically synthesized DNA. In response to the ongoing global pandemic caused by SARS coronavirus-2 (SARS-CoV-2), we used this novel vaccine platform to rapidly produce fully synthetic MVA (sMVA) vectors co-expressing SARS-CoV-2 spike and nucleocapsid antigens, two immunodominant antigens implicated in protective immunity. Mice immunized with these sMVA vectors developed robust SARS-CoV-2 antigen-specific humoral and cellular immune responses, including potent neutralizing antibodies. These results demonstrate the potential of a novel vaccine platform based on synthetic DNA to efficiently generate recombinant MVA vectors and to rapidly develop a multi-antigenic poxvirus-based SARS-CoV-2 vaccine candidate.
Collapse
Affiliation(s)
- Flavia Chiuppesi
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| | | | - Heidi Contreras
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| | - Vu H Nguyen
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| | - Joy Martinez
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| | - Soojin Park
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| | - Jenny Nguyen
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| | - Mindy Kha
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| | - Angelina Iniguez
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| | - Qiao Zhou
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| | - Teodora Kaltcheva
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| | - Roman Levytskyy
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| | - Nancy D Ebelt
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte CA 91010, USA
| | - Tae Hyuk Kang
- Department of Genomic core facility, Beckman Research Institute of the City of Hope, Duarte CA 91010, USA
| | - Xiwei Wu
- Department of Genomic core facility, Beckman Research Institute of the City of Hope, Duarte CA 91010, USA
| | - Thomas Rogers
- University of California San Diego, School of Medicine, Division of Infectious Diseases and Global Public Health, 9500 Gilman Dr, La Jolla, CA 92093; Scripps Research, Department of Immunology and Microbiology, 10550 N Torrey Pines Rd, La Jolla, CA 92037
| | - Edwin R Manuel
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte CA 91010, USA
| | - Yuriy Shostak
- Research Business Development, City of Hope, Duarte CA 91010, USA
| | - Don J Diamond
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| | - Felix Wussow
- Department of Hematology and Transplant Center, City of Hope National Medical Center, Duarte CA 91010, USA
| |
Collapse
|
29
|
Ebelt ND, Zuniga E, Johnson BL, Diamond DJ, Manuel ER. 5-Azacytidine Potentiates Anti-tumor Immunity in a Model of Pancreatic Ductal Adenocarcinoma. Front Immunol 2020; 11:538. [PMID: 32296439 PMCID: PMC7136411 DOI: 10.3389/fimmu.2020.00538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 03/09/2020] [Indexed: 12/26/2022] Open
Abstract
Tumors evolve a variety of mechanisms to escape immune detection while expressing tumor-promoting molecules that can be immunogenic. Here, we show that transposable elements (TE) and gene encoded, tumor-associated antigens (TAA), which can be both highly immunogenic and tumor-promoting, are significantly upregulated during the transition from pre-malignancy to malignancy in an inducible model of pancreatic ductal adenocarcinoma (PDAC). Coincident with the increased presence of TEs and TAAs was the downregulation of gene transcripts associated with antigen presentation, T cell recruitment and intrinsic anti-viral responses, suggesting a unique strategy employed by PDAC to possibly augment tumorigenesis while escaping detection by the immune system. In vitro treatment of mouse and human PDAC cell lines with the DNA methyltransferase inhibitor 5-azacytidine (Aza) resulted in augmented expression of transcripts for antigen presentation machinery and T cell chemokines. When immunocompetent mice implanted with PDAC were therapeutically treated with Aza, we observed significant tumor regression that was not observed in immunocompromised mice, implicating anti-tumor immunity as the principal mechanism of tumor growth control. Analysis of PDAC tumors, immediately following Aza treatment in immunocompetent mice, revealed a significantly greater infiltration of T cells and various innate immune subsets compared to control treatment, suggesting that Aza treatment enhances tumor immunogenicity. Thus, augmenting antigen presentation and T cell chemokine expression using DNA methyltransferase inhibitors could be leveraged to potentiate adaptive anti-tumor immune responses against PDAC.
Collapse
Affiliation(s)
- Nancy D. Ebelt
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope, Duarte, CA, United States
| | - Edith Zuniga
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope, Duarte, CA, United States
| | - Benjamin L. Johnson
- Department of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Don J. Diamond
- Department of Hematology and Hematopoietic Stem Cell Transplantation, City of Hope, Duarte, CA, United States
| | - Edwin R. Manuel
- Department of Immuno-Oncology, Beckman Research Institute, City of Hope, Duarte, CA, United States
| |
Collapse
|
30
|
Aldoss I, La Rosa C, Baden LR, Longmate J, Ariza-Heredia EJ, Rida WN, Lingaraju CR, Zhou Q, Martinez J, Kaltcheva T, Dagis A, Hardwick N, Issa NC, Farol L, Nademanee A, Al Malki MM, Forman S, Nakamura R, Diamond DJ. Poxvirus Vectored Cytomegalovirus Vaccine to Prevent Cytomegalovirus Viremia in Transplant Recipients: A Phase 2, Randomized Clinical Trial. Ann Intern Med 2020; 172:306-316. [PMID: 32040960 PMCID: PMC9074089 DOI: 10.7326/m19-2511] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Triplex vaccine was developed to enhance cytomegalovirus (CMV)-specific T cells and prevent CMV reactivation early after hematopoietic stem cell transplant (HCT). Objective To determine the safety and efficacy of Triplex. Design First-in-patient, phase 2 trial. (ClinicalTrials.gov: NCT02506933). Setting 3 U.S. HCT centers. Participants 102 CMV-seropositive HCT recipients at high risk for CMV reactivation. Intervention Intramuscular injections of Triplex or placebo were given on days 28 and 56 after HCT. Triplex is a recombinant attenuated poxvirus (modified vaccinia Ankara) expressing immunodominant CMV antigens. Measurements The primary outcomes were CMV events (CMV DNA level ≥1250 IU/mL, CMV viremia requiring antiviral treatment, or end-organ disease), nonrelapse mortality, and severe (grade 3 or 4) graft-versus-host disease (GVHD), all evaluated through 100 days after HCT, and grade 3 or 4 adverse events (AEs) within 2 weeks after vaccination that were probably or definitely attributable to injection. Results A total of 102 patients (51 per group) received the first vaccination, and 91 (89.2%) received both vaccinations (46 Triplex and 45 placebo). Reactivation of CMV occurred in 5 Triplex (9.8%) and 10 placebo (19.6%) recipients (hazard ratio, 0.46 [95% CI, 0.16 to 1.4]; P = 0.075). No Triplex recipient died of nonrelapse causes during the first 100 days or had serious AEs, and no grade 3 or 4 AEs related to vaccination were observed within 2 weeks after vaccination. Incidence of severe acute GVHD after injection was similar between groups (hazard ratio, 1.1 [CI, 0.53 to 2.4]; P = 0.23). Levels of long-lasting, pp65-specific T cells with effector memory phenotype were significantly higher in Triplex than placebo recipients. Limitation The lower-than-expected incidence of CMV events in the placebo group reduced the power of the trial. Conclusion No vaccine-associated safety concerns were identified. Triplex elicited and amplified CMV-specific immune responses, and fewer Triplex-vaccinated patients had CMV viremia. Primary Funding Source National Cancer Institute and Helocyte.
Collapse
Affiliation(s)
- Ibrahim Aldoss
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Corinna La Rosa
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Lindsey R. Baden
- Division of Infectious Disease, Brigham and Women's Hospital & The Dana-Farber Cancer Institute, Boston, MA
| | - Jeffrey Longmate
- Division of Biostatistics of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Ella J. Ariza-Heredia
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Chetan Raj Lingaraju
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Qiao Zhou
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Joy Martinez
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Teodora Kaltcheva
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Andy Dagis
- Division of Biostatistics of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Nicola Hardwick
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Nicolas C. Issa
- Division of Infectious Disease, Brigham and Women's Hospital & The Dana-Farber Cancer Institute, Boston, MA
| | - Len Farol
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Auayporn Nademanee
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Monzr M. Al Malki
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Stephen Forman
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Ryotaro Nakamura
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| | - Don J. Diamond
- Department of Hematology and Hematopoietic Cell Transplantation of the City of Hope Comprehensive Cancer Center and the Beckman Research Institute of City of Hope, Duarte, CA
| |
Collapse
|
31
|
Johnson BL, d’Alincourt Salazar M, Mackenzie-Dyck S, D’Apuzzo M, Shih HP, Manuel ER, Diamond DJ. Desmoplasia and oncogene driven acinar-to-ductal metaplasia are concurrent events during acinar cell-derived pancreatic cancer initiation in young adult mice. PLoS One 2019; 14:e0221810. [PMID: 31490946 PMCID: PMC6731019 DOI: 10.1371/journal.pone.0221810] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/15/2019] [Indexed: 01/04/2023] Open
Abstract
The five-year survival rate of patients diagnosed with advanced pancreatic ductal adenocarcinoma (PDAC) has remained static at <5% despite decades of research. With the exception of erlotinib, clinical trials have failed to demonstrate the benefit of any targeted therapy for PDAC despite promising results in preclinical animal studies. The development of more refined mouse models of PDAC which recapitulate the carcinogenic progression from non-neoplastic, adult exocrine subsets of pancreatic cells to invasive carcinoma in humans are needed to facilitate the accurate translation of therapies to the clinic. To study acinar cell-derived PDAC initiation, we developed a genetically engineered mouse model of PDAC, called KPT, utilizing a tamoxifen-inducible Cre recombinase/estrogen receptor (ESR1) fusion protein knocked into the Ptf1a locus to activate the expression of oncogenic KrasG12D and Trp53R270H alleles in mature pancreatic acinar cells. Oncogene-expressing acinar cells underwent acinar-to-ductal metaplasia, and formed pancreatic intraepithelial neoplasia lesions following the induction of oncogene expression. After a defined latency period, oncogene-expressing acinar cells initiated the formation of highly differentiated and fibrotic tumors, which metastasized to the lungs and liver. Whole-transcriptome analysis of microdissected regions of acinar-to-ductal metaplasia and histological validation experiments demonstrated that regions of acinar-to-ductal metaplasia are characterized by the deposition of the extracellular matrix component hyaluronan. These results indicate that acinar cells expressing KrasG12D and Trp53R270H can initiate PDAC development in young adult mice and implicate hyaluronan deposition in the formation of the earliest characterized PDAC precursor lesions (and the progression of pancreatic cancer). Further studies are necessary to provide a comprehensive characterization of PDAC progression and treatment response in KPT mice and to investigate whether the KPT model could be used as a tool to study translational aspects of acinar cell-derived PDAC tumorigenesis.
Collapse
Affiliation(s)
- Benjamin L. Johnson
- Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA, United States of America
- Irell & Manella Graduate School of Biological Sciences, Beckman Research Institute of City of Hope, Duarte, CA, United States of America
| | - Marcela d’Alincourt Salazar
- Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA, United States of America
| | - Sarah Mackenzie-Dyck
- Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA, United States of America
| | - Massimo D’Apuzzo
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Hung Ping Shih
- Department of Translational Research and Cellular Therapeutics, Diabetes and Metabolic Research Institute, Beckman Research Institute of City of Hope, Duarte, CA, United States of America
| | - Edwin R. Manuel
- Department of Immuno-Oncology, Beckman Research Institute of City of Hope, Duarte, CA, United States of America
| | - Don J. Diamond
- Department of Hematology and Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope, Duarte, CA, United States of America
- * E-mail:
| |
Collapse
|
32
|
Chung V, Kos FJ, Hardwick N, Yuan Y, Chao J, Li D, Waisman J, Li M, Zurcher K, Frankel P, Diamond DJ. Evaluation of safety and efficacy of p53MVA vaccine combined with pembrolizumab in patients with advanced solid cancers. Clin Transl Oncol 2019; 21:363-372. [PMID: 30094792 PMCID: PMC8802616 DOI: 10.1007/s12094-018-1932-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 07/30/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vaccination of cancer patients with p53-expressing modified vaccinia Ankara virus (p53MVA) has shown in our previous studies to activate p53-reactive T cells in peripheral blood but without immediate clinical benefit. We hypothesized that the immunological responses to p53MVA vaccine may require additional immune checkpoint blockade to achieve clinically beneficial levels. We therefore conducted a phase I trial evaluating the combination of p53MVA and pembrolizumab (anti-PD-1) in patients with advanced solid tumors. PATIENTS AND METHODS Eleven patients with advanced breast, pancreatic, hepatocellular, or head and neck cancer received up to 3 triweekly vaccines in combination with pembrolizumab given concurrently and thereafter, alone at 3-week intervals until disease progression. The patients were assessed for toxicity and clinical response. Correlative studies analyzed p53-reactive T cells and profile of immune function gene expression. RESULTS We observed clinical responses in 3/11 patients who remained with stable disease for 30, 32, and 49 weeks. Two of these patients showed increased frequencies and persistence of p53-reactive CD8+ T cells and elevation of expression of multiple immune response genes. Borderline or undetectable p53-specific T cell responses in 7/11 patients were related to no immediate clinical benefit. The first study patient had a grade 5 fatal myocarditis. After the study was amended for enhanced cardiac monitoring, no additional cardiac toxicities were noted. CONCLUSION We have shown that the combination of p53MVA vaccine with pembrolizumab is feasible, safe, and may offer clinical benefit in select group of patients that should be identified through further studies.
Collapse
Affiliation(s)
- V Chung
- Department of Medical Oncology, City of Hope National Medical Center, 1500 E. Duarte Rd., Duarte, CA, 91010, USA
| | - F J Kos
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - N Hardwick
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Y Yuan
- Department of Medical Oncology, City of Hope National Medical Center, 1500 E. Duarte Rd., Duarte, CA, 91010, USA
| | - J Chao
- Department of Medical Oncology, City of Hope National Medical Center, 1500 E. Duarte Rd., Duarte, CA, 91010, USA
| | - D Li
- Department of Medical Oncology, City of Hope National Medical Center, 1500 E. Duarte Rd., Duarte, CA, 91010, USA
| | - J Waisman
- Department of Medical Oncology, City of Hope National Medical Center, 1500 E. Duarte Rd., Duarte, CA, 91010, USA
| | - M Li
- Clinical Trials Office, City of Hope National Medical Center, Duarte, CA, USA
| | - K Zurcher
- Department of Clinical Research, City of Hope National Medical Center, Duarte, CA, USA
| | - P Frankel
- Division of Biostatistics, City of Hope National Medical Center, Duarte, CA, USA
| | - D J Diamond
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte, CA, USA.
| |
Collapse
|
33
|
Phan T, Nguyen VH, D'Alincourt MS, Manuel ER, Kaltcheva T, Tsai W, Blazar BR, Diamond DJ, Melstrom LG. Salmonella-mediated therapy targeting indoleamine 2, 3-dioxygenase 1 (IDO) activates innate immunity and mitigates colorectal cancer growth. Cancer Gene Ther 2019; 27:235-245. [PMID: 30824815 PMCID: PMC8177749 DOI: 10.1038/s41417-019-0089-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/30/2019] [Accepted: 02/10/2019] [Indexed: 12/19/2022]
Abstract
Patients with colon cancer remain largely refractory to current immunotherapeutic strategies. This is, in part, due to the overexpression of the immune checkpoint protein indoleamine 2,3-dioxygenase 1 (IDO). IDO is an important enzyme contributing to tumor-mediated immunosuppression and also correlates with poor prognosis in colon cancer patients. The aim of this study was to assess the therapeutic efficacy of attenuated Salmonella typhimurium delivering an shRNA plasmid targeting IDO (shIDO-ST) in two mouse models of colorectal cancer. In vitro, the CT26 and MC38 murine colon cancer cell lines were shown to upregulate IDO expression following stimulation with interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α). Transfection of both cell lines with shIDO plasmid reduced IDO protein expression and function. In vivo, shIDO-ST treatment significantly delayed CT26 and MC38 tumor progression compared to mice treated with scrambled shRNA control (shScr-ST) or the clinically-tested IDO inhibitor epacadostat. Increased tumor infiltration of neutrophils was found to be the primary immune cell population associated with shIDO-ST treatment, suggesting robust activation of innate immunity. Although increased tumor expression of IDO is associated with resistance to antibody therapy against programed cell death-1 (anti-PD1), co-administration of anti-PD1 with shIDO-ST did not provide additional tumor growth control in either model of colorectal cancer. Altogether, we demonstrate that treatment with shIDO-ST markedly delays tumor growth in two immunocompetent colorectal mouse models and this appears to be a superior therapeutic strategy compared to epacadostat or blocking anti-PD1 antibody therapy in colon cancer.
Collapse
Affiliation(s)
- Thuy Phan
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Vu H Nguyen
- Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA
| | | | - Edwin R Manuel
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Teodora Kaltcheva
- Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA
| | - Weimin Tsai
- Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA
| | - Bruce R Blazar
- Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Don J Diamond
- Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA
| | - Laleh G Melstrom
- Department of Immuno-Oncology, Beckman Research Institute of the City of Hope, Duarte, CA, USA. .,Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA.
| |
Collapse
|
34
|
Nakamura R, La Rosa C, Longmate J, Lingaraju CR, Zhou Q, Kaltcheva T, Aldoss I, Diamond DJ. Rapid Acquisition of Cytomegalovirus-Specific T Cells with a Differentiated Phenotype, in Non-Viremic Hematopoietic Stem Transplant Recipients Vaccinated with Cmvpepvax. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
35
|
Cichocki F, Taras E, Chiuppesi F, Wagner JE, Blazar BR, Brunstein C, Luo X, Diamond DJ, Cooley S, Weisdorf DJ, Miller JS. Adaptive NK cell reconstitution is associated with better clinical outcomes. JCI Insight 2019; 4:e125553. [PMID: 30674718 PMCID: PMC6413795 DOI: 10.1172/jci.insight.125553] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 12/18/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Human cytomegalovirus (CMV) reactivation is a common occurrence early after transplant and is associated with heterogeneous NK cell subset expansion. These adaptive NK cell expansions are highly variable between recipients, with respect to magnitude and relative frequencies of adaptive NK cell subsets. METHODS To gain insight into the factors that influence adaptive NK cell expansion from a CMV naive graft source, we performed a high-resolution NK cell and CD8+ T cell phenotypic analysis of 215 patients with hematological malignancies that were transplanted with 2 partially HLA matched CMV negative umbilical cord blood units. RESULTS We found that adaptive NK cells were significantly higher in recipients who received nonmyeloablative conditioning (NMAC) relative to myeloablative conditioning (MAC), and high CMV neutralizing antibody titers correlated with the degree of adaptive NK cell expansion. The frequencies of adaptive NK cell subsets (defined by NKG2C, FcεRγ, EAT-2, and SYK expression) that reconstitute from donor hematopoietic progenitor cells largely matched the frequencies observed in the NK cell compartment of the recipient prior to conditioning, suggesting that host - as well as viral reactivation factors - may determine the phenotypic diversification after transplant. Additionally, multivariable analyses show that higher adaptive NK cell expansion associated with better disease-free survival. CONCLUSIONS Our findings provide important insights into adaptive NK cell reconstitution after transplant and support a role for adaptive NK cells in promoting better clinical outcomes. FUNDING The NIH and the National Marrow Donor Program.
Collapse
Affiliation(s)
- Frank Cichocki
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Emily Taras
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Flavia Chiuppesi
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, Duarte, California, USA
| | | | | | - Claudio Brunstein
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Xianghua Luo
- Division of Biostatistics, School of Public Health, and
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Don J. Diamond
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, Duarte, California, USA
| | - Sarah Cooley
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Daniel J. Weisdorf
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jeffrey S. Miller
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
36
|
La Rosa C, Longmate J, Lingaraju CR, Zhou Q, Kaltcheva T, Hardwick N, Aldoss I, Nakamura R, Diamond DJ. Rapid Acquisition of Cytomegalovirus-Specific T Cells with a Differentiated Phenotype, in Nonviremic Hematopoietic Stem Transplant Recipients Vaccinated with CMVPepVax. Biol Blood Marrow Transplant 2018; 25:771-784. [PMID: 30562587 DOI: 10.1016/j.bbmt.2018.12.070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 12/10/2018] [Indexed: 12/12/2022]
Abstract
Early cytomegalovirus (CMV) reactivation remains a significant cause of morbidity and mortality in allogeneic hematopoietic cell transplant (HCT) recipients. CMVPepVax is an investigational peptide vaccine designed to control CMV infection in HCT recipients seropositive for CMV by stimulating the expansion of T cell subsets that target the CMV tegument protein pp65. In a randomized Phase Ib pilot trial (ClinicalTrials.gov NCT01588015), two injections of CMVPepVax (at days 28 and 56 post-HCT) demonstrated safety, immunogenicity, increased relapse-free survival, and reduced CMV reactivation and use of antivirals. In the present study, we assessed the phenotypes and time courses of the pp65-specific CD8 T cell subsets that expanded in response to CMVPepVax vaccination. The functionality and antiviral role of CMV-specific T cells have been linked to immune reconstitution profiles characterized predominantly by differentiated effector memory T (TEM) subsets that have lost membrane expression of the costimulatory molecule CD28 and often reexpress the RA isoform of CD45 (TEMRA). Major histocompatibility complex class I pp65495-503 multimers, as well as CD28 and CD45 memory markers, were used to detect immune reconstitution in blood specimens from HCT recipients enrolled in the Phase Ib clinical trial. Specimens from the 10 (out of 18) vaccinated patients who had adequate (≥.2%) multimer binding to allow for memory analysis showed highly differentiated TEM and TEMRA phenotypes for pp65495-503-specific CD8 T cells during the first 100days post-transplantation. In particular, by day 70, during the period of highest risk for CMV reactivation, combined TEM and TEMRA phenotypes constituted a median of 90% of pp65495-503-specific CD8 T cells in these vaccinated patients. CMV viremia was not detectable in the patients who received CMVPepVax, although their pp65495-503-specific CD8 T cell profiles were strikingly similar to those observed in viremic patients who did not receive the vaccine. Collectively, our findings indicate that in the absence of clinically relevant viremia, CMVPepVax reconstituted significant levels of differentiated pp65495-503-specific CD8 TEMs early post-HCT. Our data indicate that the rapid reconstitution of CMV-specific T cells with marked levels of effector phenotypes may have been key to the favorable outcomes of the CMVPepVax clinical trial.
Collapse
Affiliation(s)
- Corinna La Rosa
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Jeffrey Longmate
- Division of Biostatistics, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Chetan Raj Lingaraju
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Qiao Zhou
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Teodora Kaltcheva
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Nicola Hardwick
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Ibrahim Aldoss
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Ryotaro Nakamura
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Don J Diamond
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, California.
| |
Collapse
|
37
|
Diamond DJ, LaRosa C, Chiuppesi F, Contreras H, Dadwal S, Wussow F, Bautista S, Nakamura R, Zaia JA. A fifty-year odyssey: prospects for a cytomegalovirus vaccine in transplant and congenital infection. Expert Rev Vaccines 2018; 17:889-911. [PMID: 30246580 PMCID: PMC6343505 DOI: 10.1080/14760584.2018.1526085] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 09/17/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION It has been almost fifty years since the Towne strain was used by Plotkin and collaborators as the first vaccine candidate for cytomegalovirus (CMV). While that approach showed partial efficacy, there have been a multitude of challenges to improve on the promise of a CMV vaccine. Efforts have been dichotomized into a therapeutic vaccine for patients with CMV-infected allografts, either stem cells or solid organ, and a prophylactic vaccine for congenital infection. AREAS COVERED This review will evaluate research prospects for a therapeutic vaccine for transplant recipients that recognizes CMV utilizing primarily T cell responses. Similarly, we will provide an extensive discussion on attempts to develop a vaccine to prevent the manifestations of congenital infection, based on eliciting a humoral anti-CMV protective response. The review will also describe newer developments that have upended the efforts toward such a vaccine through the discovery of a second pathway of CMV infection that utilizes an alternative receptor for entry using a series of antigens that have been determined to be important for prevention of infection. EXPERT COMMENTARY There is a concerted effort to unify separate therapeutic and prophylactic vaccine strategies into a single delivery agent that would be effective for both transplant-related and congenital infection.
Collapse
Affiliation(s)
- Don J. Diamond
- Department of Experimental Therapeutics, Beckman Research
Institute of City of Hope, Duarte, CA
| | - Corinna LaRosa
- Department of Experimental Therapeutics, Beckman Research
Institute of City of Hope, Duarte, CA
| | - Flavia Chiuppesi
- Department of Experimental Therapeutics, Beckman Research
Institute of City of Hope, Duarte, CA
| | - Heidi Contreras
- Department of Experimental Therapeutics, Beckman Research
Institute of City of Hope, Duarte, CA
| | - Sanjeet Dadwal
- Department of Medical Specialties, City of Hope National
Medical Center, Duarte, CA
| | - Felix Wussow
- Department of Experimental Therapeutics, Beckman Research
Institute of City of Hope, Duarte, CA
| | - Supriya Bautista
- Department of Experimental Therapeutics, Beckman Research
Institute of City of Hope, Duarte, CA
| | - Ryotaro Nakamura
- Department of Hematology & Hematopoetic Cell
Transplantation, City of Hope National Medical Center, Duarte, CA
| | - John A. Zaia
- Center for Gene Therapy, Hematological Malignancy and Stem
Cell Transplantation Institute, City of Hope, Duarte, CA
| |
Collapse
|
38
|
Chung VM, Kos F, Hardwick N, Yuan Y, Chao J, Li M, Zurcher K, Frankel PH, Li D, Waisman JR, Diamond DJ. A phase 1 study of p53MVA vaccine in combination with pembrolizumab. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.5_suppl.206] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
206 Background: Mutations in the p53 gene are present in a majority of solid tumors, resulting in the accumulation of oncogenic and potentially immunogenic p53 protein within tumor cells. We have developed a genetically engineered Modified Vaccinia Ankara (MVA) virus to express wild type p53 transgene (p53MVA) as an immunotherapeutic strategy. We observed robust p53-specific CD8+ T cell responses which were further enhanced by anti-PD-1 treatment. This phase 1 study evaluates the safety and tolerability of the p53MVA vaccine in combination with pembrolizumab. Methods: Patients with non-small cell lung, head and neck squamous cell (HNSCC), hepatocellular (HCC), renal cell, melanoma, bladder, soft tissue sarcoma, triple-negative breast (TNBC), pancreatic (PDAC) and MSI high colorectal cancer failing or intolerant to standard treatment were eligible. Confirmation of p53 involvement by immunohistochemistry or mutational analysis was required for eligibility. A 3-at-risk rolling design was employed and patients received 5.6 x 108 pfu p53MVA for 3 doses in combination with 200 mg pembrolizumab for 7 doses every 3 weeks. Blood draws for immunological monitoring were obtained pre-treatment and up to week 19. Results: Two patients (TNBC and HNSCC) showed clinical benefit associated with durable p53-specific CD8+ T cell responses with gene expression pathway scores of T cell function and associated immune response categories elevated for more than 6 months. The TNBC patient had complete regression of cutaneous metastases and stable disease for > 6 months. Two patients (TNBC and PDAC) were on study for 35 and 9 weeks respectively; however, p53-specific T cells were not generated. Four patients (HCC, PDAC and 2 with TNBC) had rapidly progressive disease. Conclusions: Targeting p53 antigen associated with cancer using a viral vaccine p53MVA in combination with PD-1 blockade represents a novel immunotherapeutic approach capable of stimulating systemic immune responses and associated clinical benefit. Clinical trial information: NCT02432963.
Collapse
|
39
|
Hardwick NR, Frankel P, Ruel C, Kilpatrick J, Tsai W, Kos F, Kaltcheva T, Leong L, Morgan R, Chung V, Tinsley R, Eng M, Wilczynski S, Ellenhorn JDI, Diamond DJ, Cristea M. p53-Reactive T Cells Are Associated with Clinical Benefit in Patients with Platinum-Resistant Epithelial Ovarian Cancer After Treatment with a p53 Vaccine and Gemcitabine Chemotherapy. Clin Cancer Res 2018; 24:1315-1325. [PMID: 29301826 DOI: 10.1158/1078-0432.ccr-17-2709] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/27/2017] [Accepted: 12/19/2017] [Indexed: 01/05/2023]
Abstract
Purpose: To conduct a phase I trial of a Modified Vaccinia Ankara vaccine delivering wild-type human p53 (p53MVA) in combination with gemcitabine chemotherapy in patients with platinum-resistant ovarian cancer.Experimental Design: Patients received gemcitabine on days 1 and 8 and p53MVA vaccine on day 15, during the first 3 cycles of chemotherapy. Toxicity was classified using the NCI Common Toxicity Criteria and clinical response assessed by CT scan. Peripheral blood samples were collected for immunophenotyping and monitoring of anti-p53 immune responses.Results: Eleven patients were evaluated for p53MVA/gemcitabine toxicity, clinical outcome, and immunologic response. TOXICITY there were no DLTs, but 3 of 11 patients came off study early due to gemcitabine-attributed adverse events (AE). Minimal AEs were attributed to p53MVA vaccination. Immunologic and clinical response: enhanced in vitro recognition of p53 peptides was detectable after immunization in both the CD4+ and CD8+ T-cell compartments in 5 of 11 and 6 of 11 patients, respectively. Changes in peripheral T regulatory cells (Tregs) and myeloid-derived suppressor cells (MDSC) did not correlate significantly with vaccine response or progression-free survival (PFS). Patients with the greatest expansion of p53-reactive T cells had significantly longer PFS than patients with lower p53-reactivity after therapy. Tumor shrinkage or disease stabilization occurred in 4 patients.Conclusions: p53MVA was well tolerated, but gemcitabine without steroid pretreatment was intolerable in some patients. However, elevated p53-reactive CD4+ and CD8+ T-cell responses after therapy correlated with longer PFS. Therefore, if responses to p53MVA can be enhanced with alternative agents, superior clinical responses may be achievable. Clin Cancer Res; 24(6); 1315-25. ©2018 AACR.
Collapse
Affiliation(s)
- Nicola R Hardwick
- Department of Experimental Therapeutics, Beckman Research Institute, Duarte, California
| | - Paul Frankel
- Division of Biostatistics, Beckman Research Institute, Duarte, California
| | - Christopher Ruel
- Division of Biostatistics, Beckman Research Institute, Duarte, California
| | - Julie Kilpatrick
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California
| | - Weimin Tsai
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California
| | - Ferdynand Kos
- Department of Experimental Therapeutics, Beckman Research Institute, Duarte, California
| | - Teodora Kaltcheva
- Department of Experimental Therapeutics, Beckman Research Institute, Duarte, California
| | - Lucille Leong
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California
| | - Robert Morgan
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California
| | - Vincent Chung
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California
| | - Raechelle Tinsley
- Clinical Trials Office, City of Hope National Medical Center, Duarte, California
| | - Melissa Eng
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California
| | - Sharon Wilczynski
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | | | - Don J Diamond
- Department of Experimental Therapeutics, Beckman Research Institute, Duarte, California.
| | - Mihaela Cristea
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California
| |
Collapse
|
40
|
Wussow F, Chiuppesi F, Contreras H, Diamond DJ. Neutralization of Human Cytomegalovirus Entry into Fibroblasts and Epithelial Cells. Vaccines (Basel) 2017; 5:E39. [PMID: 29088098 PMCID: PMC5748606 DOI: 10.3390/vaccines5040039] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 10/26/2017] [Accepted: 10/27/2017] [Indexed: 12/12/2022] Open
Abstract
Human cytomegalovirus (HCMV) is a leading cause of permanent birth defects, highlighting the need to develop an HCMV vaccine candidate. However, HCMV vaccine development is complicated by the varying capacity of neutralizing antibodies (NAb) to interfere in vitro with the HCMV entry routes mediating infection of fibroblast (FB) and epithelial cells (EC). While HCMV infection of FB and EC requires glycoprotein complexes composed of gB and gH/gL/gO, EC infection depends additionally on the envelope pentamer complex (PC) composed of gH, gL, UL128, UL130 and UL131A. Unlike NAb to gB or gH epitopes that can interfere with both FB and EC infection, NAb targeting predominantly conformational epitopes of the UL128/130/131A subunits are unable to prevent FB entry, though they are highly potent in blocking EC infection. Despite the selective requirement of the PC for EC entry, the PC is exceptionally immunogenic as vaccine antigen to stimulate both EC- and FB-specific NAb responses due to its capacity to elicit NAb that target epitopes of the UL128/130/131A subunits and gH. These findings suggest that the PC could be sufficient in a subunit vaccine formulation to induce robust FB- and EC-specific NAb responses. In this short review, we discuss NAb responses induced through natural infection and vaccination that interfere in vitro with HCMV infection of FB and EC.
Collapse
Affiliation(s)
- Felix Wussow
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, CA 91010, USA.
| | - Flavia Chiuppesi
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, CA 91010, USA.
| | - Heidi Contreras
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, CA 91010, USA.
| | - Don J Diamond
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, CA 91010, USA.
| |
Collapse
|
41
|
Phan T, Diamond DJ, D'Alincourt MS, Nguyen VH, Manuel E, Kaltcheva T, Melstrom LG. Salmonella-Mediated Therapy Targeting Indoleamine 2, 3-Dioxygenase (IDO) Mitigates Colorectal Cancer Growth in an Immunocompetent. J Am Coll Surg 2017. [DOI: 10.1016/j.jamcollsurg.2017.07.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
42
|
Chiuppesi F, Wussow F, Scharf L, Contreras H, Gao H, Meng Z, Nguyen J, Barry PA, Bjorkman PJ, Diamond DJ. Comparison of homologous and heterologous prime-boost vaccine approaches using Modified Vaccinia Ankara and soluble protein to induce neutralizing antibodies by the human cytomegalovirus pentamer complex in mice. PLoS One 2017; 12:e0183377. [PMID: 28813507 PMCID: PMC5558987 DOI: 10.1371/journal.pone.0183377] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 08/02/2017] [Indexed: 01/15/2023] Open
Abstract
Since neutralizing antibodies (NAb) targeting the human cytomegalovirus (HCMV) pentamer complex (PC) potently block HCMV host cell entry, anti-PC NAb induction is thought to be important for a vaccine formulation to prevent HCMV infection. By developing a vaccine strategy based on soluble PC protein and using a previously generated Modified Vaccinia Ankara vector co-expressing all five PC subunits (MVA-PC), we compared HCMV NAb induction by homologous immunization using prime-boost vaccine regimen employing only PC protein or MVA-PC and heterologous immunization using prime-boost combinations of PC protein and MVA-PC. Utilizing a recently isolated anti-PC NAb, we produced highly pure soluble PC protein that displayed conformational and linear neutralizing epitopes, interfered with HCMV entry, and was recognized by antibodies induced by HCMV during natural infection. Mice vaccinated by different immunization routes with the purified PC protein in combination with a clinically approved adjuvant formulation elicited high-titer and durable HCMV NAb. While MVA-PC and soluble PC protein either alone or in combination elicited robust HCMV NAb, significantly different potencies of these vaccine approaches were observed in dependence on immunization schedule. Using only two immunizations, vaccination with MVA-PC alone or prime-boost combinations of MVA-PC and PC protein was significantly more effective in stimulating HCMV NAb than immunization with PC protein alone. In contrast, with three immunizations, NAb induced by soluble PC protein either alone or combined with two boosts of MVA-PC increased to levels that exceeded NAb titer stimulated by MVA-PC alone. These results provide insights into the potency of soluble protein and MVA to elicit NAb by the HCMV PC via homologous and heterologous prime-boost immunization, which may contribute to develop clinically deployable vaccine strategies to prevent HCMV infection.
Collapse
Affiliation(s)
- Flavia Chiuppesi
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, CA, United States of America
| | - Felix Wussow
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, CA, United States of America
| | - Louise Scharf
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, United States of America
| | - Heidi Contreras
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, CA, United States of America
| | - Han Gao
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, United States of America
| | - Zhuo Meng
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, CA, United States of America
| | - Jenny Nguyen
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, CA, United States of America
| | - Peter A. Barry
- Center for Comparative Medicine, California National Primate Research Center, Department of Pathology and Laboratory Medicine, University of California Davis, Davis, CA, United States of America
| | - Pamela J. Bjorkman
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, United States of America
| | - Don J. Diamond
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, CA, United States of America
- * E-mail:
| |
Collapse
|
43
|
Yuan Y, Kos FJ, He TF, Yin HH, Li M, Hardwick N, Zurcher K, Schmolze D, Lee P, Pillai RK, Chung V, Diamond DJ. Complete regression of cutaneous metastases with systemic immune response in a patient with triple negative breast cancer receiving p53MVA vaccine with pembrolizumab. Oncoimmunology 2017; 6:e1363138. [PMID: 29209571 DOI: 10.1080/2162402x.2017.1363138] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 07/28/2017] [Accepted: 07/28/2017] [Indexed: 12/17/2022] Open
Abstract
A heavily pretreated patient with triple negative breast cancer distinguished by cutaneous metastases received p53MVA vaccine in combination with pembrolizumab. Her cutaneous metastases regressed and after 2 cycles of therapy, a skin biopsy showed a complete pathological response. Systemic response was confirmed with restaging CT and bone scans. Activation of p53-specific T cell responses and elevation of multiple immune response genes in peripheral blood correlated with the rapid clinical response which lasted for 6 months after the initiation of combined therapy.
Collapse
Affiliation(s)
- Yuan Yuan
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA
| | - Ferdynand J Kos
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Ting-Fang He
- Department of Immuno-Oncology, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Hongwei H Yin
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Mengsha Li
- Research Operations, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Nicola Hardwick
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Kathryn Zurcher
- Research Operations, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Daniel Schmolze
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Peter Lee
- Department of Immuno-Oncology, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Raju K Pillai
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
| | - Vincent Chung
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA
| | - Don J Diamond
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, Duarte, CA, USA
| |
Collapse
|
44
|
Nelson CS, Cruz DV, Tran D, Bialas KM, Stamper L, Wu H, Gilbert M, Blair R, Alvarez X, Itell H, Chen M, Deshpande A, Chiuppesi F, Wussow F, Diamond DJ, Vandergrift N, Walter MR, Barry PA, Cohen-Wolkowiez M, Koelle K, Kaur A, Permar SR. Preexisting antibodies can protect against congenital cytomegalovirus infection in monkeys. JCI Insight 2017; 2:94002. [PMID: 28679960 PMCID: PMC5499366 DOI: 10.1172/jci.insight.94002] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 05/23/2017] [Indexed: 12/17/2022] Open
Abstract
Human cytomegalovirus (HCMV) is the most common congenital infection and a known cause of microcephaly, sensorineural hearing loss, and cognitive impairment among newborns worldwide. Natural maternal HCMV immunity reduces the incidence of congenital infection, but does not prevent the disease altogether. We employed a nonhuman primate model of congenital CMV infection to investigate the ability of preexisting antibodies to protect against placental CMV transmission in the setting of primary maternal infection and subsequent viremia, which is required for placental virus exposure. Pregnant, CD4+ T cell-depleted, rhesus CMV-seronegative (RhCMV-seronegative) rhesus monkeys were treated with either standardly produced hyperimmune globulin (HIG) from RhCMV-seropositive macaques or dose-optimized, potently RhCMV-neutralizing HIG prior to intravenous challenge with an RhCMV mixture. HIG passive infusion provided complete protection against fetal loss in both groups. The dose-optimized, RhCMV-neutralizing HIG additionally inhibited placental transmission of RhCMV and reduced viral replication and diversity. Our findings suggest that the presence of durable and potently neutralizing antibodies at the time of primary infection can prevent transmission of systemically replicating maternal RhCMV to the developing fetus, and therefore should be a primary target of vaccines to eliminate this neonatal infection.
Collapse
Affiliation(s)
- Cody S. Nelson
- Human Vaccine Institute, Duke University School of Medicine, and
| | - Diana Vera Cruz
- Department of Biology, Duke University, Durham, North Carolina, USA
| | - Dollnovan Tran
- Tulane National Primate Research Center, Tulane University, Covington, Louisiana, USA
| | - Kristy M. Bialas
- Human Vaccine Institute, Duke University School of Medicine, and
| | - Lisa Stamper
- Human Vaccine Institute, Duke University School of Medicine, and
| | - Huali Wu
- Duke Clinical Research Unit, Duke University School of Medicine, Durham, North Carolina, USA
| | - Margaret Gilbert
- Tulane National Primate Research Center, Tulane University, Covington, Louisiana, USA
| | - Robert Blair
- Tulane National Primate Research Center, Tulane University, Covington, Louisiana, USA
| | - Xavier Alvarez
- Tulane National Primate Research Center, Tulane University, Covington, Louisiana, USA
| | - Hannah Itell
- Human Vaccine Institute, Duke University School of Medicine, and
| | - Meng Chen
- Human Vaccine Institute, Duke University School of Medicine, and
| | - Ashlesha Deshpande
- Department of Microbiology, University of Alabama, Birmingham, Alabama, USA
| | - Flavia Chiuppesi
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, California, USA
| | - Felix Wussow
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, California, USA
| | - Don J. Diamond
- Department of Experimental Therapeutics, Beckman Research Institute of the City of Hope, Duarte, California, USA
| | | | - Mark R. Walter
- Department of Microbiology, University of Alabama, Birmingham, Alabama, USA
| | - Peter A. Barry
- Center for Comparative Medicine, Department of Pathology and Laboratory Medicine, University of California, Davis, California, USA
| | - Michael Cohen-Wolkowiez
- Duke Clinical Research Unit, Duke University School of Medicine, Durham, North Carolina, USA
| | - Katia Koelle
- Department of Biology, Duke University, Durham, North Carolina, USA
| | - Amitinder Kaur
- Tulane National Primate Research Center, Tulane University, Covington, Louisiana, USA
| | - Sallie R. Permar
- Human Vaccine Institute, Duke University School of Medicine, and
| |
Collapse
|
45
|
Melstrom LG, Salazar MD, Diamond DJ. The pancreatic cancer microenvironment: A true double agent. J Surg Oncol 2017; 116:7-15. [PMID: 28605029 DOI: 10.1002/jso.24643] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 03/17/2017] [Indexed: 12/18/2022]
Abstract
The tumor microenvironment in pancreatic cancer is a complex balance of pro- and anti-tumor components. The dense desmoplasia consists of immune cells, extracellular matrix, growth factors, cytokines, and cancer associated fibroblasts (CAF) or pancreatic stellate cells (PSC). There are a multitude of targets including hyaluronan, angiogenesis, focal adhesion kinase (FAK), connective tissue growth factor (CTGF), CD40, chemokine (C-X-C motif) receptor 4 (CXCR-4), immunotherapy, and Vitamin D. The developing clinical therapeutics will be reviewed.
Collapse
Affiliation(s)
- Laleh G Melstrom
- Department of Surgery and Experimental Therapeutics, City of Hope National Medical Center, Duarte, California
| | - Marcela D Salazar
- Department of Experimental Therapeutics, City of Hope National Medical Center, Duarte, California
| | - Don J Diamond
- Department of Experimental Therapeutics, City of Hope National Medical Center, Duarte, California
| |
Collapse
|
46
|
Cristea MC, Hardwick N, Frankel PH, Morgan R, Leong LA, Diamond DJ. A phase I study of a p53MVA vaccine in combination with gemcitabine (GEM) in recurrent ovarian cancer (OC). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e17040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Mihaela C. Cristea
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA
| | | | | | | | | | | |
Collapse
|
47
|
D'Alincourt Salazar M, Manuel ER, Tsai W, D'Apuzzo M, Goldstein L, Blazar BR, Diamond DJ. Evaluation of innate and adaptive immunity contributing to the antitumor effects of PD1 blockade in an orthotopic murine model of pancreatic cancer. Oncoimmunology 2016; 5:e1160184. [PMID: 27471630 DOI: 10.1080/2162402x.2016.1160184] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/22/2016] [Accepted: 02/25/2016] [Indexed: 10/22/2022] Open
Abstract
Despite the clinical success of anti-PD1 antibody (α-PD1) therapy, the immune mechanisms contributing to the antineoplastic response remain unclear. Here, we describe novel aspects of the immune response involved in α-PD1-induced antitumor effects using an orthotopic Kras (G12D)/p53(R172H)/Pdx1-Cre (KPC) model of pancreatic ductal adenocarcinoma (PDA). We found that positive therapeutic outcome involved both the innate and adaptive arms of the immune system. Adoptive transfer of total splenocytes after short-term (3 d) but not long-term (28 d) PD1 blockade significantly extended survival of non-treated tumor-bearing recipient mice. This protective effect appeared to be mostly mediated by T cells, as adoptive transfer of purified natural killer (NK) cells and/or granulocyte receptor 1 (Gr1)(+) cells or splenocytes depleted of Gr1(+) cells and NK cells did not exhibit transferrable antitumor activity following short-term PD1 blockade. Nevertheless, splenic and tumor-derived CD11b(+)Gr1(+) cells and NK cells showed significant persistence of α-PD1 bound to these cells in the treated primary recipient mice. We observed that short-term inhibition of PD1 signaling modulated the profiles of multifunctional cytokines in the tumor immune-infiltrate, including downregulation of vascular endothelial growth factor A (VEGF-A). Altogether, the data suggest that systemic blockade of PD1 results in rapid modulation of antitumor immunity that differs in the tumor microenvironment (TME) when compared to the spleen. These results demonstrate a key role for early immune-mediated events in controlling tumor progression in response to α-PD1 treatment and warrant further investigation into the mechanisms governing responses to the therapy at the innate-adaptive immune interface.
Collapse
Affiliation(s)
| | - Edwin R Manuel
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope , Duarte, CA, USA
| | - Weimin Tsai
- Department of Hematology/Hematopoietic Cell Transplantation, Beckman Research Institute of City of Hope , Duarte, CA, USA
| | - Massimo D'Apuzzo
- Department of Pathology, Beckman Research Institute of City of Hope , Duarte, CA, USA
| | - Leanne Goldstein
- Department of Information Sciences, Beckman Research Institute of City of Hope , Duarte, CA, USA
| | - Bruce R Blazar
- Department of Pediatrics, University of Minnesota , Minneapolis, MN, USA
| | - Don J Diamond
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope , Duarte, CA, USA
| |
Collapse
|
48
|
Yue Y, Kaur A, Lilja A, Diamond DJ, Walter MR, Barry PA. The susceptibility of primary cultured rhesus macaque kidney epithelial cells to rhesus cytomegalovirus strains. J Gen Virol 2016; 97:1426-1438. [PMID: 26974598 DOI: 10.1099/jgv.0.000455] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Kidney epithelial cells are common targets for human and rhesus cytomegalovirus (HCMV and RhCMV) in vivo, and represent an important reservoir for long-term CMV shedding in urine. To better understand the role of kidney epithelial cells in primate CMV natural history, primary cultures of rhesus macaque kidney epithelial cells (MKE) were established and tested for infectivity by five RhCMV strains, including two wild-type strains (UCD52 and UCD59) and three strains containing different coding contents in UL/b'. The latter strains included 180.92 [containing an intact RhUL128-RhUL130-R hUL131 (RhUL128L) locus but deleted for the UL/b' RhUL148-rh167-loci], 68-1 (RhUL128L-defective and fibroblast-tropic) and BRh68-1.2 (the RhUL128L-repaired version of 68-1). As demonstrated by RhCMV cytopathic effect, plaque formation, growth kinetics and early virus entry, we showed that MKE were differentially susceptible to RhCMV infection, related to UL/b' coding contents of the different strains. UCD52 and UCD59 replicated vigorously in MKE, 68-1 replicated poorly, and 180.92 grew with intermediate kinetics. Reconstitution of RhUL128L in 68-1 (BRh68-1.2) restored its replication efficiency in MKE as compared to UCD52 and UCD59, consistent with the essential role of UL128L for HCMV epithelial tropism. Further analysis revealed that the UL/b' UL148-rh167-loci deletion in 180.92 impaired RhUL132 (rh160) expression. Given that 180.92 retains an intact RhUL128L, but genetically or functionally lacks genes from RhUL132 (rh160) to rh167 in UL/b', its attenuated infection efficiency indicated that, along with RhUL128L, an additional protein(s) encoded within the UL/b' RhUL132 (rh160)-rh167 region (potentially, RhUL132 and/or RhUL148) is indispensable for efficient replication in MKE.
Collapse
Affiliation(s)
- Yujuan Yue
- Center for Comparative Medicine, University of California, Davis, CA, USA
| | - Amitinder Kaur
- Department of Immunology, Tulane National Primate Research Center, Tulane University, Covington, LA, USA
| | - Anders Lilja
- Hookipa Biotech AG, Helmut-Qualtinger-Gasse 2, Vienna, Austria.,Department of Molecular Biology, Lewis Thomas Laboratory, Princeton University, Princeton, NJ 08544, USA
| | - Don J Diamond
- Division of Translational Vaccine Research, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Mark R Walter
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Peter A Barry
- Center for Comparative Medicine, University of California, Davis, CA, USA.,Department of Pathology and Laboratory Medicine, University of California, Davis, CA, USA.,California National Primate Research Center, University of California, Davis, CA, USA
| |
Collapse
|
49
|
Nakamura R, La Rosa C, Longmate J, Drake J, Slape C, Zhou Q, Lampa MG, O'Donnell M, Cai JL, Farol L, Salhotra A, Snyder DS, Aldoss I, Forman SJ, Miller JS, Zaia JA, Diamond DJ. Viraemia, immunogenicity, and survival outcomes of cytomegalovirus chimeric epitope vaccine supplemented with PF03512676 (CMVPepVax) in allogeneic haemopoietic stem-cell transplantation: randomised phase 1b trial. Lancet Haematol 2016; 3:e87-98. [PMID: 26853648 PMCID: PMC4926626 DOI: 10.1016/s2352-3026(15)00246-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 10/30/2015] [Accepted: 11/02/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients seropositive for cytomegalovirus (CMV) and undergoing allogeneic haemopoietic stem-cell transplantation (HCT) are at risk for CMV reactivation. Stimulating viral immunity by vaccination might achieve CMV viraemia control without the need for antiviral agents. CMVPepVax is a chimeric peptide composed of a cytotoxic CD8 T-cell epitope from CMV pp65 and a tetanus T-helper epitope. It is formulated with the adjuvant PF03512676, a Toll-like receptor 9 agonist, which augments cellular immunity. We aimed to assess safety, immunogenicity, and possible clinical benefit of the CMVPepVax vaccine in patients undergoing HCT. METHODS We did a randomised, open-label, phase 1b trial at one transplant centre in the USA. Eligible patients were CMV-seropositive, positive for HLA-A*0201, aged 18-75 years, and undergoing HCT from a matched-related or matched-unrelated donor. Patients were reassessed for eligibility on day 28 after HCT. We randomly allocated patients to either the CMVPepVax vaccine or observation, in blocks stratified by CMV donor serostatus. CMVPepVax was administered subcutaneously on days 28 and 56. The primary outcome was safety, which consisted of secondary graft failure, grade III-IV acute GVHD, non-relapse mortality by day 100, serious adverse events related to the vaccine (judged by the data and safety monitoring committee [DSMC]) grade 3-4 adverse events related to the vaccine (judged by the DSMC) within 2 weeks of vaccination, and development of double-strand (ds) DNA autoantibodies. Statistical analyses included all randomised patients and were done per-protocol. This study is registered with ClinicalTrials.gov, number NCT01588015. This trial is closed to accrual and the final analysis is presented in this report. FINDINGS Between Oct 31, 2012, and Nov 5, 2014, 36 eligible patients were allocated to either CMVPepVax (n=18) or observation (n=18), with no adverse effect on HCT (no secondary graft failures in either group) or cases of acute GVHD (seven patients assigned vaccine and six under observation had acute GVHD of grade 2 or less), and no unexpected adverse events. Compared with observation, better relapse-free survival was recorded in patients allocated the vaccine (seven vs one; hazard ratio [HR] 0·12, 95% CI 0·01-0·94; p=0·015). No patients had non-relapse mortality by day 100. One serious adverse event (grade 1 fever) was attributed to CMVPepVax but resolved within 48 h. Four patients assigned the vaccine had a serious adverse event, which was unrelated to the vaccine (grade 3 thrombocytopenia, grade 3 device-related infection, grade 2 nausea, and grade 1 fever), compared with nine patients under observation (grade 4 maculopapular rash, grade 3 nausea, grade 3 infection, grade 3 thrombotic thrombocytopenic purpurea, grade 2 nausea, grade 2 generalised muscle weakness, grade 2 infection, grade 1 fever, and grade 1 fatigue; p=0·16). 54 grade 3-4 adverse events were reported in patients assigned the vaccine compared with 91 in patients who were under observation (p=0·2). No patients had grade III-IV acute GVHD or developed dsDNA autoantibodies. INTERPRETATION The results show safety and immunogenicity of the CMVPepVax vaccine. The prospect of substantial clinical benefits warrant testing in a phase 2 trial. FUNDING National Cancer Institute.
Collapse
Affiliation(s)
- Ryotaro Nakamura
- Department of Hematology and Hematopoietic cell Transplantation, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Corinna La Rosa
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Jeffrey Longmate
- Division of Biostatistics, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Jennifer Drake
- Department of Hematology and Hematopoietic cell Transplantation, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Cynthia Slape
- Department of Hematology and Hematopoietic cell Transplantation, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Qiao Zhou
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Melanie G Lampa
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Margaret O'Donnell
- Department of Hematology and Hematopoietic cell Transplantation, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Ji-Lian Cai
- Department of Hematology and Hematopoietic cell Transplantation, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Len Farol
- Department of Hematology and Hematopoietic cell Transplantation, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Amandeep Salhotra
- Department of Hematology and Hematopoietic cell Transplantation, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - David S Snyder
- Department of Hematology and Hematopoietic cell Transplantation, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Ibrahim Aldoss
- Department of Hematology and Hematopoietic cell Transplantation, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Stephen J Forman
- Department of Hematology and Hematopoietic cell Transplantation, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Jeffrey S Miller
- University of Minnesota Medical Center, Medicine/Blood and Marrow Transplantation, Minneapolis, MN, USA
| | - John A Zaia
- Department of Virology, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Don J Diamond
- Department of Experimental Therapeutics, Beckman Research Institute of City of Hope, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
| |
Collapse
|
50
|
Affiliation(s)
- Jeremy Chen
- Department of Experimental Therapeutics, City of Hope, Duarte CA, USA
| | - Don J Diamond
- Department of Experimental Therapeutics, City of Hope, Duarte CA, USA
| | - Edwin R Manuel
- Department of Experimental Therapeutics, City of Hope, Duarte CA, USA
| |
Collapse
|