Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Phase 1/2 trial of autologous tumor mixed with an allogeneic GVAX® vaccine in advanced-stage non-small-cell lung cancer

Abstract

Tumor vaccines composed of autologous tumor cells genetically modified to secrete granulocyte–macrophage colony-stimulating factor (GM-CSF) (GVAX®) have demonstrated clinical activity in advanced-stage non-small-cell lung cancer (NSCLC). In an effort to remove the requirement for genetic transduction of individual tumors, we developed a ‘bystander’ GVAX® platform composed of autologous tumor cells mixed with an allogeneic GM-CSF-secreting cell line. We conducted a phase I/II trial of this vaccine (3–12 biweekly vaccinations) in advanced-stage NSCLC. Tumors were harvested from 86 patients, tumor cell processing was successful in 76, and 49 proceeded to vaccination. The most common toxicity was local vaccine injection site reactions. Serum GM-CSF pharmacokinetics were consistent with secretion of GM-CSF from vaccine cells for up to 4 days with associated transient leukocytosis confirming the bioactivity of vaccine-secreted GM-CSF. Evidence of vaccine-induced immune activation was demonstrated; however, objective tumor responses were not seen. Compared with autologous GVAX® vaccines prepared by transduction of individual tumors with an adenoviral GM-CSF vector, vaccine GM-CSF secretion was approximately 25-fold higher with the bystander GVAX® vaccine used in this trial. However, the frequency of vaccine site reactions, tumor response, time to disease progression, and survival were all less favorable in the current study.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Dranoff G, Jaffee E, Lazenby A, Golumbek P, Levitsky H, Brose K et al. Vaccination with irradiated tumor cells engineered to secrete murine granulocyte–macrophage colony-stimulating factor stimulates potent, specific, and long-lasting anti-tumor immunity. Proc Natl Acad Sci USA 1993; 90: 3539–3543.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Lee CT, Wu S, Ciernik IF, Chen HL, Nadaf-Rahrov S, Gabrilovich D et al. Genetic immunotherapy of established tumors with adenovirus-murine granulocyte–macrophage colony-stimulating factor. Hum Gene Ther 1997; 8: 187–193.

    Article  CAS  PubMed  Google Scholar 

  3. Nagai E, Ogawa T, Kielian T, Ikubo A, Suzuki T . Irradiated tumor cells adenovirally engineered to secrete granulocyte/macrophage-colony-stimulating factor establish antitumor immunity and eliminate pre-existing tumors in syngeneic mice. Cancer Immunol Immunother 1998; 47: 72–80.

    Article  CAS  PubMed  Google Scholar 

  4. Jaffee E, Thomas M, Huang A, Hauda K, Levitsky H, Pardoll D . Enhanced immune priming with spatial distribution of paracrine cytokine vaccines. J Immunother Emphasis Tumor Immunol 1996; 19: 176–183.

    Article  CAS  PubMed  Google Scholar 

  5. Soiffer R, Hodi FS, Haluska F, Jung K, Gillessen S, Singer S et al. Vaccination with irradiated, autologous melanoma cells engineered to secrete granulocyte–macrophage colony-stimulating factor by adenoviral-mediated gene transfer augments antitumor immunity in patients with metastatic melanoma. J Clin Oncol 2003; 21: 3343–3350.

    Article  CAS  PubMed  Google Scholar 

  6. Kusumoto M, Umeda S, Ikubo A, Aoki Y, Tawfik O, Oben R et al. Phase 1 clinical trial of irradiated autologous melanoma cells adenovirally transduced with human GM-CSF gene. Cancer Immunol Immunother 2001; 50: 373–381.

    Article  CAS  PubMed  Google Scholar 

  7. Chang A, Li Q, Bishop D, Normolle D, Redman B, Nickoloff B . Immunogenetic therapy of human melanoma utilizing autologous tumor cells transduced to secrete granulocyte–macrophage colony-stimulating factor. Hum Gene Ther 2000; 11: 839–850.

    Article  CAS  PubMed  Google Scholar 

  8. Simons JW, Mikhak B, Chang JF, DeMarzo AM, Carducci MA, Lim M et al. Induction of immunity to prostate cancer antigens: results of a clinical trial of vaccination with irradiated autologous prostate tumor cells engineered to secrete granulocyte–macrophage colony-stimulating factor using ex vivo gene transfer. Cancer Res 1999; 59: 5160–5168.

    CAS  PubMed  Google Scholar 

  9. Simons J, Jaffee E, Weber C, Levitsky H, Nelson W, Carducci M et al. Bioactivity of autologous irradiated renal cell carcinoma vaccines generated by ex vivo granulocyte–macrophage colony-stimulating factor gene transfer. Cancer Res 1997; 57: 1537–1546.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Jaffee E, Hruban R, Laheru D, Schepers K, Sauter P, Goemann M et al. Novel allogeneic GM-CSF-secreting tumor vaccine for pancreatic cancer: a phase I trial of safety and immune activation. J Clin Oncol 2001; 19: 145–156.

    Article  CAS  PubMed  Google Scholar 

  11. Nemunaitis J, Sterman D, Jablons D, Smith J, Maples P, Hamilton S et al. Granulocyte–macrophage colony-stimulating factor gene-modified autologous tumor vaccines in non-small-cell lung cancer. J Natl Cancer Inst 2004; 96: 1–6.

    Article  Google Scholar 

  12. Salgia R, Lynch T, Skarin A, Lucca J, Lynch C, Jung K et al. Vaccination with irradiated autologous tumor cells engineered to secrete granulocyte–macrophage colony-stimulating factor augments antitumor immunity in some patients with metastatic non-small-cell lung carcinoma. J Clin Oncol 2003; 21: 624–630.

    Article  PubMed  Google Scholar 

  13. Borrello I, Sotomayor E, Cooke S, Levitsky H . A universal granulocyte–macrophage colony-stimulating factor-producing bystander cell line for use in the formulation of autologous tumor cell-based vaccines. Hum Gene Ther 1999; 10: 1983–1991.

    Article  CAS  PubMed  Google Scholar 

  14. Green S, Weiss GR . Southwest oncology group standard response criteria, endpoint definitions, and toxicity criteria. Invest New Drugs 1992; 10: 239–253.

    Article  CAS  PubMed  Google Scholar 

  15. DeAngelo D, Alyea E, Borrello I, Levitsky H, Stock W, Scher D et al. Posttransplant immunotherapy with a GM-CSF-based tumor vaccine (GVAX) following autologous stem cell transplant for acute myeloid leukemia (AML). J Clin Oncol 2004 ASCO Annu Meet Proc (Post-meeting Edition) 2004; 22: 6545.

    Google Scholar 

  16. Nemunaitis J, Sterman D, Jablons D, Smith II JW, Fox B, Maples P et al. Granulocyte–macrophage colony-stimulating factor gene-modified autologous tumor vaccines in non-small-cell lung cancer. J Natl Cancer Inst 2004; 96: 326–331.

    Article  CAS  PubMed  Google Scholar 

  17. Schirrmacher V . Clinical trials of antitumor vaccination with an autologous tumor cell vaccine modified by virus infection: improvement of patient survival based on improved antitumor immune memory. Cancer Immunol Immunother 2005; 54: 587–598.

    Article  CAS  PubMed  Google Scholar 

  18. Wang J, Zganiacz A, Xing Z . Enhanced immunogenicity of BCG vaccine by using a viral-based GM-CSF transgene adjuvant formulation. Vaccine 2002; 20: 2887–2898.

    Article  CAS  PubMed  Google Scholar 

  19. Abdel-Wahab Z, Dar MM, Hester D, Vervaert C, Gangavalli R, Barber J et al. Effect of irradiation on cytokine production, MHC antigen expression, and vaccine potential of interleukin-2 and interferon-gamma gene-modified melanoma cells. Cell Immunol 1996; 171: 246–254.

    CAS  PubMed  Google Scholar 

  20. Nemunaitis J, Bohart C, Fong T, Meyer W, Edelman G, Paulson R et al. Phase I trial of retroviral vector-mediated interferon (IFN)-gamma gene transfer into autologous tumor cells in patients with metastatic melanoma. Cancer Gene Ther 1998; 5: 292–300.

    CAS  PubMed  Google Scholar 

  21. Serafini P, Carbley R, Noonan K, Tan G, Bronte V, Borrello I . High-dose granulocyte–macrophage colony-stimulating factor-producing vaccines impair the immune response through the recruitment of myeloid suppressor cells. Cancer Res 2004; 64: 6337–6343.

    Article  CAS  PubMed  Google Scholar 

  22. Borrello I, Biedrzyki B, Sheets N, Racke F, Loper K, Lemas V et al. Autologous tumor combined with a GM-CSF-secreting cell line vaccine (GVAX) following autologous stem cell transplant (ASCT) in multiple myeloma. Blood 2003; 102: 493a.

    Google Scholar 

Download references

Acknowledgements

We acknowledge Brenda Marr, Casey Cunningham, Neil Senzer, Sasha Vukelja, Tom Meyers, and Karen Nelson for their contributions to this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J Nemunaitis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nemunaitis, J., Jahan, T., Ross, H. et al. Phase 1/2 trial of autologous tumor mixed with an allogeneic GVAX® vaccine in advanced-stage non-small-cell lung cancer. Cancer Gene Ther 13, 555–562 (2006). https://doi.org/10.1038/sj.cgt.7700922

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.cgt.7700922

Keywords

This article is cited by

Search

Quick links