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[Immunotherapy for esophageal carcinoma]
1Multidisciplinary Treatment Center, Kurume University School of Medicine, Kurume, Japan.
Abstract:
Recent progress in gene technology has clarified the existence of some cancer-rejection genes and peptides such as MAGE, MART, etc. Many clinical trials with cancer vaccines have been performed. Since the clinical efficacy of HLA class I-restricted peptide vaccines is still poor, many researchers are mainly administering dendritic cell therapies. However, there have been few clinicals trials of cancer-specific immunotherapy for esophageal carcinomas. We have performed cancer vaccine therapy with SART-1 peptide and locoregional adoptive immunotherapy with activated autologous lymphocytes for patients with advanced esophageal carcinoma in a phase I and a phase I/II trial, respectively. The clinical responses were poor in the vaccine trial because of the rapid growth of esophageal cancers and the requirement for more than 2 months to activate and increase killer T cells after in vivo vaccination, while locoregional adoptive immunotherapy was effective for the treatment of esophageal cancers even in advanced stages with organ metastases. Based on these results, we think that a combination immunotherapy with adoptive immunotherapy and vaccine therapy is needed for the treatment of advanced esophageal carcinomas.
Insights
Cancer immunotherapy trials for esophageal cancer show promise. Locoregional adoptive immunotherapy effectively treated advanced cases, while SART-1 peptide vaccines had limited success, suggesting combination therapy is needed.
Area of Science:
- Immunotherapy
- Cancer Genetics
- Molecular Biology
Context:
- Advancements in gene technology have identified cancer-rejection genes and peptides.
- Clinical trials for cancer vaccines, particularly HLA class I-restricted peptides, show limited efficacy.
- Esophageal carcinomas have seen few cancer-specific immunotherapy trials.
Purpose:
- To evaluate SART-1 peptide cancer vaccine therapy in a phase I trial.
- To assess locoregional adoptive immunotherapy with activated autologous lymphocytes in a phase I/II trial for advanced esophageal carcinoma.
- To determine the efficacy of different immunotherapy approaches for esophageal cancer.
Summary:
- SART-1 peptide vaccine therapy yielded poor clinical responses due to rapid cancer growth and delayed T-cell activation.
- Locoregional adoptive immunotherapy demonstrated effectiveness in treating advanced esophageal carcinoma, including cases with organ metastases.
- The study highlights the need for combination immunotherapy strategies for advanced esophageal carcinomas.
Impact:
- Locoregional adoptive immunotherapy shows potential for treating advanced esophageal cancer.
- Combination immunotherapy integrating adoptive and vaccine-based approaches may improve outcomes for esophageal carcinoma patients.
- This research contributes to the development of novel treatment strategies for a challenging cancer type.