Vaccination with longer tumor peptides results in more efficient peptide processing and presentation than short peptides. The treatment of 20 women with high grade vulvar intraepithelial neoplasia with 3 subcutaneous Human Papilloma Virus 16 E6 and E7 synthetic peptide vaccines resulted in clinical responses in 15 of 19 patients at 12 months of follow though up. HPV 16 specific T cell responses were significantly greater in the group of patients with complete regression Inhibitors,Modulators,Libraries of their lesions com pared to the non responders. NK cells Autologous NK cells are being expanded ex vivo by 100 1000 fold and used to treat patients with CLL, colon cancer and renal cell carcinoma.
Patients are first treated with the proteasome inhibitor bortezomib to increase tumor sensitivity to NK cell Inhibitors,Modulators,Libraries cytotoxicity mediated by TNF related apoptosis inducing ligand prior to infusion of expanded autologous NK cells with low dose subcutaneous IL 2 administered twice daily for 1 week following infusion. Phase I dose escalation of increasing numbers of adoptively transferred autologous NK cells continues, with 2 infu sions of up to a dose of 1108 NK cellskg having already been established to be safe, with preliminary evi dence for anti tumor effects being observed against tumors such as RCC and CLL. Allogeneic NK cells are being used to treat hematolo gical malignancies. These allogeneic NK cells protocols make use of in vivo expansion by using pretreatment lymphoreduction therapy and post infusion IL 2 therapy. As an alternative to IL 2, the CITN recently devel oped a clinical trial to test the safety and efficacy of out patient IL 15 therapy in order to stimulate NK and CD8 T cells.
IL 15, compared to IL 2, may enhance cell based immunotherapy Inhibitors,Modulators,Libraries as it is hypothesized to have less of an effect on suppressive regulatory T cells that down regulate NK cell and T cell function. This Inhibitors,Modulators,Libraries may lead to better clinical efficacy Inhibitors,Modulators,Libraries and has selleck broad implications for the field of immunotherapy. Evaluation of biomarkers for adoptive cellular therapies A critical part of the treatment of cancer with adoptive cellular therapies is the monitoring of recipients follow ing treatment. Clinical trials of cellular therapies for cancer should include biomarker studies in an inte grated, quality, supported, and meta analyzeable manner. For T cell therapy clinical trials, the biomarker classes assessed should evaluate T cell presence, biologi cally relevant phenotypes and functions of the T cells, T cell bioactivity, as well as recipient immune responses to the infused T cells. Numerous approaches can be used to evaluate each of these classes of biomarkers.