Abstract
A 62-year-old woman who underwent surgery to treat pancreatic cancer provided written, informed consent to undergo adjuvant therapy with gemcitabine, tegafur, and uracil. However, this was stopped after only 14 days due to Grade 4 neutropenia. She was then started on vaccine therapy with Survivin 2B peptide (SVN-2B) including IFA and INF-α. Although metastatic lung tumors were identified and resected at 82 months after surgery, the patient has remained free of new or relapsed disease for 12 years thereafter. Tetramer and ELISPOT assays revealed the continuous circulation of SVN-2B-restricted cytotoxic T-lymphocytes (CTLs) in her peripheral blood, and CTL clones had specific activity for SVN-2B at 12 years after surgery. The adverse effects of the peptide vaccination were tolerable and comprised low-grade headache, nausea, and fatigue. A prognosis beyond 10 years in the face of pancreatic cancer with distant metastasis is extremely rare. This experience might indicate the value of cancer vaccination therapy.
Highlights
Immune reactions against cancer cells depend on an acquired immune system that antigen-dependently recognizes target cells
We investigated the effects of Survivin 2B 80-88 (SVN-2B) on pancreatic cancer between 2005 and 2010 (UMIN000000905) [4] and experienced a patient who was remarkable for being the only one of six treated patients to achieve over 12 years of survival
SVN-2B-specific cytotoxic T-lymphocytes (CTLs) were detected throughout the clinical course between 5 and 122 months after the primary surgery (Figs. 3b, 5a), and tetramer-positive rates ranging from 0.16 to 3.11% were sustained at 3% even at 120 months thereafter (Fig. 3b)
Summary
Immune reactions against cancer cells depend on an acquired immune system that antigen-dependently recognizes target cells. Peptide vaccination therapy is a rational approach to the enhancement of immune reactions against antigens expressed by cancer cells. An early review article described that peptide vaccination therapy elicits a response rate of only 2.6% [1]. Cancer Immunology, Immunotherapy (2018) 67:1603–1609 patients with colon, breast, lung, oral cavity, urinary bladder, and pancreatic cancers in clinical trials since 2003 [3]. We investigated the effects of SVN-2B on pancreatic cancer between 2005 and 2010 (UMIN000000905) [4] and experienced a patient who was remarkable for being the only one of six treated patients to achieve over 12 years of survival. We describe the clinical course and distinctive immunological response of this patient
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