A pilot study of MUC-1/CEA/TRICOM poxviral-based vaccine in patients with metastatic breast and ovarian cancer

Abstract

Purpose: PANVAC is a recombinant poxviral vaccine that contains transgenes for MUC-1, CEA, and 3 T-cell costimulatory molecules. This study was conducted to obtain preliminary evidence of clinical response in metastatic breast and ovarian cancer patients.

Experimental design: Twenty-six patients were enrolled and given monthly vaccinations. Clinical and immune outcomes were evaluated.

Results: These patients were heavily pretreated, with 21 of 26 patients having 3 or more prior chemotherapy regimens. Side effects were largely limited to mild injection-site reactions. For the 12 breast cancer patients enrolled, median time to progression was 2.5 months (1-37+) and median overall survival was 13.7 months. Four patients had stable disease. One patient had a complete response by RECIST and remained on study for 37 months or more, with a significant drop in serum interleukin (IL)-6 and IL-8 by day 71. Another patient with metastatic disease confined to the mediastinum had a 17% reduction in mediastinal mass and was on study for 10 months. Patients with stable or responding disease had fewer prior therapies and lower tumor marker levels than patients with no evidence of response. For the ovarian cancer patients (n = 14), the median time to progression was 2 months (1-6) and median overall survival was 15.0 months. Updated data are presented here for one patient treated with this vaccine in a previous trial, with a time to progression of 38 months.

Conclusions: Some patients who had limited tumor burden with minimal prior chemotherapy seemed to benefit from the vaccine. Further studies to confirm these results are warranted.

Fig. 1

Patient 24 had a subcarinal lymph node mass measuring 2.8 cm (panel A) which decreased to 0.8 cm (panel B) after 10 months of vaccine, a > 50% reduction by RECIST, followed by a CR after 18 months (panel C). She remains on study 37 months after enrollment, with a durable CR.

Fig. 1

Patient 24 had a subcarinal lymph node mass measuring 2.8 cm (panel A) which decreased to 0.8 cm (panel B) after 10 months of vaccine, a > 50% reduction by RECIST, followed by a CR after 18 months (panel C). She remains on study 37 months after enrollment, with a durable CR.

Fig. 1

Patient 24 had a subcarinal lymph node mass measuring 2.8 cm (panel A) which decreased to 0.8 cm (panel B) after 10 months of vaccine, a > 50% reduction by RECIST, followed by a CR after 18 months (panel C). She remains on study 37 months after enrollment, with a durable CR.