Q1 · MEDICINE
Article
Author: Neuberg, Donna ; Elagina, Liudmila ; Huang, Teddy ; Olsen, Lars Rønn ; Leet, Donna E ; Liu, Jinyan ; Buchbinder, Elizabeth I ; Bachireddy, Pavan ; Hacohen, Nir ; Keskin, Derin B ; Forman, Juliet ; Li, Shuqiang ; Lee, Patrick C ; Allesøe, Rosa L ; Wu, Catherine J ; Redd, Robert A ; Peter, Lauren ; Ciantra, Zoe ; Olive, Oriol ; Holden, Rebecca ; Livak, Kenneth J ; Hu, Zhuting ; Yoon, Charles H ; Fritsch, Edward F ; Pyrdol, Jason ; Shetty, Keerthi ; Gohil, Satyen H ; Oliveira, Giacomo ; Giobbie-Hurder, Anita ; Iorgulescu, J Bryan ; Zhang, Wandi ; Wucherpfennig, Kai W ; Sarkizova, Siranush ; Sun, Jing ; Luoma, Adrienne M ; Pentelute, Bradley L ; Uduman, Mohamed ; Barouch, Dan H ; Ott, Patrick A ; Shukla, Sachet A ; Rodig, Scott
Personal neoantigen vaccines have been envisioned as an effective approach to induce, amplify and diversify antitumor T cell responses. To define the long-term effects of such a vaccine, we evaluated the clinical outcome and circulating immune responses of eight patients with surgically resected stage IIIB/C or IVM1a/b melanoma, at a median of almost 4 years after treatment with NeoVax, a long-peptide vaccine targeting up to 20 personal neoantigens per patient ( NCT01970358 ). All patients were alive and six were without evidence of active disease. We observed long-term persistence of neoantigen-specific T cell responses following vaccination, with ex vivo detection of neoantigen-specific T cells exhibiting a memory phenotype. We also found diversification of neoantigen-specific T cell clones over time, with emergence of multiple T cell receptor clonotypes exhibiting distinct functional avidities. Furthermore, we detected evidence of tumor infiltration by neoantigen-specific T cell clones after vaccination and epitope spreading, suggesting on-target vaccine-induced tumor cell killing. Personal neoantigen peptide vaccines thus induce T cell responses that persist over years and broaden the spectrum of tumor-specific cytotoxicity in patients with melanoma.