Long-term administration of Wilms tumor-1 peptide vaccine in combination with gemcitabine causes severe local skin inflammation at injection sites

Atsuko Soeda, Yuriko Morita-Hoshi, Miho Kaida, Takako Wakeda, Yuni Yamaki, Yasushi Kojima, Hideki Ueno, Shunsuke Kondo, Chigusa Morizane, Masafumi Ikeda, Takuji Okusaka, Yuji Heike

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

The skin toxicity of vaccine therapy at injection sites is generally limited to Grades 1-2 due to the nature of their function. We experienced two cases of severe and prolonged local adverse effects in 25 patients following a Phase I study of gemcitabine and Wilms tumor-1 peptide vaccine mixed with incomplete Freund's adjuvant for inoperable pancreatic or biliary tract cancer. These patients requested to continue the treatment after the study period; however, in the course of compassionate use, they developed unacceptable local skin reactions and terminated their vaccine treatment. One patient (human leukocyte antigen, A0201, 3 mg) developed Grade 3 ulceration at the 10th vaccination and another (human leukocyte antigen, A2402, 1 mg) developed Grade 2 indulation and fibrosis at the 16th vaccination. Skin toxicity occurred at 6.4-8.4 months and continued for several months after the final vaccination during gemcitabine treatment. In these cases, activation or induction of Wilms tumor-1-specific T lymphocytes was not apparent in the peripheral blood despite their severe local reactions. Therefore, we need to monitor patients for late-onset, severe and long-lasting skin reactions at injection sites in Wilms tumor-1 cancer vaccine therapy, particularly for combination treatment with gemcitabine.

Original languageEnglish
Article numberhyq112
Pages (from-to)1184-1188
Number of pages5
JournalJapanese Journal of Clinical Oncology
Volume40
Issue number12
DOIs
StatePublished - Dec 2010
Externally publishedYes

Keywords

  • Gemcitabine
  • Incomplete Freund's adjuvant
  • Inflammation
  • Ulcer
  • WT-1 peptide vaccine

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