Despite advances in surgical, radiation and medical therapies of early stage breast cancer, some patients will experience disease recurrence. Because recurrence may not happen for years after definitive treatment, there is a period of time between resection and relapse when micrometastatic disease may be amenable to immune eradication or modulation. While the ultimate goal of any cancer treatment is clinical efficacy, the immediate urgency in breast immunotherapy is to define treatments that have immunologic efficacy. In this study, the investigators will determine whether a vaccine consisting of nine-class I breast specific peptides plus a class II tetanus toxoid helper peptide is immunogenic when administered with poly-ICLC to participants with stage IB to IIIA breast cancer in the adjuvant setting.
The study is a single arm, open label, pilot study of safety and immune efficacy of peptide vaccination with poly-ICLC in patients with stage IB-IIIA resected breast cancer. Participants will be patients who have completed their last dose/treatment of any single treatment or combination of adjuvant surgery, radiation, chemotherapy or trastuzumab therapy between 45 days and 6 months (180 days) prior to enrollment. Each vaccination will be administered on days 1, 8, 15, 36, 57, and 78. All participants will receive 9 class I MHC-restricted synthetic peptides (restricted by HLA-A1, -A2, -A3, or -A31) and a class II MHC-restricted tetanus helper peptide mixed with 1mg poly-ICLC and administered in sterile water. The vaccine will be administered intramuscular (IM) (1 ml) and intradermally (ID) (1 ml) at vaccination sites in the arm and leg. (Each vaccine given IM and ID at one site; site to alternate between arm site opposite the breast cancer and an anterior thigh site.) Participants will be screened for HLA type and must be HLA-A1, -A2, -A3, or -A31 (80% of the Virginia population in prior studies1). Annual follow-up for progression and survival for 3 years after study withdrawal/completion.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
11
poly-ICLC
9 synthetic peptides derived from Her-2/neu, CEA \& CTA derived breast cancer proteins.
A class II MHC-restricted helper peptide derived from tetanus toxoid protein.
University of Virginia Health System
Charlottesville, Virginia, United States
Safety (Frequency of dose limiting adverse events)
Time frame: 30 days post-administration of the last vaccine
Immune response rate
Measured as the number of IFN-gamma producing cells in the blood in response to the vaccine.
Time frame: through day 108
Safety (adverse event profile)
Time frame: 30 days post-administration of the last vaccine
Immunogenicity- CD8+ T cell specificity
Characterize vaccine specific peripheral CD8+ T-cell specificity by tetramer staining and flow cytometric analysis
Time frame: through day 108
Immunogenicity- CD8+ cytokine production
Estimate the Tc1/Tc2 cytokine production bias of circulating vaccine-specific T cells.
Time frame: through day 108
Immunogenicity- immue responses among subjects treated with anti-estrogen therapies
Using the ELIspot assay, describe the frequency of immune responses among patients treated with anti-estrogen therapies
Time frame: through day 108
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