Breast cancer: Updated vaccination with an autologous hemoderivative in changing tumor antigen library

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Abstract
2594 Background. We have previously described a vaccination procedure with an Autologous Hemoderivative (AH) that in solid tumors, including breast cancer, inhibited the progressive disease condition, elicited Delayed Type Hypersensibility (DTH) and induced a tumor stroma modification in responder patients (E. Lasalvia-Prisco et al, Cancer Biology & Therapy, 2003; ASCO 2003). The present study describes the disease and DTH evolution in responder vaccinated patients. Methods. Thirty metastatic (1–3 sites), chemotherapy resistant (3-lines) breast cancer patients (Ages: 38–72 y.o.) in progressive disease (RECIST assessment) were included. Written informed consents and institutional ethical committee approval were accomplished. The included patients were vaccinated with AH with the procedure above referred. After 6 months, 11 patients were responders (Stable disease + Partial Remission) and DTH-positive response elicited by AH (≥ 5mm). When progressive disease reappeared, a second vaccination with a second AH was performed. Follow up of these 11 responder patients was analyzed (RECIST assessment and intradermal DTH-test elicited with the first and second AH). Results. Progressive Disease reappeared in 10 responder patients 7–14 months after vaccination. In these 10 patients, a second AH was freshly prepared and a second vaccination was performed. Previously to the second vaccination, DTH response elicited by intradermal test with the first AH persisted positive in 9, and it was negative in all 10 when it was performed with the second AH. Six month after the second vaccination with the new AH, a second Tumor-Growth response (Stable disease + Partial Remission) was evident in 8 patients and the DTH response elicited with the second AH was positive in 7 of them. ConclusionsResults are consistent with a tumor immuno-escape by changes in the neo-antigen library and the feasibility of re-vaccination with an updated AH containing neo-antigens delivered from the tumors to the blood.

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