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Noguchi, Masanori; Arai, Gaku; Egawa, Shin; Ohyama, Chikara; Naito, Seiji; Matsumoto, Kazumasa; Uemura, Hirotsugu; Nakagawa, Masayuki; Nasu, Yasutomo; Eto, Masatoshi; Suekane, Shigetaka; Sasada, Tetsuro; Shichijo, Shigeki; Yamada, Akira; Kakuma, Tatsuyuki; Itoh, Kyogo
Cancer Immunology, Immunotherapy, 05/2020, Volume: 69, Issue: 5Journal Article
A novel cancer vaccine consisting of 20 mixed peptides (KRM-20) was designed to induce cytotoxic T lymphocytes (CTL) against twelve different tumor-associated antigens. The aim of this phase II trial was to examine whether KRM-20 in combination with docetaxel and dexamethasone enhances the antitumor effects in patients with castration-resistant prostate cancer (CRPC). In this double-blind, placebo-controlled, randomized phase II study, we enrolled chemotherapy-naïve patients with CRPC from ten medical centers in Japan. Eligible patients were randomly assigned 1:1 centrally to receive either KRM-20 combined with docetaxel and dexamethasone ( n = 25) or placebo with docetaxel and dexamethasone ( n = 26). The primary endpoint was the difference in prostate-specific antigen (PSA) decline between each treatment. The rates of > 50% PSA decline in the two arms were similar (56.5% versus 53.8%; P = 0.851). Human leukocyte antigen (HLA)-matched peptide-specific immunoglobulin G ( P = 0.018) and CTL ( P = 0.007) responses in the KRM-20 arm significantly increased after treatment. The addition of KRM-20 did not increase toxicity. There were no between-group differences in progression-free or overall survival (OS). The addition of KRM-20 was safe, and similar PSA decline and HLA-matched peptide-specific CTL and IgG responses increased in combination with docetaxel and dexamethasone in CRPC patients. Subgroup analysis suggested that this treatment is favorable for CRPC patients with ≥ 26% lymphocytes or PSA levels of < 11.2 ng/ml, but further clinical trials comparing OS are required.
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