Affiliation:
1. From the Division of Medical Oncology, Department of Internal Medicine, Stanford University School of Medicine, Stanford, CA
Abstract
Purpose The unique immunoglobulin idiotype (Id) expressed by each B-cell lymphoma is a target for immunotherapy. Vaccination with Id induces humoral and/or cellular anti-Id immune responses. However, the clinical impact of these anti-Id immune responses is unknown. We and others have previously reported that immunoglobulin G Fc receptor (FcγR) polymorphisms predict the clinical response of lymphoma patients to passive anti-CD20 antibody infusions. In this study, we tested whether anti-Id immune responses or FcγR polymorphisms associate with clinical outcome of patients who received Id vaccination. Patients and Methods We analyzed 136 patients with follicular lymphoma who had received Id vaccination. The anti-Id immune responses were measured and FcγRIIIa and FcγRIIa polymorphisms were determined and correlated with clinical outcome for these patients. Results Patients who mounted humoral immune responses had a longer progression-free survival (PFS) than those who did not (8.21 v 3.38 years; P = .018). Patients with FcγRIIIa 158 valine/valine (V/V) genotype also had a longer PFS than those with valine/phenylalanine (V/F) or phenylalanine/phenylalanine (F/F) genotypes (V/V, 8.21 v V/F, 3.38 years; P = .004; v F/F, 4.47 years; P = .035). Multivariate analysis using the Cox proportional hazards model showed that V/V genotype and humoral immune responses were independent positive predictors for PFS. Conclusion This study is the first to identify the predictive value of FcγR polymorphism on clinical outcome in patients who received active immunotherapy with tumor antigen vaccines. Our results imply that the antibodies induced against a tumor antigen are beneficial and that FcγR-bearing cells mediate an antitumor effect by killing antibody-coated tumor cells.
Publisher
American Society of Clinical Oncology (ASCO)
Reference40 articles.
1. Horning SJ: Natural history of and therapy for indolent non-Hodgkin's lymphoma. Semin Oncol 20:75,1993-88,
2. Induction of Immune Responses in Patients with B-Cell Lymphoma against the Surface-Immunoglobulin Idiotype Expressed by Their Tumors
3. Tumor-Specific Idiotype Vaccines in the Treatment of Patients With B-Cell Lymphoma — Long-Term Results of a Clinical Trial
4. High Resolution Mapping of the Binding Site on Human IgG1 for FcγRI, FcγRII, FcγRIII, and FcRn and Design of IgG1 Variants with Improved Binding to the FcγR
5. Vance BA, Huizinga TWJ, Wardwell K, et al: Binding of monomeric human IgG defines an expression polymorphism of Fc gamma RIII on large granular lymphocyte/natural killer cells. J Immunol 151:6429,1993-6439,
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