p. trAb infusion or antigen restimulation.
According to RECIST criteria, 5 of 9 patients (Patients B, C, F, G, H) showed a clinically stable disease or partial tumor regression with a mean time to progression of 3.6 months (range 1 to 6 months) without any further tumor specific treatment. After trAb therapy and restimulation, overall survival was 8.0 months (median; range 1 to 31 months). 6 patients received chemotherapy after trAb immunotherapy. In none of the patients accumulation of malignant ascites was observed after trAb therapy. Discussion The results of this pilot study on the i.p. application and restimulation by trAb in patients with PC provide strong evidence for the induction of specific immune reactions against autologous tumor cells by T-lymphocytes upon trifunctional antibody treatment. Further more the study confirmed the safety and feasibility data of i.p. application of trAb in patients check details without
accumulation of ascites. TrAb application was accompanied with “”immunological”" side effects like fever, elevation of inflammatory markers and allergic skin reactions. Further symptoms like abdominal pain and nausea could be attributed to the disturbance of the peritoneum by trAb mediated local www.selleckchem.com/products/dabrafenib-gsk2118436.html inflammation. Transient elevation of liver enzymes, γ-glutamyl transferase and alkaline phosphatase were observed after application of the anti-EpCAM × anti-CD3 trAb, www.selleckchem.com/products/acalabrutinib.html but were not correlated to clinical symptoms. As the epithelium of the biliary system typically expresses the EpCAM-antigen [25], this side effect could be presumably attributed to a transient trAb-induced cholangitis. In summary, all these side effects are very well in concordance with the recently published results of our studies investigating the trAb therapy in malignant ascites [21, 22]. Major aim of this study was to investigate the induction of T-cell mediated immune responses to autologous tumor cells by intraperitoneal treatment and restimulation, as induction of long-term immunity by trifunctional antibodies was successfully demonstrated in an animal model [15]. In five out of nine patients, specific tumor reactive
CD4/CD8 + T lymphocytes were found in PBMC by the IFN-γ secretion assay, demonstrating find more that i.p. trAb therapy is able to induce a verifiable increase of autologous tumor reactive T lymphocytes. Additionally, sIL-2 levels also indicated T-cell activation. Therefore we conclude that formation of the so called tri-cell-complex of T-lymphocytes, tumor cells and accessory cells by trifunctional antibodies may result in induction of T-cell mediated anti-tumor reactivity. Regarding the structural binding sites of trifunctional antibodies, one of the unique capacities of trAb is to bind and activate CD3+ lymphocytes and CD64+ accessory cells simultaneously. Several previous studies were performed using anti-CD3 × anti-tumor bispecific antibodies (bsAb) in non Hodgkin’s lymphoma and solid tumors like ovarian and renal cell cancer [26–28].