Vaccine shows promise for early-stage HER2-positive breast cancer

January 18, 2017

A study looks at the effectiveness of a dendritic cell vaccine in early-stage HER2-positive breast cancer. Plus: A look at whether fish oil consumed during pregnancy reduces the risk of asthma in offspring.

A dendritic cell vaccine that targets HER2 protein may induce an immune response leading to regression of early-stage breast tumors, according to results of research from the Moffitt Cancer Center published in Clinical Cancer Research.

Fifty-four HER2-positive patents were enrolled in a neoadjuvant HER2 peptide-pulsed DC1 vaccine trial. Of the enrolled patients, 42 had ductal carcinoma in situ (DCIS) and 12 had early invasive breast cancer (IBC). The patients were randomized to receive intralesional (IL, n = 19), intranodal (IN, n = 19), or both intralesional and intranodal (ILN, n =16) injection. Responses were measured in peripheral blood and sentinel lymph nodes by in vitro sensitization assay or ELISPOT. Resected surgical specimens were assessed to determine pathologic response.

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Vaccination by all routes was well tolerated and the rate of immune response did not differ significantly based on vaccination route (IL 84.2% vs IN 89.5% vs ILN 66.7%; P=0.30). Pathologic complete response (pCR) was higher among DCIS patients in comparison to the IBC patients (28.6% vs 8.3%). Among the DCIS patients, those who achieved pCR (N = 12) and who did not (n = 30) had similar peripheral blood anti-HER2 immune responses. Every patient who attained pCR had an anti-HER2 CD4 immune response in the sentinel lymph node. The quantified response was higher by cumulative response (P=0.04) and response repertoire (P=0.03).

The researchers concluded that the vaccination is a safe and immunogenic treatment for inducing tumor-specific T-cell responses in HER2-positive patients and that the immune and clinical responses were similar regardless of the vaccination route.

NEXT: Does prenatal fish oil reduce asthma in offspring?

 

Does prenatal fish oil reduce asthma in offspring?

Results of a prospective study suggest that taking fish oil during the third trimester can lower the risk of persistent wheeze or asthma and infections in offspring. The findings, published in The New England Journal of Medicine, were reported by a team of Danish, Canadian, and US investigators.

A total of 695 children from the Copenhagen Prospective Studies on Asthma in Childhood2010 cohort were followed prospectively with extensive clinical phenotyping. They were the offspring of 736 pregnant women randomly assigned to receive 2.5 g of n-3 LCPUFA (fish oil) or placebo (olive oil) per day beginning at 24 weeks’ gestation.

For the first 3 years of the children’s lives, neither the investigators nor the participants were aware of the group assignments. Only the investigators were unaware of the randomization assignments during the subsequent 2-year follow-up period.

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In the treatment group, risk of persistent wheeze or asthma was 16.9% versus 23.7% in the control group (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.49 to 0.97; P=0.035 for a relative risk reduction of 30.7%. Analysis of secondary end points-lower respiratory tract infections, asthma exacerbations, eczema, and allergic sensitization-showed that the fish oil supplementation was associated with a reduce risk of lower respiratory tract infection (31.7% to 39.1%; HR 0.75, 95% CI 0.58 to 0.98; P=0.033). There was no statistically significant association between intake of fish oil and the other secondary end points.

Supplementation with fish oil in the third trimester, the investigators concluded, reduced absolute risk of persistent wheeze or asthma and infections of the lower respiratory tract in offspring by 7% or one-third. The authors of an accompanying editorial posited that a precision medicine approach may be better than widespread use of fish oil because the results were largely driven by women with the lowest baseline levels of EPA and DHA, particularly those with a variant gene for fatty acid desaturase. Because the very high doses of EPA and DHA used in the study also may be associated with other adverse effects, long-term follow-up and study of lower doses are needed.