Phase Ib Trial of HER2/Neu Peptide (E75) Vaccine in Breast Cancer Patients at Risk for Recurrence After Surgical and Medical Therapies
Breast cancer is the most common malignancy and second most common cause of cancer-specific
death among women in the United States. Despite advances in the diagnosis and treatment of
breast cancer, one third of the women who develop the disease will die of the disease,
accounting for approximately 46,300 deaths/year. While good primary therapies are available
to treat early stage breast cancer, there is a substantial failure rate to these therapies
in more advanced disease.
Advances in the understanding of the immune response to cancer have lead to the genesis of
immunotherapeutic approaches. Specifically, the development of anti-cancer vaccines holds
promise as an adjuvant and preventive therapy for patients after both primary surgical and
medical treatment for breast cancer, but who are at a high risk for recurrence. Patients
with greater than four lymph nodes positive have an 87% chance of recurrence post standard
surgical and medical therapies at 10 years. While patients with hormone receptor positive
tumors have the option to undergo hormonal therapy, recurrence is especially high among
estrogen receptor/progesterone receptor (ER/PR) negative patients. For these patients,
currently there is no good treatment option after completion of primary therapy; close
surveillance and watchful waiting is the standard.
It is this population of patients that a vaccine strategy to induce cellular immunity would
target. We propose to vaccinate these patients with an immunogenic peptide from the
HER2/neu protein. If successful, this vaccine strategy could be utilized as an adjuvant to
currently accepted first line therapy in future clinical trials.
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
The primary endpoints are the safety and optimal dosing of the vaccine to induce an in vivo peptide-specific immune response.
Time period needed to determine the maximum tolerated and optimal biologic doses.
George E Peoples, MD
Cancer Vaccine Development Program
United States: Food and Drug Administration
|Walter Reed National Military Medical Center||Bethesda, Maryland 20889|
|Windber Medical Center||Windber, Pennsylvania 15963|