PURPOSE: A phase I study was conducted to determine safety, clinical efficacy, and anti-tumor immune responses in patients with advanced non-small cell lung carcinoma (NSCLC) following intratumoral (IT) administration of autologous dendritic cells (DC) transduced with an adenoviral (Ad) vector expressing the CCL21 gene (Ad-CCL21-DC). We evaluated safety and tumor antigen-specific immune responses following in situ vaccination (ClinicalTrials.gov: NCT01574222). EXPERIMENTAL DESIGN: Sixteen stage IIIB/IV NSCLC subjects received two vaccinations (1 x 106, 5 x 106, 1 x 107, or 3 x 107 dendritic cells/injection) by CT- or bronchoscopic-guided IT injections (days 0 and 7). Immune responses were assessed by tumor antigen-specific peripheral blood lymphocyte induction of IFN-gamma in ELISPOT assays. Tumor biopsies were evaluated for CD8+ T cells by immunohistochemistry (IHC) and for PD-L1 expression by IHC and real-time PCR (RT-PCR). RESULTS: Twenty-five percent (4/16) of patients had stable disease at day 56. Median survival was 3.9 months. ELISPOT assays revealed 6 of 16 patients had systemic responses against tumor associated antigens (TAA). Tumor CD8+ T cell infiltration was induced in 54% of subjects (7/13; 3.4-fold average increase in the number of CD8+ T cells per mm2). Patients with increased CD8+ T cells following vaccination showed significantly increased PD-L1 mRNA expression. CONCLUSIONS: Intratumoral vaccination with Ad-CCL21-DC resulted in 1) induction of systemic tumor antigen-specific immune responses, 2) enhanced tumor CD8+ T cell infiltration, and 3) increased tumor PD-L1 expression. Future studies will evaluate the role of combination therapies with PD-1/PD-L1 checkpoint inhibition combined with DC-CCL21 in situ vaccination.

Author Info: (1) Surgery, Division of Cardiac and Thoracic Surgery, University of California, Los Angeles jaymoonlee@mednet.ucla.edu. (2) Thoracic Surgery, Univerysity of California Los Angeles

Author Info: (1) Surgery, Division of Cardiac and Thoracic Surgery, University of California, Los Angeles jaymoonlee@mednet.ucla.edu. (2) Thoracic Surgery, Univerysity of California Los Angeles. (3) University of California Los Angeles. (4) Division of Hematology/Oncology, UCLA - Department of Medicine. (5) University of California, Los Angeles. (6) David Geffen School of Medicine at UCLA. (7) Radiation Oncology, University of California Los Angeles. (8) David Geffen School of Medicine at UCLA. (9) David Geffen School of Medicine at UCLA. (10) Medicine, UCLA. (11) Medicine, David Geffen School of Medicine at UCLA. (12) Medicine, David Geffen School of Medicine at UCLA. (13) Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA. (14) National Institutes of Health. (15) Department of Transfusion Medicine Clinical Center, NIH. (16) Oncology, Acteris, Inc. (17) David Geffen School of Medicine at UCLA. (18) David Geffen School of Medicine at UCLA. (19) Medical Oncology, City of Hope Comprehensive Cancer Center. (20) 3Lung Cancer Research Program of the Jonsson Comprehensive Cancer Center; 4Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Los Angeles; Jonsson Comprehensive Cancer Center. (21) Pathology and Laboratory Medicine, UCLA. (22) UCLA. (23) Urology, UCLA. (24) University of California Los Angeles. (25) West Los Angeles VA Healthcare System. (26) Division of Pulmonary and Critical Care Medicine, University of California, Los Angeles.