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Annals of Surgical Oncology

, Volume 20, Issue 10, pp 3233–3239 | Cite as

Response to HER-2 Pulsed DC1 Vaccines is Predicted by Both HER-2 and Estrogen Receptor Expression in DCIS

  • Megan Fracol
  • Shuwen Xu
  • Rosemarie Mick
  • Elizabeth Fitzpatrick
  • Harvey Nisenbaum
  • Robert Roses
  • Carla Fisher
  • Julia Tchou
  • Kevin Fox
  • Paul Zhang
  • Brian J Czerniecki
Breast Oncology

Abstract

Background

Patients with estrogen-independent (ERneg) human epidermal growth factor receptor-2 (HER-2)-positive ductal carcinoma in situ (DCIS) treated with lumpectomy alone or lumpectomy and radiation are at increased risk of developing subsequent breast cancer events.

Methods

Thirty-eight patients with HER-2 expressing DCIS received a HER-2 pulsed autologous dendritic cell (DC1) vaccine administered over 4–6 weeks before surgical resection. HER-2 and estrogen receptor (ER) expression were determined by immunohistochemistry. In 35 patients, CD4pos T-cell sensitization to HER-2 peptides was identified by ELISPOT. In 19 patients, CD8pos T-cell responses were identified by ELISA. Clinical and immune responses postvaccination were compared between intermediate-expressing HER-2 (2+) and high-expressing HER-2 (3+) patients, as well as ERneg and estrogen-dependent (ERpos) patients.

Results

There was no significant difference in immune response after HER-2 vaccination in patients with HER-2 (2+) and (3+) tumors or ERneg and ERpos tumors. Complete tumor regression rates were similar in patients with HER-2 (2+) and (3+) DCIS. Overall, clinical response rates were similar in patients with ERneg and ERpos DCIS, but complete tumor regression was significantly more common in patients with ERneg DCIS.

Conclusions

Despite equivalent immune responses after vaccination in patients with HER-2 (2+), HER-2 (3+), ERneg and ERpos DCIS, HER-2 pulsed DC1 induces more complete responses in patients with ERneg DCIS. These data provide a rationale for developing vaccinations to reduce recurrence in patients with ERneg DCIS for whom there are currently limited adjuvant options.

Keywords

Luminal Breast Cancer Complete Tumor Regression Exact Confidence Interval ERneg Patient Immune Response Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosure

Dr. Czerniecki has licensing agreement with Immunocellular Therapeutics.

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Megan Fracol
    • 1
  • Shuwen Xu
    • 2
    • 3
    • 4
  • Rosemarie Mick
    • 5
  • Elizabeth Fitzpatrick
    • 2
    • 3
    • 4
  • Harvey Nisenbaum
    • 2
    • 3
    • 6
  • Robert Roses
    • 2
    • 3
    • 4
  • Carla Fisher
    • 2
    • 3
    • 4
  • Julia Tchou
    • 2
    • 3
    • 4
  • Kevin Fox
    • 2
    • 3
    • 7
  • Paul Zhang
    • 2
    • 3
    • 8
  • Brian J Czerniecki
    • 2
    • 3
    • 4
  1. 1.Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Rena Rowan Breast CenterPenn MedicinePhiladelphiaUSA
  3. 3.Abramson Cancer CenterPenn MedicinePhiladelphiaUSA
  4. 4.Department of SurgeryPenn MedicinePhiladelphiaUSA
  5. 5.Department of Biostatistics and EpidemiologyPenn MedicinePhiladelphiaUSA
  6. 6.Department of RadiologyPenn MedicinePhiladelphiaUSA
  7. 7.Department of MedicinePenn MedicinePhiladelphiaUSA
  8. 8.Department of PathologyPenn MedicinePhiladelphiaUSA

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