T-cell therapy for EBV-associated nasopharyngeal carcinoma: Preparative lymphodepleting chemotherapy does not improve clinical results

S. Secondino, M. Zecca, L. Licitra, A. Gurrado, I. Schiavetto, P. Bossi, L. Locati, R. Schiavo, S. Basso, F. Baldanti, R. Maccario, F. Locatelli, S. Siena, P. Pedrazzoli, P. Comoli

Research output: Contribution to journalArticle

Abstract

Background: We and others have demonstrated that adoptive cell therapy with Epstein-Barr virus (EBV)-specific autologous cytotoxic T lymphocytes (CTLs) may control disease progression in patients with EBV-associated nasopharyngeal carcinoma (NPC). With the aim of favoring in vivo T-cell expansion, we optimized our cell therapy approach by administering higher doses of EBV-specific CTLs, following lymphodepleting chemotherapy. Patients and methods: Eleven patients with EBV-related NPC in whom conventional treatment failed have been enrolled. Patients received nonmyeloablative lymphodepleting chemotherapy consisting of cyclophosphamide and fludarabine. Two doses of autologous EBV-specific CTLs were subsequently infused, 2 weeks apart. Study end points were feasibility and clinical outcome. Results: All patients enrolled completed the treatment and were assessable for analysis. The median dose of CTLs per infusion was 3.7 × 10 8. Therapy was well tolerated, with no severe adverse events ascribable to either chemotherapy or cell therapy. Disease control (defined as either tumor regression or disease stabilization lasting >4 months) was obtained in 6 of 11 patients, in keeping with previously published results. Conclusions: Our data confirm that EBV-specific CTL therapy is safe and associated with antitumor activity in patients with advanced NPC. The use of lymphodepleting chemotherapy before high-dose CTL infusion did not enhance the clinical benefit observed in our previous series.

Original languageEnglish
Pages (from-to)435-441
Number of pages7
JournalAnnals of Oncology
Volume23
Issue number2
DOIs
Publication statusPublished - Feb 2012

Keywords

  • Cell therapy
  • Cytotoxic T lymphocytes
  • Epstein-Barr virus
  • Lymphodepletion
  • Nasopharyngeal carcinoma

ASJC Scopus subject areas

  • Oncology
  • Hematology

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