International Journal of Clinical Case Reports 2024, Vol.14, No.3, 132-143 http://medscipublisher.com/index.php/ijccr 138 achieved complete response, and six patients revealed stable disease for 4 to 7 months. The median overall survival time (MST) was 13.5 months. Patients with induction of cytotoxic T lymphocytes specific to three or more peptides had significantly better prognosis (MST; 27.8 months) compared to those with poorer immune responses (MST; 3.7 months) (Hazama et al., 2014). Case Study 2: castration-resistant prostate cancer A phase II randomized controlled trial was conducted to evaluate the safety and clinical outcomes of personalized peptide vaccine (PPV) immunotherapy in chemotherapy-naive castration-resistant prostate cancer (CRPC) patients2. Thirty-seven patients received peptide vaccinations, and 35 received dexamethasone alone. The primary endpoint was PSA progression-free survival (PFS), which was significantly longer in the vaccination group than in the dexamethasone group (22.0 vs 7.0 months; p=0.0076). Median overall survival (OS) was also significantly longer in the vaccination group (73.9 vs 34.9 months; p=0.00084). The study concluded that PPV immunotherapy was well tolerated and associated with longer PSA PFS and OS in men with chemotherapy-naive CRPC (Table 1) (Yoshimura et al., 2016). Table 1 Summary of the clinical results (Adopted from Yoshimura et al., 2016) - Vaccination and Dex n=37 Dexalone n=36 PSA response rates (%) - >50%decline 22 (59.6) 19 (54.3) >90%decline 5 (13.5) 7 (20.0) PSA progression-free survival,median,d 665 210 Median 95%CI 277-1054 156-264 Hazard ratio(95%Cl) 0.39 (0.22-0.68) p value 0.0076 Time to chemotherapy initiation, median, d 1576 719 Median 95% CI 1203-1949 634-804 Hazard ratio (95% Cl) 0.50 (0.25-1.003) p value 0.047 Overall survival, median, d 2219 1054 Median 95%CI 1546-2892 769-1340 Hazard ratio(95% CI) 0.41(0.21-0.83) p value 0.00084 Cancer death 10 25 Table caption: CI=confidence interval; Dex=dexamethasone; PSA=prostate-specific antigen Case Study 3: Non-Small-Cell lung cancer A phase Ib/IIa trial was designed to test the safety, immunogenicity, and efficacy of a universal cancer peptide-based vaccine (UCPVax) in patients with metastatic non-small-cell lung cancer (NSCLC)3. Fifty-nine patients received UCPVax, and no dose-limiting toxicity was observed. The vaccine induced specific CD4+ T helper 1 response in 56% and 87.2% of patients after the third and sixth doses, respectively. Twenty-one patients achieved disease control (stable disease, n=20; complete response, n=1). The 1-year overall survival (OS) was 34.1%, and the median OS was 9.7 months. The study concluded that UCPVax was highly immunogenic and safe, providing an interesting 1-year OS rate in heavily pretreated advanced NSCLC (Adotévi et al., 2022). These case studies highlight the potential of peptide-based vaccines in improving clinical outcomes for cancer patients, including those with oral cancer. The favorable safety profile and ability to induce robust immune responses make these vaccines a promising approach in cancer immunotherapy (Parmiani et al., 2014; Liu et al., 2021; Abd-Aziz and Poh, 2022).
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