Abstract
The antitumor effector functions of unconjugated monoclonal antibodies (mAb) in cancer therapy are not fully understood. Direct cytotoxic mechanisms such as antibody-dependent cellular cytotoxicity, complement-dependent cytolysis and apoptosis have been suggested. Induction of anti-idiotypic (ab2) and anti-anti-idiotypic (ab3) antibodies as well as the corresponding T cells (T2 and T3) has also been proposed to be of therapeutic significance. In this study induction of an immune network cascade in ten patients with colorectal carcinoma, treated with mAb 17-1A (ab1) was assessed. After treatment, all ten patients had anti-idiotypic antibodies and anti-anti-idiotypic antibodies with ab1-like binding specificity while only five of ten patients had T cells corresponding to ab3 (T3) as assessed by a proliferation assay (DNA synthesis), and an assay of interferon γ production (ELISPOT) (Enzyme-linked immuno SPOT) in vitro or by a delayed-type hypersensitivity reaction in vivo. Purified T cells from four of the five patients with a positive T3 test responded with DNA synthesis after stimulation using human anti-mAb 17-1A anti-idiotypic monoclonal antibodies. These four patients had a clinical response showing a tumor reduction after therapy, while all six patients lacking a proliferative response failed to show tumor regression. Induction of a cell-mediated immune network cascade might accordingly be an important anti-tumor effector function of mAb and should be considered in the future design of mAb-based therapy protocols in cancer patients.
Key words: Monoclonal antibodies, Network response, Anti-idiotype antibodies, T cells, Colon carcinoma
References
- 1.Adams DO, Hall T, Steplewski Z, Koprowski H. Tumors undergoing rejection induced by monoclonal antibodies of the IgG2A isotype containing increased numbers of macrophages activated for distinctive form of antibody dependent cytolysis. Proc Natl Acad Sci USA. 1984;81:3506. doi: 10.1073/pnas.81.11.3506. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Atzpodien J, Körfer A, Franks CR, Poliwoda H, Kirchner H. Home therapy with recombinant interleukin-2 and interferon-α2b in advanced human malignancies. Lancet. 1990;335:1509. doi: 10.1016/0140-6736(90)93039-R. [DOI] [PubMed] [Google Scholar]
- 3.Bergenbrant S, Österborg A, Holm G, Mellstedt H, Lefvert A-K. Anti-idiotypic antibodies in patients with monoclonal gammopathies: relation to the tumour load. Br J Haematol. 1991;78:66. doi: 10.1111/j.1365-2141.1991.tb04384.x. [DOI] [PubMed] [Google Scholar]
- 4.Böyum A. Isolation of human blood monocytes with Nycodenz, a new non-ionic iodinated gradient medium. Scand J Immunol. 1983;17:429. doi: 10.1111/j.1365-3083.1983.tb00809.x. [DOI] [PubMed] [Google Scholar]
- 5.Bruck C, Sung Co M, Slaoui M, Gaulton GN, Smith T, Fields BN, Mullins JI, Greene MI. Nucleic acid sequence of an internal image-bearing monoclonal anti-idiotype and its comparison to the sequence of the external antigen. Proc Natl Acad Sci USA. 1986;83:6578. doi: 10.1073/pnas.83.17.6578. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Cheung N-KV, Lazarus H, Miraldi FD, Abramowsky CR, Kallick S, Saarinen UM, Spitzer T, Stransjord SE, Coccia PF, Berger NA. Ganglioside GD2 specific monoclonal antibody 3F8: a phase-I study in patients with neuroblastoma and malignant melanoma. J Clin Oncol. 1987;5:1430. doi: 10.1200/JCO.1987.5.9.1430. [DOI] [PubMed] [Google Scholar]
- 7.van Cleave VH, Naeve CW, Metzger DW. Do antibodies recognize amino acid side chains of protein antigens independently of the carbon backbone? J Exp Med. 1988;167:1841. doi: 10.1084/jem.167.6.1841. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Courtenay-Luck NS, Epenetos AA, Sivolapenko GB, Barkans JR, Larche M, Ritter MA. Development of anti-idiotypic anti-bodies against tumor antigens and auto-antigens in ovarian cancer patients treated intraperitoneally, with mouse monoclonal antibodies. Lancet. 1988;II:894. doi: 10.1016/S0140-6736(88)92482-8. [DOI] [PubMed] [Google Scholar]
- 9.Czerkinsky C, Andersson G, Ehre H-P, Nilsson L-Å, Klareskog L, Ouchterlony Ö. Reverse ELISPOT assay for clonal analysis of cytokine production. I. Enumeration of gamma-interferon-secreting cells. J Immunol Methods. 1988;110:29. doi: 10.1016/0022-1759(88)90079-8. [DOI] [PubMed] [Google Scholar]
- 10.Fagerberg J, Frödin J-E, Wigzell H, Mellstedt H. Induction of an immune network cascade in cancer patients treated with monoclonal antibodies (ab2). I. May induction of ab1 reactive T cells and anti-anti-idiotypic antibodies (ab3) lead to tumor regression after mAb therapy? Cancer Immunol Immunother. 1993;37:264. doi: 10.1007/BF01518521. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Fagreus A, Espmark JÅ, Jonsson J. Mixed haemadsorption: a mixed anti-globulin reaction applied to antigens on a glass surface. Immunology. 1965;9:161. [PMC free article] [PubMed] [Google Scholar]
- 12.Friguet B, Chaffotte A, Djavadi-Ohaniance L, Goldberg M. Measurements of the true affinity constant in solution of antigen-antibody complexes by enzyme-linked immunosorbent assay. J Immunol Methods. 1985;77:305. doi: 10.1016/0022-1759(85)90044-4. [DOI] [PubMed] [Google Scholar]
- 13.Frödin J-E, Pihlstedt P, Lefvert A-K, Mellstedt H. Isolation and characterization of autologous blood mononuclear cells used for auto-infusion together with monoclonal antibodies in tumor treatment. Hybridoma. 1987;6:555. doi: 10.1089/hyb.1987.6.555. [DOI] [PubMed] [Google Scholar]
- 14.Frödin J-E, Harmenberg U, Biberfeld P, Christensson B, Lefvert A-K, Rieger Ä, Shetye J, Wahren B, Mellstedt H. Clinical effects of monoclonal antibodies (mAb 17-1A) in patients with metastatic colorectal carcinoma. Hybridoma. 1988;7:309. doi: 10.1089/hyb.1988.7.309. [DOI] [PubMed] [Google Scholar]
- 15.Frödin J-E, Lefvert A-K, Mellstedt H. Pharmacokinetics of the mouse monoclonal antibody 17-1A in cancer patients receiving various treatment schedules. Cancer Res. 1990;50:4866. [PubMed] [Google Scholar]
- 16.Frödin J-E, Faxas M-E, Hagström B, Lefvert A-K, Masucci G, Nilsson B, Steinitz M, Unger P, Mellstedt H. Induction of anti-idiotypic (ab2) and anti-anti-idiotypic (ab3) antibodies in patients treated with the mouse monoclonal antibody 17-1A (ab1). Relation to the clinical outcome — an important antitumoral effector function? Hybridoma. 1991;10:421. doi: 10.1089/hyb.1991.10.421. [DOI] [PubMed] [Google Scholar]
- 17.Hearing VJ, Leong SPL, Vieira WD, Law LW. Suppression of established pulmonary metastases by murine melanoma-specific monoclonal antibodies. Int J Cancer. 1991;47:148. doi: 10.1002/ijc.2910470126. [DOI] [PubMed] [Google Scholar]
- 18.Hellström K, Hellström I. Antitumor vaccines. I. Why cancer vaccines? In: Woodrow GC, Levine MM, editors. New generation vaccines. New York: Dekker; 1990. p. 855. [Google Scholar]
- 19.Herlyn DM, Koprowski H. Monoclonal anticolon carcinoma antibodies in complement-dependent cytotoxicity. Int J Cancer. 1981;27:769. doi: 10.1002/ijc.2910270607. [DOI] [PubMed] [Google Scholar]
- 20.Herlyn M, Steplewski Z, Herlyn D, Koprowski H. Colorectal carcinoma-specific antigen detection by means of monoclonal antibodies. Proc Natl Acad Sci USA. 1979;76:1438. doi: 10.1073/pnas.76.3.1438. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Herlyn DM, Steplewski Z, Herlyn MF, Koprowski H. Inhibition of growth of colorectal carcinoma in nude mice by monoclonal antibody. Cancer Res. 1980;40:717. [PubMed] [Google Scholar]
- 22.Herlyn D, Sears H, Iliopoulos D, Lubeck M, Douillard J-Y, Sindelar W, Tempero M, Mellstedt H, Maher M, Koprowski H. Anti-idiotypic antibodies to monoclonal antibody CO17-1A. Hybridoma. 1986;5:51. [PubMed] [Google Scholar]
- 23.Herlyn D, Wettendorff M, Schmoll E, Iliopoulos D, Schedel I, Dreikhausen U, Raab R, Ross AH, Jaksche H, Scriba M, Koprowski H. Anti-idiotype immunization of cancer patients: Modulation of the immune response. Proc Natl Acad Sci USA. 1987;84:8055. doi: 10.1073/pnas.84.22.8055. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24.Houghton AN, Mintzner D, Cordon-Cardo C, Welt S, Fliegel F, Vadham S, Carswell E, Melamed MR, Oettgen HF, Old LY. Mouse monoclonal IgG3 antibody detecting GD3 ganglioside: a phase I trial in patients with malignant melanoma. Proc Natl Acad Sci USA. 1985;82:1242. doi: 10.1073/pnas.82.4.1242. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25.Hunter WM, Greenwood FC. Preparation of iodine-131 labelled human growth hormone of high specific activity. Nature. 1962;194:495. doi: 10.1038/194495a0. [DOI] [PubMed] [Google Scholar]
- 26.Iriei RF, Morton DL. Regression of cutaneous metastatic melanoma by intralesional injection with human monoclonal antibody to ganglioside GD2. Proc Natl Acad Sci USA. 1986;83:8694. doi: 10.1073/pnas.83.22.8694. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Jerne NK. Towards a network theory of the immune system. Ann Immunol. 1974;125:373. [PubMed] [Google Scholar]
- 28.Kabilan L, Troye-Blomberg M, Perlmann H, Andersson G, Högh B, Petersen E, Björkman A, Perlmann P. T-cell epitopes in Pf155/RESA, a major candidate for aPlasmodium falciparum malaria vaccine. Proc Natl Acad Sci USA. 1988;85:5659. doi: 10.1073/pnas.85.15.5659. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 29.Kabilan L, Troye-Blomberg M, Andersson G, Riley EM, Ehre HP, Whittle HC, Perlmann P. Number of cells fromPlasmodium falciporum-immune donors that produce gamma interferon in vitro in response to PF155/RESA, a malaria vaccine candidate antigen. Infect Immun. 1990;58:2989. doi: 10.1128/iai.58.9.2989-2994.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 30.Koprowski H, Herlyn D, Lubeck M, DeFreitas E, Sears HF. Human anti-idiotype antibodies in cancer patients: is the modulation of the immune response beneficial for the patient? Proc Natl Acad Sci USA. 1984;81:216. doi: 10.1073/pnas.81.1.216. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 31.Kosmas C, Man S, Epenetos AA, Courtenay-Luck NS. The role of humoral and cellular immunity in patients developing human anti-murine immunoglobulin, antibody responses after radioimmunotherapy. Br J Cancer. 1990;62:85. [PMC free article] [PubMed] [Google Scholar]
- 32.Lanzavecchia A, Abrignani S, Scheidegger D, Obrist R, Dörken B, Moldenhauer G. Antibodies as antigens. The use of mouse monoclonal antibodies to focus human T cells against selected targets. Exp Med. 1988;167:345. doi: 10.1084/jem.167.2.345. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 33.Lehmann HP, Zwicky C, Waibel R, Stahel R. Tumor-antigen-specific humoral immune response of animals to anti-idiotypic antibodies and comparative serological analysis of patients with small-cell lung carcinoma. Int J Cancer. 1992;50:86. doi: 10.1002/ijc.2910500118. [DOI] [PubMed] [Google Scholar]
- 34.Lehtinen T, Perlmann P, Hellström U, Hammarström S. Proliferative and cytolytic reactivities of human lymphocytes fractionated on wheat germ agglutinin-sepharose columns before or after allo-activation in mixed lymphocyte culture. Scand J Immunol. 1980;12:309. doi: 10.1111/j.1365-3083.1980.tb00072.x. [DOI] [PubMed] [Google Scholar]
- 35.LoBuglio AF, Salch MN, Lee J, Khazaeci MB, Carrano R, Holden H, Wheeler RH. Phase I trial of multiple large doses of murine monoclonal antibody CO17-1A. I. Clinical aspects. J Natl Cancer Inst. 1988;12:932. doi: 10.1093/jnci/80.12.932. [DOI] [PubMed] [Google Scholar]
- 36.Mellstedt H, Frödin J-E, Biberfeld P, Fagerberg J, Giscombe R, Hernandez A, Masucci G, Li S-L, Steinitz M. Patients treated with a monoclonal antibody (ab1) to the colorectal carcinoma antigen 17-1A develop a cellular response (DTH) to “the internal image of the antigen” (ab2) Int J Cancer. 1991;48:344. doi: 10.1002/ijc.2910480306. [DOI] [PubMed] [Google Scholar]
- 37.Mellstedt H, Frödin J-E, Masucci G, Ragnhammar P, Fagerberg J, Hjelm A-L, Shetye J, Wersäll P, Österborg A. The therapeutic use of monoclonal antibodies in colorectal carcinoma. Semin Oncol. 1991;18:462. [PubMed] [Google Scholar]
- 38.Neville AM, Gusterson BA. Monoclonal antibodies and human tumours: Pathological and clinical aspects. Eur J Cancer Clin Oncol. 1985;21:355. doi: 10.1016/0277-5379(85)90136-1. [DOI] [PubMed] [Google Scholar]
- 39.Ragnhammar P, Fagerberg J, Frödin J-E, Hjelm A-L, Lindemalm C, Magnusson I, Masucci G, Mellstedt H. Effect of the monoclonal antibody 17-1A and GM-csf in patients with advanced colorectal carcinoma-long lasting, complete remissions can be induced. Int J Cancer. 1993;53:751. doi: 10.1002/ijc.2910530508. [DOI] [PubMed] [Google Scholar]
- 40.Raychaudhuri S, Kang C-Y, Kaveri S-V, Kieber-Emmons T, Köhler H. tumor idiotype vaccines. VII. Analysis and correlation of structural, idiotypic, and biologic properties of protective and nonprotective Ab2. J Immunol. 1990;145:760. doi: 10.4049/jimmunol.145.2.760. [DOI] [PubMed] [Google Scholar]
- 41.Robins RA, Denton GWL, Hardcastle JD, Austin EB, Baldwin RW, Durrant LG. Antitumor immune response and interleukin-2 production induced in colorectal cancer patients by immunization with human monoclonal anti-idiotypic antibody. Cancer Res. 1991;51:5425. [PubMed] [Google Scholar]
- 42.Sears HF, Mattis J, Herlyn D, Hayry P, Atkinson B, Ermst C, Steplewski Z, Koprowski H. Phase I clinical trial of monoclonal antibody treatment of gastrointestinal tumors. Lancet. 1982;1:762. doi: 10.1016/S0140-6736(82)91811-6. [DOI] [PubMed] [Google Scholar]
- 43.Sears HF, Herlyn D, Steplewski Z, Koprowski H. Phase II clinical trial of a murine monoclonal antibody cytotoxic for gastrointestinal adenocarcinoma. Cancer Res. 1985;45:5910. [PubMed] [Google Scholar]
- 44.Shaw D, Khazaeli MB, Suu L, Ghrayeb J, Daddona P, McKinney S, Lobuglio A. Characterization of a mouse/human chimeric monoclonal antibody (17-1A) to a colon cancer tumor-associated antigen. J Immunol. 1987;138:4534. doi: 10.4049/jimmunol.138.12.4534. [DOI] [PubMed] [Google Scholar]
- 45.Steinitz M, Tamir S, Frödin J-E, Lefvert A-K, Mellstedt H. Human monoclonal anti-idiotypic antibodies. I. Establishment of immortalized cell lines from a tumor patient treated with mouse monoclonal antibodies. J Immunol. 1988;141:3516. doi: 10.4049/jimmunol.141.10.3516. [DOI] [PubMed] [Google Scholar]
- 46.Steinitz M, Tamir S, Frödin J-E, Mellstedt H. Human monoclonal anti-idiotypic antibodies against, a murine monoclonal antibody (mAb17-1A) as an anti-tumor vaccine. In: Borrebaeck CAK, Larrick JW, editors. Therapeutic monoclonal antibodies. London: Stockton Press; 1990. p. 159. [Google Scholar]
- 47.Steplewski Z, Lubeck MD, Koprowski H. Human macrophages armed with murine IgG2a anti-tumor immunoglobulins destroy human cancer cells. Science. 1983;221:865. doi: 10.1126/science.6879183. [DOI] [PubMed] [Google Scholar]
- 48.Strassburg CP, Kasai Y, Seng BA, Miniou P, Zaloudik J, Herlyn D, Koprowski H, Linnenbach AJ. Baculovirus recombinant expressing a secreted form of a transmembrane carcinoma-associated antigen. Cancer Res. 1992;52:815. [PubMed] [Google Scholar]
- 49.Sun L, Curtis P, Rabrowicz-Szulezyska E, Ghrayeb J, Morrison S, Chang N, Koprowski H. Chimeric antibodies with 17-1A derived variable and human constant regions. Hybridoma. 1986;5(Suppl 1):17. [PubMed] [Google Scholar]
- 50.Szala S, Froehlich M, Scollon M, Kasai Y, Steplewski Z, Koprowski H, Linnenbach AJ. Molecular cloning of cDNA for the carcinoma-associated antigen GA733-2. Proc Natl Acad Sci USA. 1990;87:3542. doi: 10.1073/pnas.87.9.3542. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 51.Traub UC, DeJager RL, Primus FJ, Losman M, Goldenberg DM. Anti-idiotype antibodies in cancer patients receiving monoclonal antibody to carcinoembryonic antigen. Cancer Res. 1988;48:4002. [PubMed] [Google Scholar]
- 52.Trauth BC, Klas C, Peters AMJ, Matzku S, Möller P, Falk W, Debatin KM, Krummer PH. Monoclonal antibody mediated tumor regression by induction of apoptosis. Science. 1989;245:301. doi: 10.1126/science.2787530. [DOI] [PubMed] [Google Scholar]
- 53.Waller M, Curry N, Mallory J. Immunochemical and serological studies of enzymatically fractionated human IgG immunoglobulins. I. Hydrolysis with pepsin papain, ficin and bromelin. Immunochemistry. 1968;5:577. doi: 10.1016/0019-2791(68)90093-1. [DOI] [PubMed] [Google Scholar]
- 54.Wettendorff M, Iliopoulos D, Tempero M, Kay D, DeFreitas E, Koprowski H, Herlyn D. Idiotypic cascades in cancer patients treated with monoclonal antibody CO17-1A. Proc Natl Acad Sci USA. 1989;86:3787. doi: 10.1073/pnas.86.10.3787. [DOI] [PMC free article] [PubMed] [Google Scholar]
