Marked clinical and immunological response of MAGE-A3 peptides vaccination in a patient with adenocarcinoma of the lung case report: A case report

A 56-year patient was diagnosed adenocarcinoma of the right lung and underwent lower lobectomy. Pleural dissemination was observed, and the pathological stage was T4N0M0. Systemic chemotherapy was performed with paclitaxel and vinorelbine after the surgery. Because multiple pulmonary and liver metastases were appeared 1 year after the surgery, the second line chemotherapy (CDDP and 5FU) was performed. The response of the chemotherapy was not observed, and thus the patient was enrolled in the clinical trial of MAGE-A3 peptide vaccine with OK-432. The peptide (300 mg) was injected subcutaneously at the upper thigh or upper arm a total of 6 times over 2 months (days 1, 8, 15, 22, 36, and 50) with OK432. During two courses of the vaccinations, the tumor markers (CA19-9 and CEA) decreased markedly. Furthermore, the tumor size of the lung and liver metastases decreased to 30% of their pre-treatment size. The delayed type hypersensitive reaction became positive after the first course of vaccinations. The precursor CTL for the peptide in the peripheral blood had increased after the vaccination. MAGE-A3 peptide vaccination with OK-432 has a potential to induce immunological response and clinical response in advanced lung cancer patients