Cancer regression and autoimmunity induced by cytotoxic t lymphocyte-associated antigen 4 blockade in patients with metastatic melanoma
Open accessAbstract
Cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) is a critical immunoregulatory molecule (expressed on activated T cells and a subset of regulatory T cells) capable of down-regulating T cell activation. Blockade of CTLA-4 has been shown in animal models to improve the effectiveness of cancer immunotherapy. We thus treated 14 patients with metastatic melanoma by using serial i.v. administration of a fully human anti-CTLA-4 antibody (MDX-010) in conjunction with s.c. vaccination with two modified HLA-A*0201-restricted peptides from the gp100 melanoma-associated antigen, gp100:209-217(210M) and gp100:280-288(288V). This blockade of CTLA-4 induced grade III/IV autoimmune manifestations in six patients (43%), including dermatitis, enterocolitis, hepatitis, and hypophysitis, and mediated objective cancer regression in three patients (21%; two complete and one partial responses). This study establishes CTLA-4 as an important molecule regulating tolerance to "self" antigens in humans and suggests a role for CTLA-4 blockade in breaking tolerance to human cancer antigens for cancer immunotherapy.
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Ipilimumab was the first immune checkpoint inhibitor tested and approved for cancer treatment.
“The anti-CTLA-4 blocking antibody ipilimumab was the first immune checkpoint inhibitor to be tested and approved for the treatment of cancer patients (19, 20).”
From Anti-PD-1 and Anti-CTLA-4 Therapies in Cancer: Mechanisms of Action, Efficacy, and Limitations (2018) · cites this paper as [20]
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- Authors
- Phan, G. Q., Yang, J. C., Sherry, R. M., Hwu, P., Topalian, S. L., Schwartzentruber, D. J., Restifo, N. P., Haworth, L. R., Seipp, C. A., Freezer, L. J., Morton, K. E., Mavroukakis, S. A., Duray, P. H., Steinberg, S. M., Allison, J. P., Davis, T. A., & Rosenberg, S. A.
- Affiliations
- National Institutes of Health (US)
- Surgery Branch, Laboratory of Pathology, and Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892; Howard Hughes Medical Institute, Department of Molecular and Cell Biology, University of California, Berkeley, CA 94720; and Medarex, Inc., Princeton, NJ 08540
- ORCID
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2003-06-25
- Volume
- 100
- Issue
- 14
- Pages
- 8372-8377
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC166236
- OpenAlex
- W2134638467
- Cited by
- 1,575
- References
- 38
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 26 · 2023: 41 · 2022: 48 · 2021: 52 · 2020: 58 · 2019: 56 · 2018: 68 · 2017: 82 · 2016: 58 · 2015: 72 · 2014: 70 · 2013: 78 · 2012: 72
- FWCI
- 46.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (Z99 CA999999)
- National Cancer Institute (Z01BC010763)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
- Keywords
- CTLA-4 blockade, metastatic melanoma, autoimmunity, tumor regression, anti-CTLA-4 antibody, HLA-A*0201, cancer immunotherapy, self-tolerance, regulatory T cells, T cell activation, enterocolitis, hypophysitis, hepatitis, skin inflammation
- MeSH terms
- Adult, Antibodies, Monoclonal, Antibodies, Neoplasm, Antigens, Differentiation, Antigens, Neoplasm, Autoimmune Diseases, Colitis, Dermatitis, Female, Humans, Immune Tolerance, Immunotherapy, Injections, Intravenous, Injections, Subcutaneous, Lymphocyte Activation, Male, Melanoma, Membrane Glycoproteins, Middle Aged, Neoplasm Metastasis, Neoplasm Proteins, Peptide Fragments, Peptides, T-Lymphocytes, Cytotoxic, Vaccination, Vitiligo, Antigens, CD, HLA-A2 Antigen, T-Lymphocyte Subsets, Salvage Therapy, Hepatitis, Autoimmune, gp100 Melanoma Antigen, CTLA-4 Antigen
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