Clinical trials are governed by an increasingly stringent regulatory framework, which applies to all levels of trial conduct.
Study critical immunological endpoints, which define success or failure in early phase clinical immunological trials, require
formal pre-trial validation. In this case study, we describe the assay validation process, during which the sensitivity, and
precision of immunological endpoint assays were defined. The purpose was the evaluation of two multicentre phase I/II clinical
trials from our unit in Southampton, UK, which assess the effects of DNA fusion vaccines on immune responses in HLA-A2+ patients
with carcinoembryonic antigen (CEA)-expressing malignancies and prostate cancer. Validated immunomonitoring is being performed
using ELISA and IFNγ ELISPOTs to assess humoral and cellular responses to the vaccines over time. The validated primary endpoint
assay, a peptide-specific CD8+ IFNγ ELISPOT, was tested in a pre-trial study and found to be suitable for the detection of
low frequency naturally occurring CEA- and prostate-derived tumour-antigen-specific T cells in patients with CEA-expressing
malignancies and prostate cancer.
Keywords Immunotherapy - Immunomonitoring - Assay validation - DNA fusion vaccine - CEA - PSMA
This paper is a Focussed Research Review based on a presentation given at the Sixth Annual Meeting of the Association for
Immunotherapy of Cancer (CIMT), held in Mainz, Germany, 15–16 May 2008.