The interpretation of the results obtained from immunomonitoring of clinical trials is a difficult task due to the variety
of methods and protocols available to detect vaccine-specific T-cell responses. This heterogeneity as well as the lack of
standards has led to significant scepticism towards published results. In February 2005, a working group was therefore founded
under the aegis of the Association for Immunotherapy of Cancer (“CIMT”) in order to compare techniques and protocols applied
for the enumeration of antigen-specific T-cell responses. Here we present the results from two consecutive phases of an international
inter-laboratory testing project referred to as the “CIMT monitoring panel”. A total of 13 centers from six European countries
participated in the study in which pre-tested PBMC samples, synthetic peptides and PE-conjugated HLA-tetramers were prepared
centrally and distributed to participants. All were asked to determine the number of antigen-specific T-cells in each sample
using tetramer staining and one functional assay. The results of the first testing round revealed that the total number of
cells analyzed was the most important determinant for the sensitive detection of antigen-specific CD8
+ T-cells by tetramer staining. Analysis by ELISPOT was influenced by a combination of cell number and a resting phase after
thawing of peripheral blood mononuclear cells. Therefore, the experiments were repeated in a second phase but now the participants
were asked to change their protocols according to the new guidelines distilled from the results of the first phase. The recommendations
improved the number of antigen-specific T-cell responses that were detected and decreased the variability between the laboratories.
We conclude that a two-step approach in inter-laboratory testing allows the identification of distinct variables that influence
the sensitivity of different T-cell assays and to formally show that a defined correction to the protocols successfully increases
the sensitivity and reduces the inter-center variability. Such “two-step” inter-laboratory projects could define rational
bases for accepted international guidelines and thereby lead to the harmonization of the techniques used for immune monitoring.
Keywords ELISPOT - Tetramer - Standardization - Interlaboratory testing
C. M. Britten and C. Gouttefangeas contributed equally to this work. This manuscript is published in association with the
original article “Results and Harmonization Guidelines from two large-scale international Elispot proficiency panels conducted
by the Cancer Vaccine Consortium (CVC/SVI)” by S. Janetzki et al. and a commentary by C. M. Britten, S. Janetzki et al.: "Toward
the harmonization of immune monitoring in clinical trials-Quo vadis?".