SummaryHepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and is often diagnosed at an advanced stage. We have investigated α-fetoprotein (AFP) as a tumor-associated antigen for HCC. We identified major histocompatibility complex class I-restricted peptide epitopes derived from AFP and studied CD8 + T-cell responses in vivo and in vitro in ongoing immunotherapy studies. Helper T cells are of critical importance in shaping the immune response; therefore, we investigated the frequency and function of AFP-specific CD4 + T cells in the general population and among HCC patients. CD4 + T-cell responses were assessed by direct ex vivo multicytokine enzyme-linked immunospot assay and by measurement of cytokine levels using a multicytokine assay. Our analysis indicates that healthy donors have very low frequencies of AFPspecific CD4 + T-cell responses, which are of T H 1 type, detectable ex vivo. In contrast, these T cells were either reduced or eliminated in HCC patients at advanced stages of disease. To better activate these cells, we compared the stimulatory capacity of both AFP protein-fed and AdVhAFP-engineered dendritic cells (DC). Healthy donors have CD4 + T-cell responses, which were activated in response to AFP protein-fed DC whereas HCC patients do not demonstrate significant responses to AFP protein. AdVhAFP-transduced DC were capable of activating higher frequency T H 1 CD4 + responses to AFP in both healthy donors and AFP-positive HCC patients. Importantly, CD4 + T-cell cytokine expression profiles were skewed towards interleukin-2 and interferon-γ production when activated by adenovirally engineered DC, which has therapeutic implications for vaccination efforts. Financial Disclosure: One of the authors is a coinventor on a recently granted US Patent (L. H. B., US Patent No. 7,098,306, "Method and compositions for treating hepatocellular cancer," granted August 2006), which covers some of the MHC class I peptides used in a recently published clinical trial testing AFP class I peptides pulsed onto autologous DC. The intellectual property is owned by the University of California, has not been licensed, and there has been no financial interest for the inventors, to date. The HCC patient PBMC samples used in this work were from that clinical trial. The remaining authors have declared there are no financial conflicts of interest related to this work. [1][2][3] However, the majority of cases are detected at advanced stages, which, even if adequately treated locally, relapse systemically, and HCC recurs in 75% to 100% of patients at 5 years. 4 There are no effective systemic therapies for this disease. 5,6 This leads to a 9% 5-year survival rate after diagnosis in the United States, the second lowest survival rate for any type of cancer. 7
NIH Public Accessα-fetoprotein (AFP) is the most common serum protein during embryonic development, and is a physiologic counterpart of adult serum albumin. Suppression of AFP synthesis occurs shortly after birth. However, AFP mRNA can be detected in hum...