Light-based enhancement of vaccination in humans

Customer case

PCI Biotech is a biopharmaceutical company located in Norway.

They are developing a novel light based technology called photochemical internalization (PCI) that has potential to enhance delivery and efficacy of many types of therapies, including certain chemotherapies, peptide vaccines, and nucleic acid therapies. It can also decrease side effects thanks to improved spatiotemporal control of the treatment.

The technology is currently in a pivotal clinical study for the treatment of inoperable bile duct cancer where PCI with gemcitabine is combined with standard gemcitabine/cisplatin chemotherapy.


Per Walday (CEO)


Kristian Berg (Inventor of the PCI technology)


Anders Høgset (CSO)


Pål Kristian Selbo

Modulight products: Multiport ML7710 (652 nm). ML7710 is a platform product supporting all photo­sensitizers.

Laser use: Induction of photochemical internalization of vaccines and chemotherapeutics

Link to the study:

 

Motivation

Vaccines should activate all branches of immunity, including T cells and antibody responses, for generating a strong immune response. For therapeutic cancer vaccines it is especially important to induce strong cytotoxic T-cell responses, since cytotoxic T-cells are the most potent immune cells for killing cancer cells. While cytotoxic T-cells can often be induced  with viral vector and nucleic acid based vaccines, peptide based vaccines often induce only weak cytotoxic T-cell responses . When peptide antigens are taken up into antigen presenting cells, they are generally located inside intracellular vesicles, leading to presentation on MHC Class II molecules. This activates helper T-cell responses but is generally inefficient for inducing cytotoxic T-cells, which are dependent on MHC Class I antigen presentation for their activation.  To address this problem, a novel light-based technology, called photochemical internalization, was studied in a Phase 1 clinical trial to evaluate its safety, tolerable dosing, and immunological responses.

 

Photochemical internalization technology

Photochemical internalization (PCI) is a novel technology for enhancing cytosolic drug delivery via a light-activated process. PCI vaccine includes an amphiphilic photoactive molecule called fimaporfin, the antigen, an immunological adjuvant, and 652 nm laser light. Antigen presenting cells take up vaccine antigens inside intracellular vesicles, and fimaporfin localizes on the inner surface of these vesicles. Upon laser light illumination, reactive oxygen species (ROS) are locally generated, inducing photochemical reactions, leading to permeabilization of the vesicle membranes. This releases the trapped antigens from vesicles into the cell cytosol, where the antigens can interact with the MHC Class I antigen presentation machinery, leading to presentation of the antigens on MHC Class I molecules and induction of cytotoxic T-cells.

 

Methods

96 healthy volunteers were recruited in the study. Participants received different doses of firmaporfin (0.75-50 µg) together with HPV16 (human papilloma virus) E6 peptide antigen and Hiltonol vaccine adjuvant. Each subject received up to 3 vaccinations intradermally at separate injection sites in the upper arms and belly with 2-week intervals. 20 hours after vaccination, injection site was illuminated with Modulight’s CE certified ML7710 laser (5 mW/cm2 for 200 s, total light dose of 1 J/cm2). Subjects in the control group received only HPV antigen and adjuvant without fimaporfin or laser to compare effects without PCI treatment. Adverse reactions were monitored, and blood samples collected to study immunological responses by ELISpot immunoassay and flow cytometry.

 

Results

PCI with fimaporfin doses below 17.5 µg was safe and well tolerated, while higher doses caused local tolerability problems in some subjects, like erythema at the injection site and pain during illumination. There were only few and mild systemic adverse events and no serious adverse events reported. Evaluation of immunological responses revealed that PCI vaccination with a fimaporfin dose of 12.5 μg led to a 10-fold increase in the percentage of subjects exhibiting a T-cell response to vaccination, as compared to a control group without PCI treatment (83 % vs. 8%). Substantial number of responses were seen after the second vaccination (day 29) and the third vaccination boosted the response rates further (day 43). Moreover, the use of PCI seemed to result in a more consistent, multifunctional, and robust CD8+ T-cell responses to vaccination.

 

 

Percentage of responders to HPV16 E7 peptide vaccination with or without PCI treatment at different doses of fimaporfin. Responders were determined based on the ELISpot assay results measuring interferon-y secretion from antigen-stimulated T cells. Graphs from the original publication reproduced under the terms of the CC BY 4.0 International License.

 

 

Conclusions:
PCI in combination with Hiltonol adjuvant for intradermal vaccination is safe and tolerable at fimaporfin doses below 17.5 μg, and results in substantially enhanced cellular immune responses to peptide based vaccination. Demonstration of clinical efficacy warrants further clinical trials.

 

 

Related Modulight products and Services

 

Related Publications

Photochemical Internationalization Enhanced Vaccination Is Safe, and Gives Promising Cellular Immune Responses to an HPV Peptide-Based Vaccine in a Phase I Clinical Study in Healthy Volunteers
Tone Ottherhaug, Sylvia Janetzki, Marij J. P. Welters, Monika Håkerud, Anne Grete Nedberg, Victoria Tudor Edwards, Sanne Boekestijn, Nikki M. Loof, Pål Kristian Selbo, Hans Olivecrona, Sjoerd H. van der Burg and Anders Høgset
Front. Immunol., 2021

 

Disulfonated tetraphenyl chlorin (TPCS2a)-induced photochemical internalisation of bleomycin in patients with solid malignancies: a phase 1, dose-escalation, first-in-man trial
Ahmed A. Sultan, Waseem Jerjes, Kristian Berg, Anders Høgset, Charles A. Mosse, Rifat Hamoudi
The Lancet Oncology, 2020, 17 (9)

 

Photochemical Internationalization: Light Paves Way for New Cancer Chemotherapies and Vaccines
Lara Šošić, Pål Kristian Selbo, Zuzanna K. Kotkowska, Thomas M. Kündig, Anders Høgset, Pål Johansen
Cancers (Basel), 2020, 12 (1)

 

 

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