Humoral anti-idiotypic and anti-anti-idiotypic immune response in cancer patients treated with monoclonal antibody 17-1A

A group of 96 patients with advanced colorectal carcinoma were treated with the mouse (m) or chimeric (c) (mouse variable regions x human IgG1 constant regions) monoclonal antibody (mAb) 17-1A recognizing the tumour-associated antigen GA733-2. Eighty-two of the 83 patients treated with mmAb17-1A and 69% of the patients given cmAb17-1A (n = 13) developed anti-idiotypic anti bodies (ab(2)). Auto-antibodies binding to tumour cells expressing GA733-2 were found in 7% of the patients. In a further 38 patients (40%) antitumour-cell antibodies, i.e. anti-anti-idiotypic antibodies (ab(3)), were induced by the mAb17-1A therapy. Patients with detectable ab(3) after treatment had significantly higher ab(2) levels than those not developing abs. Addition of granulocyte/macrophagecolony-stimulating factor (GM-CSF) to mmAb17-1A significantly enhanced the induction of ab(2) as well as induction of anti-anti-idiotypic antibodies (ab(3)), compared to mmAb17-1A alone. Patients with a high increase in antitumour-cell antibodies (ab(3)) induced by the therapy lived significantly longer than patients with no or a low level of induction of ab(3) (P = 0.016). The results indicate that induction of an idiotypic network response might be an important effector mechanism in mAb therapy.