# Agnostic Immunization by Immunogenic Cell Death

> **NIH VA I01** · U.S. DEPT/VETS AFFAIRS MEDICAL CENTER · 2021 · —

## Abstract

Cancer vaccines against defined tumor antigens in solid tumors have not worked well in patients
because the host immune response is insufficient to reject established tumor. Adoptive therapy with CAR T
cells works in leukemias where the antigens are essential for leukemia growth but solid tumors do not have
similar antigens essential for cancer growth. Adoptive therapy with ex vivo expanded immune cells has led to
complete responses in solid tumors but the immune responses have been to unanticipated antigens.
Checkpoint inhibitor (CKI) therapy has caused outstanding regressions but only in ~ 25% of all patients but
only in patients with evidence that supports the presence of an immune response to cancer: "hot" cancers
defined by tumor infiltrating immune cells, high tumor mutational burden and upregulation of PD-L1 a ligand
that stimulates expression of checkpoint inhibitors that block immune responses. "Cold" cancers like advanced
colorectal carcinoma (CRC) lack these characteristics and only have a 7% response to CKI therapy. Our
hypothesis is that primary active immune responses can be induced in cold solid tumors through
induction of Immunogenic Cell Death (ICD), a primordial process that invokes host responses to kill
invading organisms like viruses and bacteria, and that such responses can be amplified by CKI
therapy, multipeptide vaccines or repeat induction of ICD to reject established tumor. Immunogenic
Cell Death primes strong immune responses in subjects without knowing what antigens may be involved. Our
agnostic method is to sensitize subjects with a mixture of Oxaliplatin and a conditionally replicating chimeric
human adenovirus injected into cancers that would otherwise kill the subject. The mixture of Oxaliplatin-virus
injected into tumor causes ICD, a form of pre-apoptotic cell death in which malignant cells are turned inside out
causing neoantigens inside the cells to be externalized with chaperones and other signals that attract dendritic
cells and support cross-priming to tumor antigens. Our intended clinical use is in patients with liver metastases
from advanced CRC. Oxaliplatin is a FDA- approved cytotoxic agent. The virus conditionally replicates in
human malignant cells but not normal adult human cells or in mouse cells, is oncolytic and acts as an
immunogen when mixed with Oxaliplatin. In our preclinical CT26 rectal carcinoma model in BALB/c mice all 6
mm diameter tumors injected with a single intratumoral mixture of Oxaliplatin and virus undergo a 90%
reduction in size, 40% of mice had a complete response with 20% being durable. The responses are
associated with a four-fold increase in tumor-infiltrating lymphocytes, induction of lymphocyte cytotoxicity to
tumor as well the ability to reject a viable tumor cell challenge - all without CKI therapy. In this VA Merit
application we propose the following aims to begin to transition agnostic immunization to the clinic to improve
the health of US Veterans, their beneficiaries a...

## Key facts

- **NIH application ID:** 10125732
- **Project number:** 1I01BX005341-01
- **Recipient organization:** U.S. DEPT/VETS AFFAIRS MEDICAL CENTER
- **Principal Investigator:** John Milburn Jessup
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-04-01 → 2021-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10125732

## Citation

> US National Institutes of Health, RePORTER application 10125732, Agnostic Immunization by Immunogenic Cell Death (1I01BX005341-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10125732. Licensed CC0.

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