Analyses of Recombinant Vaccinia and Fowlpox Vaccine Vectors Expressing Transgenes for Two Human Tumor Antigens and Three Human Costimulatory Molecules
Purpose: The poor immunogenicity of tumor antigens and the antigenic heterogeneity of tumors call for vaccine strategies to enhance T-cell responses to multiple antigens. Two antigens expressed noncoordinately on most human carcinomas are carcinoembryonic antigen (CEA) and MUC-1. We report here the...
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Veröffentlicht in: | Clinical cancer research 2005-02, Vol.11 (4), p.1597-1607 |
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creator | TSANG, Kwong Y PALENA, Claudia MANSON, Kelledy PANICALI, Dennis SCHLOM, Jeffrey YOKOKAWA, Junko ARLEN, Philip M GULLEY, James L MAZZARA, Gail P GRITZ, Linda GOMEZ YAFAL, Alicia OGUETA, Sandra GREENHALGH, Patricia |
description | Purpose: The poor immunogenicity of tumor antigens and the antigenic heterogeneity of tumors call for vaccine strategies to enhance
T-cell responses to multiple antigens. Two antigens expressed noncoordinately on most human carcinomas are carcinoembryonic
antigen (CEA) and MUC-1. We report here the construction and characterization of two viral vector vaccines to address these
issues.
Experimental Design: The two viral vectors analyzed are the replication-competent recombinant vaccinia virus (rV-) and the avipox vector, fowlpox
(rF-), which is replication incompetent in mammalian cells. Each vector encodes the transgenes for three human costimulatory
molecules (B7-1, ICAM-1, and LFA-3, designated TRICOM) and the CEA and MUC-1 transgenes (which also contain agonist epitopes). The vectors are designated rV-CEA/MUC/TRICOM and rF-CEA/MUC/TRICOM.
Results: Each of the vectors is shown to be capable of faithfully expressing all five transgenes in human dendritic cells (DC). DCs
infected with either vector are shown to activate both CEA- and MUC-1–specific T-cell lines to the same level as DCs infected
with CEA-TRICOM or MUC-1-TRICOM vectors. Thus, no evidence of antigenic competition between CEA and MUC-1 was observed. Human
DCs infected with rV-CEA/MUC/TRICOM or rF-CEA/MUC/TRICOM are also shown to be capable of generating both MUC-1- and CEA-specific
T-cell lines; these T-cell lines are in turn shown to be capable of lysing targets pulsed with MUC-1 or CEA peptides as well
as human tumor cells endogenously expressing MUC-1 and/or CEA.
Conclusion: These studies provide the rationale for the clinical evaluation of these multigene vectors in patients with a range of carcinomas
expressing MUC-1 and/or CEA. |
doi_str_mv | 10.1158/1078-0432.CCR-04-1609 |
format | Article |
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T-cell responses to multiple antigens. Two antigens expressed noncoordinately on most human carcinomas are carcinoembryonic
antigen (CEA) and MUC-1. We report here the construction and characterization of two viral vector vaccines to address these
issues.
Experimental Design: The two viral vectors analyzed are the replication-competent recombinant vaccinia virus (rV-) and the avipox vector, fowlpox
(rF-), which is replication incompetent in mammalian cells. Each vector encodes the transgenes for three human costimulatory
molecules (B7-1, ICAM-1, and LFA-3, designated TRICOM) and the CEA and MUC-1 transgenes (which also contain agonist epitopes). The vectors are designated rV-CEA/MUC/TRICOM and rF-CEA/MUC/TRICOM.
Results: Each of the vectors is shown to be capable of faithfully expressing all five transgenes in human dendritic cells (DC). DCs
infected with either vector are shown to activate both CEA- and MUC-1–specific T-cell lines to the same level as DCs infected
with CEA-TRICOM or MUC-1-TRICOM vectors. Thus, no evidence of antigenic competition between CEA and MUC-1 was observed. Human
DCs infected with rV-CEA/MUC/TRICOM or rF-CEA/MUC/TRICOM are also shown to be capable of generating both MUC-1- and CEA-specific
T-cell lines; these T-cell lines are in turn shown to be capable of lysing targets pulsed with MUC-1 or CEA peptides as well
as human tumor cells endogenously expressing MUC-1 and/or CEA.
Conclusion: These studies provide the rationale for the clinical evaluation of these multigene vectors in patients with a range of carcinomas
expressing MUC-1 and/or CEA.</description><identifier>ISSN: 1078-0432</identifier><identifier>EISSN: 1557-3265</identifier><identifier>DOI: 10.1158/1078-0432.CCR-04-1609</identifier><identifier>PMID: 15746065</identifier><language>eng</language><publisher>Philadelphia, PA: American Association for Cancer Research</publisher><subject>Animals ; Antineoplastic agents ; B7-1 Antigen - genetics ; B7-1 Antigen - immunology ; Biological and medical sciences ; Cancer vaccine ; Cancer Vaccines - genetics ; Cancer Vaccines - immunology ; Carcinoembryonic antigen ; Carcinoembryonic Antigen - genetics ; Carcinoembryonic Antigen - immunology ; CD58 Antigens - genetics ; CD58 Antigens - immunology ; Cell Line ; Cell Line, Tumor ; Cells, Cultured ; Cytotoxicity, Immunologic - immunology ; Dendritic Cells - cytology ; Dendritic Cells - immunology ; Dendritic Cells - metabolism ; Flow Cytometry ; Fowlpox virus - genetics ; Genetic Vectors - genetics ; Humans ; Immunoblotting ; Intercellular Adhesion Molecule-1 - genetics ; Intercellular Adhesion Molecule-1 - immunology ; Interferon-gamma - biosynthesis ; Medical sciences ; MUC-1 ; Mucin-1 - genetics ; Mucin-1 - immunology ; Pharmacology. Drug treatments ; poxvirus ; Recombination, Genetic ; T-cell costimulation ; T-Lymphocytes - cytology ; T-Lymphocytes - immunology ; T-Lymphocytes - metabolism ; Transfection ; Transgenes - genetics ; Transgenes - immunology ; Vaccinia virus ; Vaccinia virus - genetics</subject><ispartof>Clinical cancer research, 2005-02, Vol.11 (4), p.1597-1607</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c430t-468687a52e077ac92c30d69fd72f8aebdfd0b3295a4858fb08c2043ad065b3563</citedby><cites>FETCH-LOGICAL-c430t-468687a52e077ac92c30d69fd72f8aebdfd0b3295a4858fb08c2043ad065b3563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3343,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16560451$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15746065$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>TSANG, Kwong Y</creatorcontrib><creatorcontrib>PALENA, Claudia</creatorcontrib><creatorcontrib>MANSON, Kelledy</creatorcontrib><creatorcontrib>PANICALI, Dennis</creatorcontrib><creatorcontrib>SCHLOM, Jeffrey</creatorcontrib><creatorcontrib>YOKOKAWA, Junko</creatorcontrib><creatorcontrib>ARLEN, Philip M</creatorcontrib><creatorcontrib>GULLEY, James L</creatorcontrib><creatorcontrib>MAZZARA, Gail P</creatorcontrib><creatorcontrib>GRITZ, Linda</creatorcontrib><creatorcontrib>GOMEZ YAFAL, Alicia</creatorcontrib><creatorcontrib>OGUETA, Sandra</creatorcontrib><creatorcontrib>GREENHALGH, Patricia</creatorcontrib><title>Analyses of Recombinant Vaccinia and Fowlpox Vaccine Vectors Expressing Transgenes for Two Human Tumor Antigens and Three Human Costimulatory Molecules</title><title>Clinical cancer research</title><addtitle>Clin Cancer Res</addtitle><description>Purpose: The poor immunogenicity of tumor antigens and the antigenic heterogeneity of tumors call for vaccine strategies to enhance
T-cell responses to multiple antigens. Two antigens expressed noncoordinately on most human carcinomas are carcinoembryonic
antigen (CEA) and MUC-1. We report here the construction and characterization of two viral vector vaccines to address these
issues.
Experimental Design: The two viral vectors analyzed are the replication-competent recombinant vaccinia virus (rV-) and the avipox vector, fowlpox
(rF-), which is replication incompetent in mammalian cells. Each vector encodes the transgenes for three human costimulatory
molecules (B7-1, ICAM-1, and LFA-3, designated TRICOM) and the CEA and MUC-1 transgenes (which also contain agonist epitopes). The vectors are designated rV-CEA/MUC/TRICOM and rF-CEA/MUC/TRICOM.
Results: Each of the vectors is shown to be capable of faithfully expressing all five transgenes in human dendritic cells (DC). DCs
infected with either vector are shown to activate both CEA- and MUC-1–specific T-cell lines to the same level as DCs infected
with CEA-TRICOM or MUC-1-TRICOM vectors. Thus, no evidence of antigenic competition between CEA and MUC-1 was observed. Human
DCs infected with rV-CEA/MUC/TRICOM or rF-CEA/MUC/TRICOM are also shown to be capable of generating both MUC-1- and CEA-specific
T-cell lines; these T-cell lines are in turn shown to be capable of lysing targets pulsed with MUC-1 or CEA peptides as well
as human tumor cells endogenously expressing MUC-1 and/or CEA.
Conclusion: These studies provide the rationale for the clinical evaluation of these multigene vectors in patients with a range of carcinomas
expressing MUC-1 and/or CEA.</description><subject>Animals</subject><subject>Antineoplastic agents</subject><subject>B7-1 Antigen - genetics</subject><subject>B7-1 Antigen - immunology</subject><subject>Biological and medical sciences</subject><subject>Cancer vaccine</subject><subject>Cancer Vaccines - genetics</subject><subject>Cancer Vaccines - immunology</subject><subject>Carcinoembryonic antigen</subject><subject>Carcinoembryonic Antigen - genetics</subject><subject>Carcinoembryonic Antigen - immunology</subject><subject>CD58 Antigens - genetics</subject><subject>CD58 Antigens - immunology</subject><subject>Cell Line</subject><subject>Cell Line, Tumor</subject><subject>Cells, Cultured</subject><subject>Cytotoxicity, Immunologic - immunology</subject><subject>Dendritic Cells - cytology</subject><subject>Dendritic Cells - immunology</subject><subject>Dendritic Cells - metabolism</subject><subject>Flow Cytometry</subject><subject>Fowlpox virus - genetics</subject><subject>Genetic Vectors - genetics</subject><subject>Humans</subject><subject>Immunoblotting</subject><subject>Intercellular Adhesion Molecule-1 - genetics</subject><subject>Intercellular Adhesion Molecule-1 - immunology</subject><subject>Interferon-gamma - biosynthesis</subject><subject>Medical sciences</subject><subject>MUC-1</subject><subject>Mucin-1 - genetics</subject><subject>Mucin-1 - immunology</subject><subject>Pharmacology. Drug treatments</subject><subject>poxvirus</subject><subject>Recombination, Genetic</subject><subject>T-cell costimulation</subject><subject>T-Lymphocytes - cytology</subject><subject>T-Lymphocytes - immunology</subject><subject>T-Lymphocytes - metabolism</subject><subject>Transfection</subject><subject>Transgenes - genetics</subject><subject>Transgenes - immunology</subject><subject>Vaccinia virus</subject><subject>Vaccinia virus - genetics</subject><issn>1078-0432</issn><issn>1557-3265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcFu1DAQhiMEoqXwCCBfqLik2EnsJMdV1NJKRUjV0qvlOJNdo8RePIm2-yS8LrPdoB45eTzzzT_2_EnyUfArIWT1VfCySnmRZ1dN80BBKhSvXyXnQsoyzTMlX1P8jzlL3iH-4lwUghdvkzMhy0JxJc-TPytvhgMCstCzB7BhbJ03fmKPxlrnnWHGd-wm7IddeFqSwB7BTiEiu37aRUB0fsPW0XjcgCelPkS23gd2O4_Gs_U80n3lJ0dVfJZbbyPAUm4CTm6cB0OCB_Y9DGDnAfB98qY3A8KH5bxIft5cr5vb9P7Ht7tmdZ_aIudTWqhKVaWRGfCyNLbObM47VfddmfWVgbbrO97mWS1NUcmqb3llM1qI6ejzbS5VfpFcnnR3MfyeASc9OrQwDMZDmFGrsqgEz-r_gqKuaYzMCZQn0MaAGKHXu-hGEw9acH20Th9t0UdbNFlHgT5aR32flgFzO0L30rV4RcDnBTBozdDTwq3DF05JxQspiPty4rZus927CNoSCZGcAhPtlh6haaasy_wvR4axzA</recordid><startdate>20050215</startdate><enddate>20050215</enddate><creator>TSANG, Kwong Y</creator><creator>PALENA, Claudia</creator><creator>MANSON, Kelledy</creator><creator>PANICALI, Dennis</creator><creator>SCHLOM, Jeffrey</creator><creator>YOKOKAWA, Junko</creator><creator>ARLEN, Philip M</creator><creator>GULLEY, James L</creator><creator>MAZZARA, Gail P</creator><creator>GRITZ, Linda</creator><creator>GOMEZ YAFAL, Alicia</creator><creator>OGUETA, Sandra</creator><creator>GREENHALGH, Patricia</creator><general>American Association for Cancer Research</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20050215</creationdate><title>Analyses of Recombinant Vaccinia and Fowlpox Vaccine Vectors Expressing Transgenes for Two Human Tumor Antigens and Three Human Costimulatory Molecules</title><author>TSANG, Kwong Y ; PALENA, Claudia ; MANSON, Kelledy ; PANICALI, Dennis ; SCHLOM, Jeffrey ; YOKOKAWA, Junko ; ARLEN, Philip M ; GULLEY, James L ; MAZZARA, Gail P ; GRITZ, Linda ; GOMEZ YAFAL, Alicia ; OGUETA, Sandra ; GREENHALGH, Patricia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c430t-468687a52e077ac92c30d69fd72f8aebdfd0b3295a4858fb08c2043ad065b3563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Animals</topic><topic>Antineoplastic agents</topic><topic>B7-1 Antigen - genetics</topic><topic>B7-1 Antigen - immunology</topic><topic>Biological and medical sciences</topic><topic>Cancer vaccine</topic><topic>Cancer Vaccines - genetics</topic><topic>Cancer Vaccines - immunology</topic><topic>Carcinoembryonic antigen</topic><topic>Carcinoembryonic Antigen - genetics</topic><topic>Carcinoembryonic Antigen - immunology</topic><topic>CD58 Antigens - genetics</topic><topic>CD58 Antigens - immunology</topic><topic>Cell Line</topic><topic>Cell Line, Tumor</topic><topic>Cells, Cultured</topic><topic>Cytotoxicity, Immunologic - immunology</topic><topic>Dendritic Cells - cytology</topic><topic>Dendritic Cells - immunology</topic><topic>Dendritic Cells - metabolism</topic><topic>Flow Cytometry</topic><topic>Fowlpox virus - genetics</topic><topic>Genetic Vectors - genetics</topic><topic>Humans</topic><topic>Immunoblotting</topic><topic>Intercellular Adhesion Molecule-1 - genetics</topic><topic>Intercellular Adhesion Molecule-1 - immunology</topic><topic>Interferon-gamma - biosynthesis</topic><topic>Medical sciences</topic><topic>MUC-1</topic><topic>Mucin-1 - genetics</topic><topic>Mucin-1 - immunology</topic><topic>Pharmacology. Drug treatments</topic><topic>poxvirus</topic><topic>Recombination, Genetic</topic><topic>T-cell costimulation</topic><topic>T-Lymphocytes - cytology</topic><topic>T-Lymphocytes - immunology</topic><topic>T-Lymphocytes - metabolism</topic><topic>Transfection</topic><topic>Transgenes - genetics</topic><topic>Transgenes - immunology</topic><topic>Vaccinia virus</topic><topic>Vaccinia virus - genetics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>TSANG, Kwong Y</creatorcontrib><creatorcontrib>PALENA, Claudia</creatorcontrib><creatorcontrib>MANSON, Kelledy</creatorcontrib><creatorcontrib>PANICALI, Dennis</creatorcontrib><creatorcontrib>SCHLOM, Jeffrey</creatorcontrib><creatorcontrib>YOKOKAWA, Junko</creatorcontrib><creatorcontrib>ARLEN, Philip M</creatorcontrib><creatorcontrib>GULLEY, James L</creatorcontrib><creatorcontrib>MAZZARA, Gail P</creatorcontrib><creatorcontrib>GRITZ, Linda</creatorcontrib><creatorcontrib>GOMEZ YAFAL, Alicia</creatorcontrib><creatorcontrib>OGUETA, Sandra</creatorcontrib><creatorcontrib>GREENHALGH, Patricia</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical cancer research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>TSANG, Kwong Y</au><au>PALENA, Claudia</au><au>MANSON, Kelledy</au><au>PANICALI, Dennis</au><au>SCHLOM, Jeffrey</au><au>YOKOKAWA, Junko</au><au>ARLEN, Philip M</au><au>GULLEY, James L</au><au>MAZZARA, Gail P</au><au>GRITZ, Linda</au><au>GOMEZ YAFAL, Alicia</au><au>OGUETA, Sandra</au><au>GREENHALGH, Patricia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analyses of Recombinant Vaccinia and Fowlpox Vaccine Vectors Expressing Transgenes for Two Human Tumor Antigens and Three Human Costimulatory Molecules</atitle><jtitle>Clinical cancer research</jtitle><addtitle>Clin Cancer Res</addtitle><date>2005-02-15</date><risdate>2005</risdate><volume>11</volume><issue>4</issue><spage>1597</spage><epage>1607</epage><pages>1597-1607</pages><issn>1078-0432</issn><eissn>1557-3265</eissn><abstract>Purpose: The poor immunogenicity of tumor antigens and the antigenic heterogeneity of tumors call for vaccine strategies to enhance
T-cell responses to multiple antigens. Two antigens expressed noncoordinately on most human carcinomas are carcinoembryonic
antigen (CEA) and MUC-1. We report here the construction and characterization of two viral vector vaccines to address these
issues.
Experimental Design: The two viral vectors analyzed are the replication-competent recombinant vaccinia virus (rV-) and the avipox vector, fowlpox
(rF-), which is replication incompetent in mammalian cells. Each vector encodes the transgenes for three human costimulatory
molecules (B7-1, ICAM-1, and LFA-3, designated TRICOM) and the CEA and MUC-1 transgenes (which also contain agonist epitopes). The vectors are designated rV-CEA/MUC/TRICOM and rF-CEA/MUC/TRICOM.
Results: Each of the vectors is shown to be capable of faithfully expressing all five transgenes in human dendritic cells (DC). DCs
infected with either vector are shown to activate both CEA- and MUC-1–specific T-cell lines to the same level as DCs infected
with CEA-TRICOM or MUC-1-TRICOM vectors. Thus, no evidence of antigenic competition between CEA and MUC-1 was observed. Human
DCs infected with rV-CEA/MUC/TRICOM or rF-CEA/MUC/TRICOM are also shown to be capable of generating both MUC-1- and CEA-specific
T-cell lines; these T-cell lines are in turn shown to be capable of lysing targets pulsed with MUC-1 or CEA peptides as well
as human tumor cells endogenously expressing MUC-1 and/or CEA.
Conclusion: These studies provide the rationale for the clinical evaluation of these multigene vectors in patients with a range of carcinomas
expressing MUC-1 and/or CEA.</abstract><cop>Philadelphia, PA</cop><pub>American Association for Cancer Research</pub><pmid>15746065</pmid><doi>10.1158/1078-0432.CCR-04-1609</doi><tpages>11</tpages></addata></record> |
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source | MEDLINE; American Association for Cancer Research; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
subjects | Animals Antineoplastic agents B7-1 Antigen - genetics B7-1 Antigen - immunology Biological and medical sciences Cancer vaccine Cancer Vaccines - genetics Cancer Vaccines - immunology Carcinoembryonic antigen Carcinoembryonic Antigen - genetics Carcinoembryonic Antigen - immunology CD58 Antigens - genetics CD58 Antigens - immunology Cell Line Cell Line, Tumor Cells, Cultured Cytotoxicity, Immunologic - immunology Dendritic Cells - cytology Dendritic Cells - immunology Dendritic Cells - metabolism Flow Cytometry Fowlpox virus - genetics Genetic Vectors - genetics Humans Immunoblotting Intercellular Adhesion Molecule-1 - genetics Intercellular Adhesion Molecule-1 - immunology Interferon-gamma - biosynthesis Medical sciences MUC-1 Mucin-1 - genetics Mucin-1 - immunology Pharmacology. Drug treatments poxvirus Recombination, Genetic T-cell costimulation T-Lymphocytes - cytology T-Lymphocytes - immunology T-Lymphocytes - metabolism Transfection Transgenes - genetics Transgenes - immunology Vaccinia virus Vaccinia virus - genetics |
title | Analyses of Recombinant Vaccinia and Fowlpox Vaccine Vectors Expressing Transgenes for Two Human Tumor Antigens and Three Human Costimulatory Molecules |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-10T11%3A33%3A22IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Analyses%20of%20Recombinant%20Vaccinia%20and%20Fowlpox%20Vaccine%20Vectors%20Expressing%20Transgenes%20for%20Two%20Human%20Tumor%20Antigens%20and%20Three%20Human%20Costimulatory%20Molecules&rft.jtitle=Clinical%20cancer%20research&rft.au=TSANG,%20Kwong%20Y&rft.date=2005-02-15&rft.volume=11&rft.issue=4&rft.spage=1597&rft.epage=1607&rft.pages=1597-1607&rft.issn=1078-0432&rft.eissn=1557-3265&rft_id=info:doi/10.1158/1078-0432.CCR-04-1609&rft_dat=%3Cproquest_cross%3E67481029%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=19929553&rft_id=info:pmid/15746065&rfr_iscdi=true |