Zhang S, Xu G, Liu C, Xiao S, Sun Y, Su X, Cai Y, Li D, Xu B
Department of Radiotherapy, School of Oncology, Beijing University, No. 52, Fu-Cheng Road, Hai-Dian District Beijing 100036, PR China.
Int J Hyperthermia. 2005 Nov;21(7):631-6. doi: 10.1080/02656730500147868.
The study was to evaluate the efficacy of the Adp53 combined with hyperthermia on advanced cancer. Fifteen patients with advanced cancer were enrolled in this clinical trial. Thirteen patients with recurrent tumours failed in conventional treatments and the two other patients with primary tumour received no treatment before they were enrolled. Recombinant adenovirus-p53 (Adp53) is a E1 substituted replication-incompetent recombinant adenovirus encoding the human wild-type p53 (wtp53) gene. The 15 patients were intra-tumourally injected with Adp53, 1x10(12)vp (virus particle) once a week, with a total of 4-8 times was given. The temperature being set hyperthermia every week 3 days after the injection of Adp53 at 43-44 degrees C using 915 MHz microwave machine for superficial tumour for 1 h or at 42-43 degrees C using 41 MHz radiofrequency machine for deep-seated tumour for 1 h. Among the 15 patients, five concurrently were added with radiotherapy and three were added with cisplatin-based chemotherapy. The treatment achieved CR in two cases, PR in four cases, SD in eight cases and PD in one case and, after the treatment, tumours of two cases disappeared and seven of the other 13 cases (54%) had low-density area (LDA) of more than 50% on CT images in tumours. In the 15 patients, no dose-limiting toxicity and adverse events were noted, except transient fever after Adp53 administration. In conclusion, Adp53 combined with hyperthermia was safe and effective in patients with advanced cancer and p53 gene therapy was potential to thermosensitize in advanced cancer.
本研究旨在评估重组人p53腺病毒(Adp53)联合热疗对晚期癌症的疗效。15例晚期癌症患者纳入本临床试验。其中13例复发肿瘤患者经传统治疗无效,另外2例原发肿瘤患者在入组前未接受过治疗。重组腺病毒-p53(Adp53)是一种E1区缺失的复制缺陷型重组腺病毒,编码人野生型p53(wtp53)基因。15例患者均采用瘤内注射Adp53,剂量为1×10¹²vp(病毒颗粒),每周1次,共注射4 - 8次。在每次注射Adp53后3天进行热疗,浅表肿瘤采用915MHz微波治疗仪,温度设定为43 - 44℃,持续1小时;深部肿瘤采用41MHz射频治疗仪,温度设定为42 - 43℃,持续1小时。15例患者中,5例同时接受了放疗,3例接受了以顺铂为主的化疗。治疗结果显示,2例患者达到完全缓解(CR),4例患者部分缓解(PR),8例患者病情稳定(SD),1例患者疾病进展(PD)。治疗后,2例患者肿瘤消失,另外13例患者中有7例(54%)在CT图像上肿瘤低密度区(LDA)超过50%。15例患者中,除注射Adp53后出现短暂发热外,未观察到剂量限制性毒性和不良事件。综上所述,Adp53联合热疗对晚期癌症患者安全有效,p53基因治疗在晚期癌症中具有热增敏潜力。