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一项针对各种实体瘤的端粒酶特异性复制型溶瘤腺病毒(端粒酶)的 I 期研究。

A phase I study of telomerase-specific replication competent oncolytic adenovirus (telomelysin) for various solid tumors.

机构信息

Mary Crowley Cancer Research Centers, Dallas, Texas, USA.

出版信息

Mol Ther. 2010 Feb;18(2):429-34. doi: 10.1038/mt.2009.262. Epub 2009 Nov 24.

Abstract

A phase I clinical trial was conducted to determine the clinical safety of Telomelysin, a human telomerase reverse transcriptase (hTERT) promoter driven modified oncolytic adenovirus, in patients with advanced solid tumors. A single intratumoral injection (IT) of Telomelysin was administered to three cohorts of patients (1 x 10(10), 1 x 10(11), 1 x 10(12) viral particles). Safety, response and pharmacodynamics were evaluated. Sixteen patients with a variety of solid tumors were enrolled. IT of Telomelysin was well tolerated at all dose levels. Common grade 1 and 2 toxicities included injection site reactions (pain, induration) and systemic reactions (fever, chills). hTERT expression was demonstrated at biopsy in 9 of 12 patients. Viral DNA was transiently detected in plasma in 13 of 16 patients. Viral DNA was detectable in four patients in plasma or sputum at day 7 and 14 post-treatment despite below detectable levels at 24 h, suggesting viral replication. One patient had a partial response of the injected malignant lesion. Seven patients fulfilled Response Evaluation Criteria in Solid Tumors (RECIST) definition for stable disease at day 56 after treatment. Telomelysin was well tolerated. Evidence of antitumor activity was suggested.

摘要

一项 I 期临床试验旨在确定 Telomelysin(一种人类端粒酶逆转录酶(hTERT)启动子驱动的修饰溶瘤腺病毒)在晚期实体瘤患者中的临床安全性。对三组患者(1x10(10)、1x10(11)、1x10(12)病毒颗粒)进行单次瘤内注射(IT)Telomelysin。评估安全性、反应和药效动力学。共招募了 16 名患有各种实体瘤的患者。Telomelysin 的 IT 在所有剂量水平均耐受良好。常见的 1 级和 2 级毒性包括注射部位反应(疼痛、硬结)和全身反应(发热、寒战)。在 12 名患者中的 9 名中通过活检证实 hTERT 表达。在 16 名患者中的 13 名中,在治疗后第 7 天和第 14 天的血浆中可检测到病毒 DNA。尽管在 24 小时内检测不到,但在血浆或痰中仍可在 4 名患者中检测到病毒 DNA,提示病毒复制。1 名患者注射的恶性病变有部分缓解。治疗后 56 天,7 名患者符合实体瘤反应评估标准(RECIST)定义的稳定疾病。Telomelysin 耐受性良好。提示有抗肿瘤活性。

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