Department of Sarcoma Medical Oncology, MD Anderson Cancer Center, Houston, Texas.
Department of Oncology, Mayo Clinic, Rochester, Minnesota.
Clin Cancer Res. 2019 Oct 1;25(19):5808-5817. doi: 10.1158/1078-0432.CCR-19-1025. Epub 2019 Jun 21.
LV305 is a modified, third-generation, nonreplicating, integration-deficient lentivirus-based vector designed to selectively transduce dendritic cells . LV305 induces expression of the New York Esophageal Squamous Cell Carcinoma-1 (NY-ESO-1) cancer testis antigen in dendritic cells, promoting immune responses against NY-ESO-1-expressing tumors. This phase I study evaluated the safety, immunogenicity, and preliminary efficacy of LV305 in patients with sarcoma or other solid tumors.
Adults with previously treated, advanced, NY-ESO-1-positive solid tumors and limited tumor burden were eligible. LV305 was administered every 3 weeks by intradermal injection in four dose cohorts (Cohort 1: 10 vector genomes (vg) x 3 doses; Cohorts 1A, 2, and 3: 10 vg, 10 vg, 10 vg x 4 doses).
Thirty-nine patients were enrolled: 3 patients each in Cohorts 1, 1A, and 2, and 30 patients in Cohort 3. No dose-limiting toxicities were observed. Tumor types included sarcoma ( = 24), ovarian ( = 8), melanoma ( = 6), and lung cancer ( = 1). All treatment-related adverse events were grade 1 or 2. Common treatment-related adverse events were fatigue (49%), injection site reactions (46%), and myalgia (21%). The disease control rate was 56.4% in all patients and 62.5% in sarcoma patients. One patient with synovial sarcoma achieved a partial response lasting >36 months. Anti-NY-ESO-1-specific CD4 and/or CD8 T cells were induced in 57% of evaluable sarcoma patients. Induction of an anti-NY-ESO-1 immune response was associated with improved 1-year survival in an exploratory analysis.
This first-in-class, first-in-human study of LV305 demonstrated a favorable safety profile, induction of antigen-specific responses, and potential clinical activity in patients with advanced cancer.
LV305 是一种改良的、第三代、非复制、整合缺陷的慢病毒载体,旨在选择性转导树突状细胞。LV305 在树突状细胞中诱导表达纽约食管鳞状细胞癌-1(NY-ESO-1)癌睾丸抗原,促进针对表达 NY-ESO-1 的肿瘤的免疫反应。这项 I 期研究评估了 LV305 在肉瘤或其他实体瘤患者中的安全性、免疫原性和初步疗效。
先前接受过治疗、晚期、NY-ESO-1 阳性的实体瘤且肿瘤负荷有限的成年人有资格参加。LV305 通过皮内注射每 3 周给药,分为四个剂量组(Cohort 1:10 个载体基因组(vg)x3 剂量;Cohorts 1A、2 和 3:10 vg、10 vg、10 vg x4 剂量)。
共纳入 39 例患者:Cohort 1、1A 和 2 各 3 例,Cohort 3 30 例。未观察到剂量限制性毒性。肿瘤类型包括肉瘤(n=24)、卵巢癌(n=8)、黑色素瘤(n=6)和肺癌(n=1)。所有与治疗相关的不良事件均为 1 级或 2 级。常见的与治疗相关的不良事件包括疲劳(49%)、注射部位反应(46%)和肌痛(21%)。所有患者的疾病控制率为 56.4%,肉瘤患者为 62.5%。1 例滑膜肉瘤患者的部分缓解持续时间超过 36 个月。57%可评估的肉瘤患者诱导出抗 NY-ESO-1 特异性 CD4 和/或 CD8 T 细胞。在探索性分析中,诱导抗 NY-ESO-1 免疫反应与 1 年生存率的提高相关。
这是首例 LV305 的 I 期、I 期临床试验,在晚期癌症患者中显示出良好的安全性、诱导抗原特异性反应和潜在的临床活性。