Servicio de Oncología, Hospital Universitario Niño Jesús, Madrid, Spain.
Servicio de Oncología Médica, Hospital Universitario Doce de Octubre, Madrid, Spain.
Mol Ther. 2020 Apr 8;28(4):1033-1042. doi: 10.1016/j.ymthe.2020.01.019. Epub 2020 Jan 21.
We present here the results of a first-in-human, first-in-child trial for patients with relapsed/refractory solid tumors using Celyvir, an advanced therapy medicine that combines autologous mesenchymal stem cells (MSCs) carrying an oncolytic adenovirus. Celyvir was manufactured from a bone marrow aspirate and then given intravenously. Patients received weekly infusions for 6 weeks at a dose of 2 × 10 cells/kg (children) or 0.5-1 × 10 cells/kg (adults), 2 × 10 viral particles per cell. Fifteen pediatric and 19 adult patients were recruited, but 18 were screen failures, mainly because rapid disease progression before Celyvir was available. No grade 2-5 toxicities were reported. Adenoviral replication detected by PCR was found in all but 2 pediatric patient and in none of the adult ones. Absolute numbers of circulating leukocytes suffered minor changes along therapy, but some subsets showed differences comparing the pediatric versus the adult cohorts. Two patients with neuroblastoma showed disease stabilization, and one of them continued on treatment for up to 6 additional weeks. Celyvir, the combination of MSCs and oncolytic adenovirus, is safe and warrants further evaluation in a phase 2 setting. The use of MSCs may be a strategy to increase the amount of oncolytic virus administered to patients, minimizing toxicities and avoiding direct tumor injections.
我们在此介绍了一项使用 Celyvir 治疗复发性/难治性实体瘤患者的首次人体、首次儿童临床试验结果。Celyvir 是一种将携带溶瘤腺病毒的自体间充质干细胞(MSCs)组合在一起的先进治疗药物。Celyvir 由骨髓抽吸物制成,然后静脉内给药。患者每周接受一次输注,持续 6 周,剂量为 2×10 细胞/kg(儿童)或 0.5-1×10 细胞/kg(成人),每个细胞 2×10 个病毒颗粒。共招募了 15 名儿科和 19 名成年患者,但有 18 名患者因在接受 Celyvir 治疗前疾病快速进展而筛选失败。未报告 2-5 级毒性。除了 2 名儿科患者外,所有患者均通过 PCR 检测到腺病毒复制,而成年患者均未检测到。循环白细胞的绝对数量沿治疗过程发生轻微变化,但一些亚群与儿科与成年队列相比存在差异。2 名神经母细胞瘤患者病情稳定,其中 1 名患者继续接受治疗长达 6 周以上。Celyvir(MSCs 和溶瘤腺病毒的组合)是安全的,值得在 2 期研究中进一步评估。使用 MSCs 可能是增加给予患者的溶瘤病毒量的一种策略,可最小化毒性并避免直接肿瘤注射。