Stein Mark N, Dumbrava Ecaterina E, Teply Benjamin A, Gergis Usama S, Guiterrez Martin E, Reshef Ran, Subudhi Sumit K, Jacquemont Céline F, Senesac Joseph H, Bayle J Henri, Scripture Charity D, Chatwal Monica S, Bilen Mehmet A, Stadler Walter M, Becerra Carlos R
Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.
The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Nat Commun. 2024 Dec 30;15(1):10743. doi: 10.1038/s41467-024-53220-6.
Here we report results of a phase 1 multi-institutional, open-label, dose-escalation trial (NCT02744287) of BPX-601, an investigational autologous PSCA-directed GoCAR-T® cell product containing an inducible MyD88/CD40 ON-switch responsive to the activating dimerizer rimiducid, in patients with metastatic pancreatic (mPDAC) or castration-resistant prostate cancer (mCRPC). Primary objectives were to evaluate safety and tolerability and determine the recommended phase 2 dose/schedule (RP2D). Secondary objectives included the assessment of efficacy and characterization of the pharmacokinetics of rimiducid. Thirty-three patients received BPX-601 with or without rimiducid, 24 patients with mPDAC and 9 with mCRPC. Two dose-limiting toxicities and two treatment-related deaths occurred in the highest-dose mCRPC cohort, after which the study was terminated, without determination of the RP2D. Two mCRPC patients experienced partial responses (one unconfirmed), and 56% of mCRPC patients achieved ≥50% reduction in prostate-specific antigen. BPX-601 cell expansion, long-term persistence in peripheral blood, and tumor infiltration were observed. Rimiducid increased circulating inflammatory cytokines/chemokines consistent with GoCAR-T® cell activation. These results suggest that pharmacological activation of GoCAR-T® cells is feasible and may offer a promising avenue to control chimeric antigen receptor-T cell activity with continued dose-optimization to improve tolerability.
在此,我们报告了一项1期多机构、开放标签、剂量递增试验(NCT02744287)的结果,该试验针对BPX - 601展开,BPX - 601是一种研究性自体PSCA导向的GoCAR - T®细胞产品,含有对激活二聚体利米度胺有反应的诱导型MyD88/CD40开关,用于治疗转移性胰腺癌(mPDAC)或去势抵抗性前列腺癌(mCRPC)患者。主要目标是评估安全性和耐受性,并确定推荐的2期剂量/给药方案(RP2D)。次要目标包括评估疗效以及对利米度胺的药代动力学进行表征。33名患者接受了含或不含利米度胺的BPX - 601治疗,其中24名患有mPDAC,9名患有mCRPC。在最高剂量的mCRPC队列中发生了2例剂量限制性毒性反应和2例与治疗相关的死亡,之后该研究终止,未确定RP2D。2例mCRPC患者出现部分缓解(1例未确认),56%的mCRPC患者前列腺特异性抗原降低≥50%。观察到BPX - 601细胞扩增、在外周血中的长期持久性以及肿瘤浸润。利米度胺增加了循环炎症细胞因子/趋化因子,这与GoCAR - T®细胞激活一致。这些结果表明,GoCAR - T®细胞的药理学激活是可行的,并且通过持续的剂量优化以提高耐受性,可能为控制嵌合抗原受体T细胞活性提供一条有前景的途径。