Caballero Aguirrechu Iraida, Mestre Fernández Braulio, Soriano García Jorge Luis, Lim Alonso Nora, Soto García Andrés, Fleites Calvo Vilma, Mariño de la Puente Daines, Vega Carvajal Geidy, Ávila Pérez Jenny Carolina, Mendoza Hernández Ivis, García López Elena, Tarinas Reyes Alicia, García-Pérez Gisela, Díaz Borges Claudia, Ledón Naranjo Nuris, Lozada Chang Sum Lai, García Vega Yanelda, Alvárez Lobaina Alexis, Alvárez Cardona Mabel, Lorenzo-Luaces Alvárez Patricia, Crombet Ramos Tania, Carmenate Portilla Tania, León Monzón Kalet
Hermanos Ameijeiras Hospital, Oncology Department, Havana, Cuba.
National Institute of Oncology and Radiobiology, Havana, Cuba.
Front Immunol. 2025 May 23;16:1589042. doi: 10.3389/fimmu.2025.1589042. eCollection 2025.
INTRODUCTION: Interleukin 2 (IL-2) is essential for immune system activation. To reduce toxicity and prevent the activation of regulatory T cells (T-regs), a novel IL-2 variant containing 4-point mutations that prevent its interaction with the alpha chain of the receptor was designed. In preclinical studies, the no-alpha mutein preferentially stimulate CD8-T cells and natural killer (NK) cells compared to Tregs. Mutein also showed greater antitumor capacity than the native molecule in several tumor models. METHODS: Patients with advanced solid tumors were included in a single-arm dose-escalation Phase I trial. The objectives of this study were to evaluate the safety and identify the recommended phase 2 dose. The effects on the most important immune subpopulations and preliminary objective response were also assessed. The protocol was listed in the National Registry for Clinical Trials (https://rpcec.sld.cu/ensayos/RPCEC00000234-En). RESULTS AND DISCUSSION: In this phase I trial, 13 patients with advanced cancer were treated with five dose levels of IL-2 mutein, from 300 to 2400 IU/kg. The treatment was safe, and the maximum tolerated dose was not reached. Dose escalation did not continue, as a greater clinical and pharmacodynamic effect was observed at intermediate doses. One patient developed a possibly related serious event consisting on ventricular dysfunction and pneumonitis. No toxic deaths or vascular leak syndromes were detected, and the most frequent toxicities were chills, fever, and tachycardia. After treatment, most patients experienced an expansion of the total lymphocyte counts and the CD8-T cells and NK cells. CLINICAL TRIAL REGISTRATION: https://rpcec.sld.cu/ensayos/RPCEC00000234-En, identifier RPCEC00000234.
引言:白细胞介素2(IL-2)对免疫系统激活至关重要。为降低毒性并防止调节性T细胞(Tregs)激活,设计了一种含有4个点突变的新型IL-2变体,该突变可阻止其与受体α链相互作用。在临床前研究中,与Tregs相比,无α突变体优先刺激CD8-T细胞和自然杀伤(NK)细胞。在多个肿瘤模型中,突变体还显示出比天然分子更强的抗肿瘤能力。 方法:晚期实体瘤患者纳入单臂剂量递增I期试验。本研究的目的是评估安全性并确定推荐的2期剂量。还评估了对最重要免疫亚群的影响和初步客观缓解情况。该方案已列入国家临床试验注册库(https://rpcec.sld.cu/ensayos/RPCEC00000234-En)。 结果与讨论:在该I期试验中,13例晚期癌症患者接受了5个剂量水平(300至2400 IU/kg)的IL-2突变体治疗。治疗是安全的,未达到最大耐受剂量。由于在中等剂量下观察到更大的临床和药效学效应,剂量递增未继续。1例患者发生了可能相关的严重事件,包括心室功能障碍和肺炎。未检测到毒性死亡或血管渗漏综合征,最常见的毒性反应是寒战、发热和心动过速。治疗后,大多数患者的总淋巴细胞计数以及CD8-T细胞和NK细胞均有所增加。 临床试验注册:https://rpcec.sld.cu/ensayos/RPCEC00000234-En,标识符RPCEC00000234
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