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Nyati S, Stricker H, Barton KN, Li P, Elshaikh M, Ali H, Brown SL, Hwang C, Peabody J, Freytag SO, Movsas B, Siddiqui F. A phase I clinical trial of oncolytic adenovirus mediated suicide and interleukin-12 gene therapy in patients with recurrent localized prostate adenocarcinoma. PLoS One 2023; 18:e0291315. [PMID: 37713401 PMCID: PMC10503775 DOI: 10.1371/journal.pone.0291315] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/06/2023] [Indexed: 09/17/2023] Open
Abstract
In a phase I dose escalation and safety study (NCT02555397), a replication-competent oncolytic adenovirus expressing yCD, TK and hIL-12 (Ad5-yCD/mutTKSR39rep-hIL-12) was administered in 15 subjects with localized recurrent prostate cancer (T1c-T2) at increasing doses (1 × 1010, to 1 × 1012 viral particles) followed by 7-day treatment of 5-fluorocytosine (5-FC) and valganciclovir (vGCV). The primary endpoint was toxicity through day 30 while the secondary and exploratory endpoints were quantitation of IL-12, IFNγ, CXCL10 and peripheral blood mononuclear cells (PBMC). The study maximum tolerated dose (MTD) was not reached indicating 1012 viral particles was safe. Total 115 adverse events were observed, most of which (92%) were grade 1/2 that did not require any treatment. Adenoviral DNA was detected only in two patients. Increase in IL-12, IFNγ, and CXCL10 was observed in 57%, 93%, and 79% patients, respectively. Serum cytokines demonstrated viral dose dependency, especially apparent in the highest-dose cohorts. PBMC analysis revealed immune system activation after gene therapy in cohort 5. The PSA doubling time (PSADT) pre and post treatment has a median of 1.55 years vs 1.18 years. This trial confirmed that replication-competent Ad5-IL-12 adenovirus (Ad5-yCD/mutTKSR39rep-hIL-12) was well tolerated when administered locally to prostate tumors.
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Affiliation(s)
- Shyam Nyati
- Department of Radiation Oncology, Henry Ford Cancer Institute, Henry Ford Health, Detroit, Michigan, United States of America
- Department of Radiology, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Hans Stricker
- Vattikuti Urology Institute, Henry Ford Cancer Institute, Henry Ford Health, Detroit, Michigan, United States of America
| | - Kenneth N. Barton
- Department of Radiation Oncology, Henry Ford Cancer Institute, Henry Ford Health, Detroit, Michigan, United States of America
| | - Pin Li
- Department of Public Health Sciences, Henry Ford Cancer Institute, Henry Ford Health, Detroit, Michigan, United States of America
| | - Mohamed Elshaikh
- Department of Radiation Oncology, Henry Ford Cancer Institute, Henry Ford Health, Detroit, Michigan, United States of America
| | - Haythem Ali
- Department of Internal Medicine, Henry Ford Cancer Institute, Henry Ford Health, Detroit, Michigan, United States of America
| | - Stephen L. Brown
- Department of Radiation Oncology, Henry Ford Cancer Institute, Henry Ford Health, Detroit, Michigan, United States of America
- College of Human Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Clara Hwang
- Department of Internal Medicine, Henry Ford Cancer Institute, Henry Ford Health, Detroit, Michigan, United States of America
| | - James Peabody
- Vattikuti Urology Institute, Henry Ford Cancer Institute, Henry Ford Health, Detroit, Michigan, United States of America
| | - Svend O. Freytag
- Department of Radiation Oncology, Henry Ford Cancer Institute, Henry Ford Health, Detroit, Michigan, United States of America
| | - Benjamin Movsas
- Department of Radiation Oncology, Henry Ford Cancer Institute, Henry Ford Health, Detroit, Michigan, United States of America
- College of Human Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Farzan Siddiqui
- Department of Radiation Oncology, Henry Ford Cancer Institute, Henry Ford Health, Detroit, Michigan, United States of America
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Abstract
Therapeutic gene manipulation has been at the forefront of popular scientific discussion and basic and clinical research for decades. Basic and clinical research applications of CRISPR-Cas9-based technologies and ongoing clinical trials in this area have demonstrated the potential of genome editing to cure human disease. Evaluation of research and clinical trials in gene therapy reveals a concentration of activity in prostate cancer research and practice. Multiple aspects of prostate cancer care - including anatomical considerations that enable direct tumour injections and sampling, the availability of preclinical immune-competent models and the delineation of tumour-related antigens that might provide targets for an induced immune system - make gene therapy an appealing treatment option for this common malignancy. Vaccine-based therapies that induce an immune response and new technologies exploiting CRISPR-Cas9-assisted approaches, including chimeric antigen receptor (CAR) T cell therapies, are very promising and are currently under investigation both in the laboratory and in the clinic. Although laboratory and preclinical advances have, thus far, not led to oncologically relevant outcomes in the clinic, future studies offer great promise for gene therapy to become established in prostate cancer care.
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Affiliation(s)
- Justin R Gregg
- Department of Urology and Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Timothy C Thompson
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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