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Yi L, Ning Z, Xu L, Shen Y, Zhu X, Yu W, Xie J, Meng Z. The combination treatment of oncolytic adenovirus H101 with nivolumab for refractory advanced hepatocellular carcinoma: an open-label, single-arm, pilot study. ESMO Open 2024; 9:102239. [PMID: 38325225 PMCID: PMC10937204 DOI: 10.1016/j.esmoop.2024.102239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 01/05/2024] [Accepted: 01/09/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND H101, an innovative oncolytic adenovirus, has shown potential in modifying the tumor microenvironment from immunologically 'cold' to 'hot'. When combined with nivolumab, a programmed cell death protein 1 inhibitor, this synergy may offer substantial therapeutic benefits beyond the capabilities of each agent alone. PATIENTS AND METHODS In this pilot study, we assessed the efficacy and safety of combining H101 with nivolumab in advanced hepatocellular carcinoma (HCC) patients who failed prior systemic therapy. The participants received initial oncolytic virus (OV) pretreatment with intratumoral H101 injections (5.0 × 1011 vp/0.5 ml/vial, two vials per lesion) on days 1 and 3. Combination therapy started on day 8, with H101 administered every 2 or 4 weeks and nivolumab (240 mg) injections every 2 weeks. Treatment continued up to 12 months or until disease progression, intolerable toxicity, consent withdrawal, or study conclusion. The primary endpoint was the objective response rate (ORR). RESULTS Between March 2020 and March 2022, 18 of 21 screened patients were assessable, showing an ORR of 11.1% [two cases of partial response (PR) and five cases of stable disease], with extrahepatic injections often leading to favorable outcomes. The disease control rate stood at 38.9%, with a 6-month survival rate of 88.9%. Median progression-free survival was 2.69 months, and overall survival (OS) was 15.04 months. Common adverse events included low-grade fever (100%) and pain related to centesis (33.3%), and no grade 3/4 events were reported. Significantly, local H101 injection showed potential in reversing immune checkpoint inhibitor resistance, evidenced by over 2.5 years of extended OS in PR cases with low α-fetoprotein. Additionally, decreasing neutrophil-to-lymphocyte ratio during OV pretreatment may predict positive outcomes. CONCLUSIONS This study demonstrates the potential efficacy of combining H101 with nivolumab in treating refractory advanced HCC, with well-tolerated toxicities.
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Affiliation(s)
- L Yi
- Department of Integrative Oncology, Shanghai, China; Department of Minimally Invasive Therapy Center, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Z Ning
- Department of Integrative Oncology, Shanghai, China; Department of Minimally Invasive Therapy Center, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - L Xu
- Department of Integrative Oncology, Shanghai, China; Department of Minimally Invasive Therapy Center, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Y Shen
- Department of Integrative Oncology, Shanghai, China; Department of Minimally Invasive Therapy Center, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - X Zhu
- Department of Integrative Oncology, Shanghai, China; Department of Minimally Invasive Therapy Center, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - W Yu
- Department of Integrative Oncology, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Medical Epigenetics, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - J Xie
- Department of Integrative Oncology, Shanghai, China; Department of Minimally Invasive Therapy Center, Fudan University Shanghai Cancer Center, Shanghai, China; Shanghai Key Laboratory of Medical Epigenetics, Institutes of Biomedical Sciences, Fudan University, Shanghai, China.
| | - Z Meng
- Department of Integrative Oncology, Shanghai, China; Department of Minimally Invasive Therapy Center, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
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Hecht JR, Raman SS, Chan A, Kalinsky K, Baurain JF, Jimenez MM, Garcia MM, Berger MD, Lauer UM, Khattak A, Carrato A, Zhang Y, Liu K, Cha E, Keegan A, Bhatta S, Strassburg CP, Roohullah A. Phase Ib study of talimogene laherparepvec in combination with atezolizumab in patients with triple negative breast cancer and colorectal cancer with liver metastases. ESMO Open 2023; 8:100884. [PMID: 36863095 PMCID: PMC10163149 DOI: 10.1016/j.esmoop.2023.100884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 12/01/2022] [Accepted: 01/21/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Talimogene laherparepvec (T-VEC), a first-in-class oncolytic viral immunotherapy, enhances tumor-specific immune activation. T-VEC combined with atezolizumab, which blocks inhibitor T-cell checkpoints, could provide greater benefit than either agent alone. Safety/efficacy of the combination was explored in patients with triple negative breast cancer (TNBC) or colorectal cancer (CRC) with liver metastases. METHODS In this phase Ib, multicenter, open-label, parallel cohort study of adults with TNBC or CRC with liver metastases, T-VEC (106 then 108 PFU/ml; ≤4 ml) was administered into hepatic lesions via image-guided injection every 21 (±3) days. Atezolizumab 1200 mg was given on day 1 and every 21 (±3) days thereafter. Treatment continued until patients experienced dose-limiting toxicity (DLT), had complete response, progressive disease, needed alternative anticancer treatment, or withdrew due to an adverse event (AE). The primary endpoint was DLT incidence, and secondary endpoints included efficacy and AEs. RESULTS Between 19 March 2018 and 6 November 2020, 11 patients with TNBC were enrolled (safety analysis set: n = 10); between 19 March 2018 and 16 October 2019, 25 patients with CRC were enrolled (safety analysis set: n = 24). For the 5 patients in the TNBC DLT analysis set, no patient had DLT; for the 18 patients in the CRC DLT analysis set, 3 (17%) had DLT, all serious AEs. AEs were reported by 9 (90%) TNBC and 23 (96%) CRC patients, the majority with grade ≥3 [TNBC, 7 (70%); CRC, 13 (54%)], and 1 was fatal [CRC, 1 (4%)]. Evidence of efficacy was limited. Overall response rate was 10% (95% confidence interval 0.3-44.5) for TNBC; one (10%) patient had a partial response. For CRC, no patients had a response; 14 (58%) were unassessable. CONCLUSIONS The safety profile reflected known risks with T-VEC including risks of intrahepatic injection; no unexpected safety findings from addition of atezolizumab to T-VEC were observed. Limited evidence of antitumor activity was observed.
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Affiliation(s)
- J R Hecht
- Division of Hematology/Oncology, David Geffen School of Medicine at UCLA, Santa Monica, USA.
| | - S S Raman
- Department of Radiology, David Geffen School of Medicine at UCLA, Santa Monica, USA
| | - A Chan
- Breast Cancer Research Centre - WA & Curtin University, Perth Breast Cancer Institute Hollywood Consulting Centre, Nedlands, Australia
| | - K Kalinsky
- Emory Winship Cancer Institute, Atlanta, USA
| | - J-F Baurain
- Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - M M Jimenez
- Hospital General Universitario Gregorio Marañon, Universidad Complutense, CIBERONC, Madrid, Spain
| | - M M Garcia
- Department of Medical Oncology, Hospital del Mar, CIOCC Barcelona, CIBERONC, Barcelona, Spain
| | - M D Berger
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - U M Lauer
- Department of Medical Oncology and Pneumology, Virotherapy Center Tübingen, University Hospital Tübingen, Tübingen, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), partner site Tübingen, Tübingen, Germany
| | - A Khattak
- Fiona Stanley Hospital & Edith Cowan University, Perth, Australia
| | - A Carrato
- Medical Oncology Department, Ramon y Cajal University Hospital, Alcala University, IRYCIS, CIBERONC, Madrid, Spain; Pancreatic Cancer Europe Chairman, Brussels, Belgium
| | - Y Zhang
- Virginia Oncology Associates, Norfolk, USA
| | - K Liu
- Amgen Inc., Thousand Oaks, USA
| | - E Cha
- Genentech, South San Francisco, USA
| | | | | | - C P Strassburg
- Department of Medicine I, University Hospital Bonn, Medical Clinic and Polyclinic I, Bonn, Germany
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Nejo T, Mende A, Okada H. The current state of immunotherapy for primary and secondary brain tumors: similarities and differences. Jpn J Clin Oncol 2020; 50:1231-1245. [PMID: 32984905 DOI: 10.1093/jjco/hyaa164] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/11/2020] [Indexed: 12/14/2022] Open
Abstract
Treatment and resolution of primary and metastatic brain tumors have long presented a challenge to oncologists. In response to the dismal survival outcomes associated with conventional therapies, various immunotherapy modalities, such as checkpoint inhibitors, vaccine, cellular immunotherapy and viral immunotherapy have been actively explored over the past couple of decades. Although improved patient survival has been more frequently noted in treatment of brain metastases, little progress has been made in improving patient survival in cases of primary brain tumors, specifically glioblastoma, which is the representative primary brain tumor discussed in this review. Herein, we will first overview the findings of recent clinical studies for treatment of primary and metastatic brain tumors with immunotherapeutic interventions. The clinical efficacy of these immunotherapies will be discussed in the context of their ability or inability to overcome inherent characteristics of the tumor as well as restricted antigen presentation and its immunosuppressive microenvironment. Additionally, this review aims to briefly inform clinicians in the field of neuro-oncology on the relevant aspects of the immune system as it pertains to the central nervous system, with special focus on the differing modes of antigen presentation and tumor microenvironment of primary and metastatic brain tumors and the role these differences may play in the efficacy of immunotherapy in eradicating the tumor.
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Affiliation(s)
- Takahide Nejo
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Abigail Mende
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Hideho Okada
- Department of Neurological Surgery, University of California, San Francisco, CA, USA.,The Parker Institute for Cancer Immunotherapy, San Francisco, CA, USA.,Cancer Immunotherapy Program, University of California, San Francisco, CA, USA
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Vassilev L, Ranki T, Joensuu T, Jäger E, Karbach J, Wahle C, Partanen K, Kairemo K, Alanko T, Turkki R, Linder N, Lundin J, Ristimäki A, Kankainen M, Hemminki A, Backman C, Dienel K, von Euler M, Haavisto E, Hakonen T, Juhila J, Jäderberg M, Priha P, Vuolanto A, Pesonen S. Repeated intratumoral administration of ONCOS-102 leads to systemic antitumor CD8 + T-cell response and robust cellular and transcriptional immune activation at tumor site in a patient with ovarian cancer. Oncoimmunology 2015; 4:e1017702. [PMID: 26140248 PMCID: PMC4485730 DOI: 10.1080/2162402x.2015.1017702] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 02/05/2015] [Accepted: 02/06/2015] [Indexed: 12/04/2022] Open
Abstract
Adenoviruses are excellent immunotherapeutic agents with a unique ability to prime and boost immune responses. Recombinant adenoviruses cause immunogenic cancer cell death and subsequent release of tumor antigens for antigen presenting cells, resulting in the priming of potent tumor-specific immunity. This effect may be further enhanced by immune-stimulating transgenes expressed by the virus. We report a case of a 38-year-old female with Stage 3 metastatic micropapillary serous carcinoma of the ovary. She was treated in a Phase I study with a granulocyte-macrophage colony stimulating factor (GMCSF)-expressing oncolytic adenovirus, Ad5/3-D24-GMCSF (ONCOS-102). The treatment resulted in progressive infiltration of CD8+ lymphocytes into the tumor and concomitant systemic induction of several tumor-specific CD8+ T-cell populations. The patient was alive at the latest follow up more than 20 months after initiation of the study.
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Affiliation(s)
| | - T Ranki
- Oncos Therapeutics ; Helsinki, Finland
| | - T Joensuu
- Docrates Cancer Center ; Helsinki, Finland
| | - E Jäger
- Hämatologie-Onkologie; Krankenhaus Nordwest ; Frankfurt, Germany
| | - J Karbach
- Hämatologie-Onkologie; Krankenhaus Nordwest ; Frankfurt, Germany
| | - C Wahle
- Hämatologie-Onkologie; Krankenhaus Nordwest ; Frankfurt, Germany
| | - K Partanen
- Docrates Cancer Center ; Helsinki, Finland
| | - K Kairemo
- Docrates Cancer Center ; Helsinki, Finland
| | - T Alanko
- Docrates Cancer Center ; Helsinki, Finland
| | - R Turkki
- Institute for Molecular Medicine Finland (FIMM) ; Helsinki, Finland
| | - N Linder
- Institute for Molecular Medicine Finland (FIMM) ; Helsinki, Finland
| | - J Lundin
- Institute for Molecular Medicine Finland (FIMM) ; Helsinki, Finland
| | - A Ristimäki
- Division of Pathology; HUSLAB and Haartman Institute; Helsinki University Central Hospital ; Helsinki, Finland ; Genome-Scale Biology; Research Programs Unit; University of Helsinki ; Helsinki, Finland
| | - M Kankainen
- Institute for Molecular Medicine Finland (FIMM) ; Helsinki, Finland
| | - A Hemminki
- University of Helsinki and Helsinki University Central Hospital; Cancer Gene Therapy Group ; Helsinki, Finland
| | - C Backman
- Oncos Therapeutics ; Helsinki, Finland
| | - K Dienel
- Oncos Therapeutics ; Helsinki, Finland
| | | | | | - T Hakonen
- Oncos Therapeutics ; Helsinki, Finland
| | - J Juhila
- Oncos Therapeutics ; Helsinki, Finland
| | | | - P Priha
- Oncos Therapeutics ; Helsinki, Finland
| | | | - S Pesonen
- Oncos Therapeutics ; Helsinki, Finland
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