Phase I study of a multitargeted recombinant Ad5 PSA/MUC-1/brachyury-based immunotherapy vaccine in patients with metastatic castration-resistant prostate cancer (mCRPC)
Background Antitumor vaccines targeting tumor-associated antigens (TAAs) can generate antitumor immune response. A novel vaccine platform using adenovirus 5 (Ad5) vectors [E1–, E2b–] targeting three TAAs—prostate-specific antigen (PSA), brachyury, and MUC-1—has been developed. Both brachyury and the...
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BMJ Publishing Group
2021-03-01
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Series: | Journal for ImmunoTherapy of Cancer |
Online Access: | https://jitc.bmj.com/content/9/3/e002374.full |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Renee N Donahue Jeffrey Schlom James L Gulley Ravi A Madan Claudia Palena Caroline Jochems Shahrooz Rabizadeh Patrick Soon-Shiong Sheri McMahon Julius Strauss Marijo Bilusic Fatima Karzai Houssein Abdul Sater Jennifer L Marté Yo-Ting Tsai Jason Redman Charalampos Floudas |
spellingShingle |
Renee N Donahue Jeffrey Schlom James L Gulley Ravi A Madan Claudia Palena Caroline Jochems Shahrooz Rabizadeh Patrick Soon-Shiong Sheri McMahon Julius Strauss Marijo Bilusic Fatima Karzai Houssein Abdul Sater Jennifer L Marté Yo-Ting Tsai Jason Redman Charalampos Floudas Phase I study of a multitargeted recombinant Ad5 PSA/MUC-1/brachyury-based immunotherapy vaccine in patients with metastatic castration-resistant prostate cancer (mCRPC) Journal for ImmunoTherapy of Cancer |
author_facet |
Renee N Donahue Jeffrey Schlom James L Gulley Ravi A Madan Claudia Palena Caroline Jochems Shahrooz Rabizadeh Patrick Soon-Shiong Sheri McMahon Julius Strauss Marijo Bilusic Fatima Karzai Houssein Abdul Sater Jennifer L Marté Yo-Ting Tsai Jason Redman Charalampos Floudas |
author_sort |
Renee N Donahue |
title |
Phase I study of a multitargeted recombinant Ad5 PSA/MUC-1/brachyury-based immunotherapy vaccine in patients with metastatic castration-resistant prostate cancer (mCRPC) |
title_short |
Phase I study of a multitargeted recombinant Ad5 PSA/MUC-1/brachyury-based immunotherapy vaccine in patients with metastatic castration-resistant prostate cancer (mCRPC) |
title_full |
Phase I study of a multitargeted recombinant Ad5 PSA/MUC-1/brachyury-based immunotherapy vaccine in patients with metastatic castration-resistant prostate cancer (mCRPC) |
title_fullStr |
Phase I study of a multitargeted recombinant Ad5 PSA/MUC-1/brachyury-based immunotherapy vaccine in patients with metastatic castration-resistant prostate cancer (mCRPC) |
title_full_unstemmed |
Phase I study of a multitargeted recombinant Ad5 PSA/MUC-1/brachyury-based immunotherapy vaccine in patients with metastatic castration-resistant prostate cancer (mCRPC) |
title_sort |
phase i study of a multitargeted recombinant ad5 psa/muc-1/brachyury-based immunotherapy vaccine in patients with metastatic castration-resistant prostate cancer (mcrpc) |
publisher |
BMJ Publishing Group |
series |
Journal for ImmunoTherapy of Cancer |
issn |
2051-1426 |
publishDate |
2021-03-01 |
description |
Background Antitumor vaccines targeting tumor-associated antigens (TAAs) can generate antitumor immune response. A novel vaccine platform using adenovirus 5 (Ad5) vectors [E1–, E2b–] targeting three TAAs—prostate-specific antigen (PSA), brachyury, and MUC-1—has been developed. Both brachyury and the C-terminus of MUC-1 are overexpressed in metastatic castration-resistant prostate cancer (mCRPC) and have been shown to play an important role in resistance to chemotherapy, epithelial–mesenchymal transition, and metastasis. The transgenes for PSA, brachyury, and MUC-1 all contain epitope modifications for the expression of CD8+ T-cell enhancer agonist epitopes. We report here the first-in-human trial of this vaccine platform.Methods Patients with mCRPC were given concurrently three vaccines targeting PSA, brachyury, and MUC-1 at 5×1011 viral particles (VP) each, subcutaneously every 3 weeks for a maximum of three doses (dose de-escalation cohort), followed by a booster vaccine every 8 weeks for 1 year (dose-expansion cohort only). The primary objective was to determine the safety and the recommended phase II dose. Immune assays and clinical responses were evaluated.Results Eighteen patients with mCRPC were enrolled between July 2018 and September 2019 and received at least one vaccination. Median PSA was 25.58 ng/mL (range, 0.65–1006 ng/mL). The vaccine was tolerable and safe, and no grade >3 treatment-related adverse events or dose-limiting toxicities (DLTs) were observed. One patient had a partial response, while five patients had confirmed PSA decline and five had stable disease for >6 months. Median progression-free survival was 22 weeks (95% CI: 19.1 to 34). Seventeen (100%) of 17 patients mounted T-cell responses to at least one TAA, whereras 8 (47%) of 17 patients mounted immune responses to all three TAAs. Multifunctional T-cell responses to PSA, MUC-1, and brachyury were also detected after vaccination in the majority of the patients.Conclusions Ad5 PSA/MUC-1/brachyury vaccine is well tolerated. The primary end points were met and there were no DLTs. The recommended phase II dose is 5×1011 VP. The vaccine demonstrated clinical activity, including one partial response and confirmed PSA responses in five patients. Three patients with prolonged PSA responses received palliative radiation therapy. Further research is needed to evaluate the clinical benefit and immunogenicity of this vaccine in combination with other immuno-oncology agents and/or palliative radiation therapy.Trial registration number NCT03481816. |
url |
https://jitc.bmj.com/content/9/3/e002374.full |
work_keys_str_mv |
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doaj-0ba9e720c5394549bc0af34acac98f932021-05-30T13:00:56ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262021-03-019310.1136/jitc-2021-002374Phase I study of a multitargeted recombinant Ad5 PSA/MUC-1/brachyury-based immunotherapy vaccine in patients with metastatic castration-resistant prostate cancer (mCRPC)Renee N Donahue0Jeffrey Schlom1James L Gulley2Ravi A Madan3Claudia Palena4Caroline Jochems5Shahrooz Rabizadeh6Patrick Soon-Shiong7Sheri McMahon8Julius Strauss9Marijo Bilusic10Fatima Karzai11Houssein Abdul Sater12Jennifer L Marté13Yo-Ting Tsai14Jason Redman15Charalampos Floudas16Laboratory of Tumor Immunology and Biology, National Cancer Institute, Bethesda, Maryland, USALaboratory of Tumor Immunology and Biology, National Cancer Institute, Bethesda, Maryland, USAGenitourinary Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USAGenitourinary Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USALaboratory of Tumor Immunology and Biology, National Cancer Institute, Bethesda, Maryland, USALaboratory of Tumor Immunology and Biology, National Cancer Institute, Bethesda, Maryland, USAImmunityBio, Culver City, California, USAImmunityBio, Culver City, California, USAGenitourinary Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USALaboratory of Tumor Immunology and Biology, National Cancer Institute, Bethesda, Maryland, USAGenitourinary Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USAGenitourinary Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USAGenitourinary Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USAGenitourinary Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USALaboratory of Tumor Immunology and Biology, National Cancer Institute, Bethesda, Maryland, USAGenitourinary Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USAGenitourinary Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USABackground Antitumor vaccines targeting tumor-associated antigens (TAAs) can generate antitumor immune response. A novel vaccine platform using adenovirus 5 (Ad5) vectors [E1–, E2b–] targeting three TAAs—prostate-specific antigen (PSA), brachyury, and MUC-1—has been developed. Both brachyury and the C-terminus of MUC-1 are overexpressed in metastatic castration-resistant prostate cancer (mCRPC) and have been shown to play an important role in resistance to chemotherapy, epithelial–mesenchymal transition, and metastasis. The transgenes for PSA, brachyury, and MUC-1 all contain epitope modifications for the expression of CD8+ T-cell enhancer agonist epitopes. We report here the first-in-human trial of this vaccine platform.Methods Patients with mCRPC were given concurrently three vaccines targeting PSA, brachyury, and MUC-1 at 5×1011 viral particles (VP) each, subcutaneously every 3 weeks for a maximum of three doses (dose de-escalation cohort), followed by a booster vaccine every 8 weeks for 1 year (dose-expansion cohort only). The primary objective was to determine the safety and the recommended phase II dose. Immune assays and clinical responses were evaluated.Results Eighteen patients with mCRPC were enrolled between July 2018 and September 2019 and received at least one vaccination. Median PSA was 25.58 ng/mL (range, 0.65–1006 ng/mL). The vaccine was tolerable and safe, and no grade >3 treatment-related adverse events or dose-limiting toxicities (DLTs) were observed. One patient had a partial response, while five patients had confirmed PSA decline and five had stable disease for >6 months. Median progression-free survival was 22 weeks (95% CI: 19.1 to 34). Seventeen (100%) of 17 patients mounted T-cell responses to at least one TAA, whereras 8 (47%) of 17 patients mounted immune responses to all three TAAs. Multifunctional T-cell responses to PSA, MUC-1, and brachyury were also detected after vaccination in the majority of the patients.Conclusions Ad5 PSA/MUC-1/brachyury vaccine is well tolerated. The primary end points were met and there were no DLTs. The recommended phase II dose is 5×1011 VP. The vaccine demonstrated clinical activity, including one partial response and confirmed PSA responses in five patients. Three patients with prolonged PSA responses received palliative radiation therapy. Further research is needed to evaluate the clinical benefit and immunogenicity of this vaccine in combination with other immuno-oncology agents and/or palliative radiation therapy.Trial registration number NCT03481816.https://jitc.bmj.com/content/9/3/e002374.full |