Immunomodulatory activities of pixatimod: emerging nonclinical and clinical data, and its potential utility in combination with PD-1 inhibitors
Abstract Background Pixatimod (PG545) is a novel clinical-stage immunomodulatory agent capable of inhibiting the infiltration of tumor-associated macrophages (TAMs) yet also stimulate dendritic cells (DCs), leading to activation of natural killer (NK) cells. Preclinically, pixatimod inhibits heparan...
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doaj-106a8f435d52440dbe798c490d6892972020-11-25T03:02:50ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262018-06-016111310.1186/s40425-018-0363-5Immunomodulatory activities of pixatimod: emerging nonclinical and clinical data, and its potential utility in combination with PD-1 inhibitorsEdward Hammond0Nicole M. Haynes1Carleen Cullinane2Todd V. Brennan3Darryn Bampton4Paul Handley5Tomislav Karoli6Fleur Lanksheer7Liwen Lin8Yiping Yang9Keith Dredge10Zucero TherapeuticsDivision of Cancer Research, Peter MacCallum Cancer CentreDivision of Cancer Research, Peter MacCallum Cancer CentreDepartment of Surgery, Duke University Medical CenterZucero TherapeuticsZucero TherapeuticsZucero TherapeuticsProgen PharmaceuticalsDepartment of Surgery, Duke University Medical CenterDepartments of Medicine and Immunology, Duke University Medical CenterZucero TherapeuticsAbstract Background Pixatimod (PG545) is a novel clinical-stage immunomodulatory agent capable of inhibiting the infiltration of tumor-associated macrophages (TAMs) yet also stimulate dendritic cells (DCs), leading to activation of natural killer (NK) cells. Preclinically, pixatimod inhibits heparanase (HPSE) which may be associated with its inhibitory effect on TAMs whereas its immunostimulatory activity on DCs is through the MyD88-dependent TLR9 pathway. Pixatimod recently completed a Phase Ia monotherapy trial in advanced cancer patients. Methods To characterize the safety of pixatimod administered by intravenous (IV) infusion, a one month toxicology study was conducted to support a Phase Ia monotherapy clinical trial. The relative exposure (AUC) of pixatimod across relevant species was determined and the influence of route of administration on the immunomodulatory activity was also evaluated. Finally, the potential utility of pixatimod in combination with PD-1 inhibition was also investigated using the syngeneic 4T1.2 breast cancer model. Results The nonclinical safety profile revealed that the main toxicities associated with pixatimod are elevated cholesterol, triglycerides, APTT, decreased platelets and other changes symptomatic of modulating the immune system such as pyrexia, changes in WBC subsets, inflammatory changes in liver, spleen and kidney. Though adverse events such as fever, elevated cholesterol and triglycerides were reported in the Phase Ia trial, none were considered dose limiting toxicities and the compound was well tolerated up to 100 mg via IV infusion. Exposure (AUC) up to 100 mg was considered proportional with some accumulation upon repeated dosing, a phenomenon also noted in the toxicology study. The immunomodulatory activity of pixatimod was independent of the route of administration and it enhanced the effectiveness of PD-1 inhibition in a poorly immunogenic tumor model. Conclusions Pixatimod modulates innate immune cells but also enhances T cell infiltration in combination with anti-PD-1 therapy. The safety and PK profile of the compound supports its ongoing development in a Phase Ib study for advanced cancer/pancreatic adenocarcinoma with the checkpoint inhibitor nivolumab (Opdivo®). Trial registration ClinicalTrials.gov Identifier: NCT02042781. First posted: 23 January, 2014 - Retrospectively registered.http://link.springer.com/article/10.1186/s40425-018-0363-5PixatimodPG545ImmunomodulatoryTumor-associated macrophageDendritic cellNK cell |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Edward Hammond Nicole M. Haynes Carleen Cullinane Todd V. Brennan Darryn Bampton Paul Handley Tomislav Karoli Fleur Lanksheer Liwen Lin Yiping Yang Keith Dredge |
spellingShingle |
Edward Hammond Nicole M. Haynes Carleen Cullinane Todd V. Brennan Darryn Bampton Paul Handley Tomislav Karoli Fleur Lanksheer Liwen Lin Yiping Yang Keith Dredge Immunomodulatory activities of pixatimod: emerging nonclinical and clinical data, and its potential utility in combination with PD-1 inhibitors Journal for ImmunoTherapy of Cancer Pixatimod PG545 Immunomodulatory Tumor-associated macrophage Dendritic cell NK cell |
author_facet |
Edward Hammond Nicole M. Haynes Carleen Cullinane Todd V. Brennan Darryn Bampton Paul Handley Tomislav Karoli Fleur Lanksheer Liwen Lin Yiping Yang Keith Dredge |
author_sort |
Edward Hammond |
title |
Immunomodulatory activities of pixatimod: emerging nonclinical and clinical data, and its potential utility in combination with PD-1 inhibitors |
title_short |
Immunomodulatory activities of pixatimod: emerging nonclinical and clinical data, and its potential utility in combination with PD-1 inhibitors |
title_full |
Immunomodulatory activities of pixatimod: emerging nonclinical and clinical data, and its potential utility in combination with PD-1 inhibitors |
title_fullStr |
Immunomodulatory activities of pixatimod: emerging nonclinical and clinical data, and its potential utility in combination with PD-1 inhibitors |
title_full_unstemmed |
Immunomodulatory activities of pixatimod: emerging nonclinical and clinical data, and its potential utility in combination with PD-1 inhibitors |
title_sort |
immunomodulatory activities of pixatimod: emerging nonclinical and clinical data, and its potential utility in combination with pd-1 inhibitors |
publisher |
BMJ Publishing Group |
series |
Journal for ImmunoTherapy of Cancer |
issn |
2051-1426 |
publishDate |
2018-06-01 |
description |
Abstract Background Pixatimod (PG545) is a novel clinical-stage immunomodulatory agent capable of inhibiting the infiltration of tumor-associated macrophages (TAMs) yet also stimulate dendritic cells (DCs), leading to activation of natural killer (NK) cells. Preclinically, pixatimod inhibits heparanase (HPSE) which may be associated with its inhibitory effect on TAMs whereas its immunostimulatory activity on DCs is through the MyD88-dependent TLR9 pathway. Pixatimod recently completed a Phase Ia monotherapy trial in advanced cancer patients. Methods To characterize the safety of pixatimod administered by intravenous (IV) infusion, a one month toxicology study was conducted to support a Phase Ia monotherapy clinical trial. The relative exposure (AUC) of pixatimod across relevant species was determined and the influence of route of administration on the immunomodulatory activity was also evaluated. Finally, the potential utility of pixatimod in combination with PD-1 inhibition was also investigated using the syngeneic 4T1.2 breast cancer model. Results The nonclinical safety profile revealed that the main toxicities associated with pixatimod are elevated cholesterol, triglycerides, APTT, decreased platelets and other changes symptomatic of modulating the immune system such as pyrexia, changes in WBC subsets, inflammatory changes in liver, spleen and kidney. Though adverse events such as fever, elevated cholesterol and triglycerides were reported in the Phase Ia trial, none were considered dose limiting toxicities and the compound was well tolerated up to 100 mg via IV infusion. Exposure (AUC) up to 100 mg was considered proportional with some accumulation upon repeated dosing, a phenomenon also noted in the toxicology study. The immunomodulatory activity of pixatimod was independent of the route of administration and it enhanced the effectiveness of PD-1 inhibition in a poorly immunogenic tumor model. Conclusions Pixatimod modulates innate immune cells but also enhances T cell infiltration in combination with anti-PD-1 therapy. The safety and PK profile of the compound supports its ongoing development in a Phase Ib study for advanced cancer/pancreatic adenocarcinoma with the checkpoint inhibitor nivolumab (Opdivo®). Trial registration ClinicalTrials.gov Identifier: NCT02042781. First posted: 23 January, 2014 - Retrospectively registered. |
topic |
Pixatimod PG545 Immunomodulatory Tumor-associated macrophage Dendritic cell NK cell |
url |
http://link.springer.com/article/10.1186/s40425-018-0363-5 |
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