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Phase 1/2 dose-escalation study of a GM-CSF-secreting, allogeneic, cellular immunotherapy for metastatic hormone-refractory prostate cancer

✍ Scribed by Celestia S. Higano; John M. Corman; David C. Smith; Arthur S. Centeno; Christopher P. Steidle; Marc Gittleman; Jonathan W. Simons; Natalie Sacks; Junko Aimi; Eric J. Small


Publisher
John Wiley and Sons
Year
2008
Tongue
English
Weight
186 KB
Volume
113
Category
Article
ISSN
0008-543X

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✦ Synopsis


Abstract

BACKGROUND

This open‐label, multicenter, dose‐escalation study evaluated multiple dose levels of immunotherapy in patients with metastatic hormone‐refractory prostate cancer (HRPC). The immunotherapy, based on the GVAX platform, consisted of 2 allogeneic prostate‐carcinoma cell lines modified to secrete granulocyte‐macrophage‐colony‐stimulating factor (GM‐CSF).

METHODS

Dose levels ranged from 100 × 10^6^ cells q28d × 6 to 500 × 10^6^ cells prime/300 × 10^6^ cells boost q14d × 11. Endpoints included safety, immunogenicity, overall survival, radiologic response, prostate‐specific antigen (PSA) kinetics, and serum GM‐CSF pharmacokinetics.

RESULTS

Eighty men, median age 69 years (range, 49‐90 years), were treated. The most common adverse effect was injection‐site erythema. Overall, the immunotherapy was well tolerated. A maximal tolerated dose was not established. The median survival time was 35.0 months in the high‐dose group, 20.0 months in the mid‐dose, group, and 23.1 months in the low‐dose group. PSA stabilization occurred in 15 (19%) patients, and a >50% decline in PSA was seen in 1 patient. The proportion of patients who generated an antibody response to 1 or both cell lines increased with dose and included 10 of 23 (43%) in the low‐dose group, 13 of 18 (72%) in the mid‐dose group, and 16 of 18 (89%) in the high‐dose group (P = .002; Cochran‐Armitage trend test).

CONCLUSIONS

This immunotherapy was well tolerated. Immunogenicity and overall survival varied by dose. Two phase 3 trials in patients with metastatic HRPC are underway. Cancer 2008. © 2008 American Cancer Society.