下一代肿瘤不可知靶点即将出现
Next-generation tumor-agnostic targets on the horizon.
肿瘤不可知药物开发将肿瘤学重新聚焦于共享的分子依赖性而非组织来源,从而能够针对跨肿瘤的罕见可操作驱动因素进行高效开发。
英文原题:A pilot study of multi-antigen stimulated cell therapy-I plus camrelizumab and apatinib in patients with advanced bone and soft-tissue sarcomas.
MASCT-I联合camrelizumab和apatinib在晚期骨与软组织肉瘤中安全且显示出令人鼓舞的疗效,推荐采用schedule-II给药方式。
基于细胞的免疫疗法在肉瘤中显示出治疗潜力,此外还有靶向血管生成的酪氨酸激酶抑制剂(TKI)和免疫检查点抑制剂(ICI)。多抗原刺激细胞疗法-I(MASCT-I)技术是一种用于癌症的序贯免疫细胞疗法,其由负载多种抗原的树突状细胞(DC)疫苗随后过继转移抗肿瘤效应T细胞组成。
在这项1期研究中,我们评估了MASCT-I联合camrelizumab(一种抗PD-1的ICI)和阿帕替尼(一种高度选择性靶向VEGFR2的TKI)用于至少接受过一线既往全身治疗后不可切除的复发或转移性骨与软组织肉瘤患者。一个MASCT-I疗程包括3次DC皮下注射,随后在每次DC注射后18-27天进行3次活性T细胞输注。在schedule-I组中,所有疗程中3次DC注射均以28天间隔给药;在schedule-II组中,第一个疗程中3次DC注射以7天间隔给药,此后以28天间隔给药。所有患者均接受静脉注射camrelizumab 200 mg每3周一次,并口服阿帕替尼250 mg每日一次。
2019年10月30日至2021年8月12日,共入组19例患者,随机分配至schedule-I组(n = 9)和schedule-II组(n = 10)。19例患者中,11例(57.9%)发生3级或4级治疗相关不良事件。未发生治疗相关死亡。schedule-II组患者的客观缓解率(ORR)与schedule-I组相似(30.0% vs 33.3%),但疾病控制率(DCR)更高(90.0% vs 44.4%),中位无进展生存期(PFS)更长(7.7个月 vs 4.0个月)。13例软组织肉瘤患者中,ORR为30.8%,DCR为76.9%,中位PFS为12.9个月;6例骨肉瘤患者中,ORR为33.3%,DCR为50.0%,中位PFS为5.7个月。
BACKGROUND: Cell-based immunotherapy shows the therapeutic potential in sarcomas, in addition to angiogenesis-targeted tyrosine kinase inhibitor (TKI) and immune checkpoint inhibitor (ICI). Multi-antigen stimulated cell therapy-I (MASCT-I) technology is a sequential immune cell therapy for cancer, which composes of multiple antigen-loaded dendritic cell (DC) vaccines followed by the adoptive transfer of anti-tumor effector T-cells. METHODS: In this phase 1 study, we assessed MASCT-I plus camrelizumab (an ICI against PD-1) and apatinib (a highly selective TKI targeting VEGFR2) in patients with unresectable recurrent or metastatic bone and soft-tissue sarcoma after at least one line of prior systemic therapy. One MASCT-I course consisted of 3 DC subcutaneous injections, followed by 3 active T cell infusions administered 18-27 days after each DC injection. In schedule-I group, 3 DC injections were administered with a 28-day interval in all courses; in schedule-II group, 3 DC injections were administered with a 7-day interval in the first course and with a 28-day interval thereafter. All patients received intravenous camrelizumab 200 mg every 3 weeks and oral apatinib 250 mg daily. RESULTS: From October 30, 2019, to August 12, 2021, 19 patients were enrolled and randomly assigned to schedule-I group (n = 9) and schedule-II group (n = 10). Of the 19 patients, 11 (57.9%) experienced grade 3 or 4 treatment-related adverse events. No treatment-related deaths occurred. Patients in schedule-II group showed similar objective response rate (ORR) with those in schedule-I group (30.0% versus 33.3%) but had higher disease control rate (DCR; 90.0% versus 44.4%) and longer median progression-free survival (PFS; 7.7 versus 4.0 months). For the 13 patients with soft-tissue sarcomas, the ORR was 30.8%, DCR was 76.9%, and median PFS was 12.9 months; for the 6 patients with osteosarcomas, the ORR was 33.3%, the DCR was 50.0%, and median PFS was 5.7 months. CONCLUSIONS: Overall, MASCT-I plus camrelizumab and apatinib was safe and showed encouraging efficacy in advanced bone and soft-tissue sarcoma, and schedule-II administration method was recommended. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04074564.
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