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胶质母细胞瘤患者树突状细胞疫苗 II 期研究(CombiG-vax)的初步结果

英文原题:First step results from a phase II study of a dendritic cell vaccine in glioblastoma patients (CombiG-vax).

查看英文原题

First step results from a phase II study of a dendritic cell vaccine in glioblastoma patients (CombiG-vax).

PubMed 2024/08/13(内容时间) Front Immunol Q1 · IF 7(JCR 2025)

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研究概要

该联合疗法耐受性良好,第一步所需的两个终点均已达到。因此,研究将继续入组剩余 19 例患者。(Eudract 号:2020-003755-15 https://www.clinicaltrialsregister.eu/ctr-search/trial/2020-003755-15/IT)。

研究思路结论见上方概要

胶质母细胞瘤(GBM)是一种预后不良的4级胶质瘤。手术切除后,标准治疗包括同步放疗(RT)和替莫唑胺(TMZ),随后单用TMZ。我们先前在黑色素瘤患者中的数据表明,树突状细胞疫苗(DCvax)可以增加瘤内活化的细胞毒性T淋巴细胞的数量。

这是一项单臂、单中心的II期试验,按照Simon设计分两步进行。该试验旨在评估切除后GBM患者接受DCvax联合标准治疗的三個月无进展生存期(PFS)和安全性。DCvax给药在RT-CT完成后开始,每周给药一次,持续4周,然后与TMZ周期交替每月给药。主要终点是三个月时的PFS和安全性。次要目标之一是评估体外和体内(DTH皮肤试验)的免疫反应。

截至2022年12月,研究的第一个预设阶段已完成,共入组、治疗并随访了9例可评估患者。两例患者在白细胞分离术后三个月内出现疾病进展,但无一例发生与DCvax相关的G3-4毒性。五例患者对KLH的DTH试验呈阳性,其中一例对自体肿瘤匀浆也呈阳性。自白细胞分离术起的中位PFS为11.3个月,自手术起为12.2个月。

展开英文摘要原文

Glioblastoma (GBM) is a poor prognosis grade 4 glioma. After surgical resection, the standard therapy consists of concurrent radiotherapy (RT) and temozolomide (TMZ) followed by TMZ alone. Our previous data on melanoma patients showed that Dendritic Cell vaccination (DCvax) could increase the amount of intratumoral-activated cytotoxic T lymphocytes.

This is a single-arm, monocentric, phase II trial in two steps according to Simon's design. The trial aims to evaluate progression-free survival (PFS) at three months and the safety of a DCvax integrated with standard therapy in resected GBM patients. DCvax administration begins after completion of RT-CTwith weekly administrations for 4 weeks, then is alternated monthly with TMZ cycles. The primary endpoints are PFS at three months and safety. One of the secondary objectives is to evaluate the immune response both in vitro and in vivo (DTH skin test).

By December 2022, the first pre-planned step of the study was concluded with the enrollment, treatment and follow up of 9 evaluable patients. Two patients had progressed within three months after leukapheresis, but none had experienced DCvax-related G3-4 toxicities Five patients experienced a positive DTH test towards KLH and one of these also towards autologous tumor homogenate. The median PFS from leukapheresis was 11.3 months and 12.2 months from surgery.

This combination therapy is well-tolerated, and the two endpoints required for the first step have been achieved. Therefore, the study will proceed to enroll the remaining 19 patients. (Eudract number: 2020-003755-15 https://www.clinicaltrialsregister.eu/ctr-search/trial/2020-003755-15/IT).

论文信息

作者
Ridolfi L、Gurrieri L、Riva N、Bulgarelli J、De Rosa F、Guidoboni M、Fausti V、Ranallo N
第一作者单位
Experimental and Clinical Oncology of Immunotherapy and Rare Cancers, Biobank Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.Italy
通讯作者单位
Neurosurgery Unit Maurizio Bufalini Hospital, Cesena, Italy.Italy
文献类型
II 期临床试验 · 非美国政府资助研究
期刊
Frontiers in immunology2024
原文标识
PubMed 39192978 · DOI 10.3389/fimmu.2024.1404861