Most gastrointestinal (GI) cancers have microsatellite-stable (MSS) tumors, which have an immunologically 'cold' phenotype with fewer genetic mutations, reduced immune cell infiltration and downregulated immune checkpoint proteins. These attributes make MSS tumors resistant to conventional immunotherapy including checkpoint blockade therapy. Pelareorep is a naturally occurring, nongenetically modified reovirus. Upon intravenous administration, pelareorep selectively kills tumor cells and promotes several immunologic changes that prime tumors to respond to checkpoint blockade therapy. Given its demonstrated synergy with checkpoint blockade, as well as its encouraging efficacy in prior GI cancer studies, pelareorep plus atezolizumab will be evaluated in the GOBLET study in multiple GI cancer indications.
Keywords: anal cancer; biomarkers/oncogenes/molecular oncology; colorectal cancer; gastrointestinal/colorectal; gastrointestinal/pancreatic-biliary; immunotherapy; oncolytic virus; pancreatic cancer; pelareorep.
The GOBLET study is investigating a new drug combination for gastrointestinal tumors, specifically pancreatic, colorectal and anal cancers, which have already spread or might spread to the body. Currently, the standard treatment in most gastrointestinal tumors still consists of chemotherapy. Newer drugs (immune checkpoint inhibitors [ICIs]), which activate the body's natural defenses (immune system) and consequently increase the triggering of the immune system against tumor cells, have been developed and are commonly used as a single agent or in combination with chemotherapy. Yet, these are only effective in a small subset of patients. Certain drugs can also make tumors respond better to ICIs. One such drug being tested is pelareorep. Pelareorep is a safe virus that detects and kills only cancer cells and has shown promising results by increasing the activity of the patient's immune system toward the tumor in combination with ICIs in previous studies. The new drug combination (ICI plus virus) is used together with or without chemotherapy in this study. The aim of the GOBLET study is to investigate the safety of the new drug combination and assess improvements in tumor size related to treatment. Eudra-CT Number: 2020-003996-16.