Phase I trial of a formulated IL-12 plasmid in combination with carboplatin and docetaxel chemotherapy in the treatment of platinum-sensitive recurrent ovarian cancer

Gynecol Oncol. 2013 Oct;131(1):169-73. doi: 10.1016/j.ygyno.2013.07.081. Epub 2013 Jul 14.

Abstract

Objectives: The primary objective of this study was to evaluate the safety and tolerability of a formulated IL-12 plasmid administered intraperitoneally (IP) in conjunction with intravenous (IV) carboplatin/docetaxel in platinum-sensitive ovarian cancer patients.

Methods: Escalating doses of IL-12 plasmid (phIL-12) formulated with the lipopolymer PEG-PEI-Cholesterol (PPC) were administered IP every 10-11 days for a total of four treatments and the highest dose was expanded to eight treatments. Patients also received IV carboplatin (AUC 5) and docetaxel (75 mg/m(2)) every 21 days. Patients were followed for safety, biological activity and antitumor activity after phIL-12/PPC treatment.

Results: All 13 patients enrolled in the study received both phIL-12/PPC and chemotherapy treatment. There were 49 plasmid-associated adverse events (AEs). The most common AEs were abdominal pain, transient hypotension, low grade fever, catheter site pain, chills, dysgeusia, infusion-related reaction, and nausea. These AEs appeared to be plasmid dose related. Grade 3 AEs included manageable abdominal pain and cytokine release syndrome. There were no dose limiting toxicities and the plasmid treatment did not augment the chemotherapy-associated AEs. The best overall antitumor response (17% CR, 33% PR, 42% SD and 8% PD) was typical of the patient population enrolled for the study. Translational studies showed rise in IFN-γ and TNF-α concentrations in a dose dependent manner.

Conclusions: The escalating doses and cycles of intraperitoneal phIL-12/PPC when combined with carboplatin/docetaxel chemotherapy in recurrent ovarian cancer patients were well tolerated and did not appear to exacerbate the side effects or attenuate the efficacy of the chemotherapy treatment.

Keywords: Chemotherapy; Gene therapy; Interleukin-12; Ovarian cancer; Plasmid DNA.

Publication types

  • Clinical Trial, Phase I
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Abdominal Pain / chemically induced
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carboplatin / administration & dosage
  • Carcinoma, Ovarian Epithelial
  • Chills / chemically induced
  • Docetaxel
  • Dysgeusia / chemically induced
  • Female
  • Fever / chemically induced
  • Genetic Therapy
  • Humans
  • Hypotension / chemically induced
  • Interleukin-12 / administration & dosage
  • Interleukin-12 / adverse effects*
  • Interleukin-12 / genetics
  • Middle Aged
  • Nausea / chemically induced
  • Neoplasms, Glandular and Epithelial / drug therapy*
  • Ovarian Neoplasms / drug therapy*
  • Plasmids / administration & dosage
  • Taxoids / administration & dosage

Substances

  • Taxoids
  • Docetaxel
  • Interleukin-12
  • Carboplatin