A phase I clinical trial of RNF43 peptide-related immune cell therapy combined with low-dose cyclophosphamide in patients with advanced solid tumors

PLoS One. 2018 Jan 2;13(1):e0187878. doi: 10.1371/journal.pone.0187878. eCollection 2018.

Abstract

The objective of this study was to investigate the safety and the tolerability of combined cellular immunotherapy with low-dose cyclophosphamide (CPA) in patients with advanced solid tumors. This study targeted a novel tumor-associated antigen, ring finger protein 43 (RNF43). Eligible patients were resistant to standard therapy, HLA-A*24:02- or A*02:01-positive and exhibiting high RNF43 expression in their tumor cells. They were administered 300 mg/m2 CPA followed by autologous lymphocytes, preliminarily cultured with autologous RNF43 peptide-pulsed dendritic cells (DCs), RNF43 peptide-pulsed DCs and systemic low dose interleukin-2. The primary endpoint was safety whereas the secondary endpoint was immunological and clinical response to treatment. Ten patients, in total, were enrolled in this trial. Primarily, no adverse events greater than Grade 3 were observed. Six out of 10 patients showed stable disease (SD) on day 49, while 4 other patients showed progressive disease. In addition, one patient with SD exhibited a partial response after the second trial. The frequency of regulatory T cells (Tregs) in patients with SD significantly decreased after CPA administration. The ratio of interferon-γ-producing, tumor-reactive CD8+ T cells increased with time in patients with SD. We successfully showed that the combination of immune cell therapy and CPA was safe, might induce tumor-specific immune responses and clinical efficacy, and was accompanied by a decreased ratio of Tregs in patients with RNF43-positive advanced solid tumors.

Publication types

  • Clinical Trial, Phase I
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents, Alkylating / therapeutic use*
  • Combined Modality Therapy
  • Cyclophosphamide / therapeutic use*
  • DNA-Binding Proteins / chemistry*
  • Dose-Response Relationship, Drug
  • Feasibility Studies
  • Female
  • Humans
  • Immunophenotyping
  • Immunotherapy*
  • Male
  • Middle Aged
  • Neoplasms / drug therapy
  • Neoplasms / immunology
  • Neoplasms / therapy*
  • Oncogene Proteins / chemistry*
  • Peptides / adverse effects
  • Peptides / therapeutic use*
  • Real-Time Polymerase Chain Reaction
  • Ubiquitin-Protein Ligases

Substances

  • Antineoplastic Agents, Alkylating
  • DNA-Binding Proteins
  • Oncogene Proteins
  • Peptides
  • Cyclophosphamide
  • RNF43 protein, human
  • Ubiquitin-Protein Ligases

Grants and funding

This study was financially supported by Grant-in-Aid for Scientific Research of Japan Society for the Promotion of Science (YS24790708, YS22790651) and Ministry of Education, Culture, Sports, Science and Technology for the Coordination, Support and Training Program for Translational Research (08061012). Additionally, K.T. received a commercial research grant from OncoTherapy Science, Inc. in 2007. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.