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2022 ASCO:RP1+nivo治疗皮肤癌的疗效与安全性——IGNYTE研究的最新结果

2022-05-31 MedSci原创 MedSci原创

RP1是HSV1的一款溶瘤单纯疱疹病毒,共表达人类GM-CSF和GALV-GP R-。

RP1是HSV1的一款溶瘤单纯疱疹病毒,共表达人类GM-CSF和GALV-GP R-。IGNYTE是一项多队列1/2期研究,评估RP1与nivo(NCT03767348)联合使用在一系列肿瘤治疗中的安全性和有效性。初步数据显示,RP1+nivo具有持久的抗肿瘤活性和耐受性。本文中,我们介绍了RP1+nivo在初治黑色素瘤(mel)和未经抗PD1治疗的非黑色素瘤皮肤癌(NMSC)队列的最新结果。

通过瘤内注射RP1给药Q2W,最多10毫升/次,先单独给药,剂量为106 PFU/mL,然后从第二剂量107 PFU/mL开始,与nivo联合使用(240 mg IV Q2W,4个月,然后480 mg IV Q4W,最多2年),最多8次,可选择重新启动RP-1。符合条件的患者必须至少有一个≥1cm的可测量和可注射的肿瘤,ECOG 0-1,并且之前没有接受过溶瘤疗法。

提取截至2022年1月31日的数据,13/36名黑色素瘤患者(36.1%)和19/31名NMSC患者(61.3%)的最佳反应为PR或CR。对于黑色素瘤、未经抗PD1治疗、抗PD-1/抗PD-1+抗CTLA-4失败的患者来说,比例分别为5/8(62.5%)、6/16(37.5%)、0/6和2/6(33.3%)的皮肤、葡萄膜和粘膜黑色素瘤患者。对于未经抗PD1治疗的NMSC,CSCC、BCC、MCC和血管肉瘤患者的比例分别为11/17(64.7%)、1/4(25%)、3/4(75%)和4/6(66.6%),对于CSCC患者CR的比例为8/17(47.1%)。目前不成熟的黑色素瘤中位DOR为13.27个月(目前范围为3.67-16.93个月),未经抗PD1治疗的NMSC为7.32个月(目前范围1.88-23.11个月)。所有队列中各种等级的TEAE(>25%)都是疲劳、恶心、热病、寒战、腹泻、瘙痒和流感样疾病。TEAE≥3级(>5%)为疾病进展和疲劳。没有观察到与RP1有关的死亡,一例死亡与nivo有关(心肌炎)。来自配对组活检的生物标志物数据表明,治疗后T细胞浸润明显,肿瘤炎症基因特征增加。观察到的临床反应与基线肿瘤PD-L1的表达状态无关。

综上所述,该研究结果表明,RP1联合nivo为皮肤癌患者提供了持久的抗肿瘤活性,包括抗PD1失败和抗PD1/抗CTLA-4失败的黑色素瘤患者。该组合治疗的耐受性普遍良好,没有发现新的安全信号。基于这些数据,目前正在招募抗PD1治疗失败的皮肤癌患者(n = 125)和抗PD1治疗失败的NMSC患者(n = 30)的注册定向队列。这个正在进行的试验的最新数据将在会议上报告。一项关于RP1+西米普利单抗与单独使用西米普利单抗治疗抗PD1失败的NMSC的随机Ph2试验也正在进行中(NCT04050436)。临床试验注册号:NCT03767348。

原始出处:

Mohammed M. Milhem, et al., Updated results from the skin cancer cohorts from an ongoing phase 1/2 multicohort study of RP1, an enhanced potency oncolytic HSV, combined with nivolumab (IGNYTE). ASCO 2022.

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    2023-02-13 quxin068
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    2023-01-19 tamgche
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    2022-11-16 贵阳
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    2022-05-31 萌宝嘟嘟

    好东西 谢谢分享

    0

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