766 A clinical trial to evaluate the safety, tolerability and preliminary efficacy of VG161 in combination with Nivolumab in patients with advanced pancreatic cancer
Notice bibliographique
Résumé
<h3>Background</h3> VG161 is a non-attenuated HSV-1 Oncolytic virus (OV) with IL-12, IL-15, IL-15Ra and PD-L1 blocking payloads. Here we report an open label, study to evaluate the safety, pharmacokinetics (PK), and biologic effects of VG161 in patients (pts) with advanced pancreatic cancer progressed after standard of care. The study is actively recruiting. NCT05162118. <h3>Methods</h3> Dose escalation follows a 3+3 design at 3 dose levels as VG161 intratumoral injections on days 1,2,3 and Nivolumab treatment on days 22 and 28 of each 28 days treatment cycle. PK and viral shedding (DNA), samples from biopsies, blood, urine, and swabs from injection site and other anatomical locations were analyzed by PCR. Changes of cytokines and lymphocyte subsets in blood were also observed as pharmacodynamic parameters. Samples were harvested on C1D1, C1D7 and C2D1 which were analyzed by single-cell sequencing. <h3>Results</h3> As of 31 May 2023, 13 pts received doses of 1.5x10<sup>8</sup> PFU, 2.0x10<sup>8</sup> PFU and 3.0x10<sup>8</sup> PFU. 10 males and 3 females with the median age of 58 years were enrolled. 76.9% were PD(L)1 refractory,46.2% had 2 Prior lines of therapy and 13% ≥3. No Dose Limiting Toxicities were observed. Any grade treatment-related AEs (TRAEs) was 5.7%. The most common TRAEs were all grade 1 and 2. 9 pts had SAEs, including 1 pts (7%) with a related SAE (cytokine release syndrome). No TRAEs leading to dose reduction and treatment discontinuation. No pts had positive viral shedding. 11 pts were efficacy evaluable; ORR 9.1% and DCR 23.1% based on RECIST v1.1. Tumor shrinkage was also observed in non-injected lesions demonstrating an abscopal effect. According to the results of single cell data analysis, patients with advanced pancreatic cancer treated with VG161 remodeled the tumor microenvironment in the tumor, torqued from a cold tumor to a hot tumor, reduced the number of tumor cells, and significantly increased T and NK cell infiltration (T cells increased by 15% in injected lesions and NK cells increased by 3% in non-injected lesions after VG161 dosing). Moreover, patients were also more sensitive to subsequent immunosuppressive therapy. <h3>Conclusions</h3> VG161 can significantly improve the immune microenvironment and provide favorable conditions for the combination of nivolumab. <h3>Trial Registration</h3> NCT05162118 <h3>Ethics Approval</h3> Approval Letter of Clinical Research Ethics Committee of the First Affiliated Hospital, College of Medicine, Zhejiang University. ID:IIT20210108C
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».