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Senzer NN, Kaufman HL, Amatruda T, Nemunaitis M, Reid T, Daniels G, Gonzalez R, Glaspy J, Whitman E, Harrington K, Goldsweig H, Marshall T, Love C, Coffin R, Nemunaitis JJ. Phase II Clinical Trial of a Granulocyte-Macrophage Colony-Stimulating Factor–Encoding, Second-Generation Oncolytic Herpesvirus in Patients With Unresectable Metastatic Melanoma. J Clin Oncol 2009; 27:5763-71. [DOI: 10.1200/jco.2009.24.3675] [Citation(s) in RCA: 472] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PurposeTreatment options for metastatic melanoma are limited. We conducted this phase II trial to assess the efficacy of JS1/34.5-/47-/granulocyte-macrophage colony-stimulating factor (GM-CSF) in stages IIIc and IV disease.Patients and MethodsTreatment involved intratumoral injection of up to 4 mL of 106pfu/mL of JS1/34.5-/47-/GM-CSF followed 3 weeks later by up to 4 mL of 108pfu/mL every 2 weeks for up to 24 treatments. Clinical activity (by RECIST [Response Evaluation Criteria in Solid Tumors]), survival, and safety parameters were monitored.ResultsFifty patients (stages IIIc, n = 10; IVM1a, n = 16; IVM1b, n = 4; IVM1c, n = 20) received a median of six injection sets; 74% of patients had received one or more nonsurgical prior therapies for active disease, including dacarbazine/temozolomide or interleukin-2 (IL-2). Adverse effects were limited primarily to transient flu-like symptoms. The overall response rate by RECIST was 26% (complete response [CR], n = 8; partial response [PR], n = 5), and regression of both injected and distant (including visceral) lesions occurred. Ninety-two percent of the responses had been maintained for 7 to 31 months. Ten additional patients had stable disease (SD) for greater than 3 months, and two additional patients had surgical CR. On an extension protocol, two patients subsequently achieved CR by 24 months (one previously PR, one previously SD), and one achieved surgical CR (previously PR). Overall survival was 58% at 1 year and 52% at 24 months.ConclusionThe 26% response rate, with durability in both injected and uninjected lesions including visceral sites, together with the survival rates, are evidence of systemic effectiveness. This effectiveness, combined with a limited toxicity profile, warrants additional evaluation of JS1/34.5-/47-/GM-CSF in metastatic melanoma. A US Food and Drug Administration–approved phase III investigation is underway.
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Affiliation(s)
- Neil N. Senzer
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Howard L. Kaufman
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Thomas Amatruda
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Mike Nemunaitis
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Tony Reid
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Gregory Daniels
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Rene Gonzalez
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - John Glaspy
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Eric Whitman
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Kevin Harrington
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Howard Goldsweig
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Tracey Marshall
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Colin Love
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - Robert Coffin
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
| | - John J. Nemunaitis
- From the Mary Crowley Cancer Research Centers; Texas Oncology Physicians Association; and Baylor Sammons Cancer Center, Dallas, TX; Columbia University, Department of Surgery, New York, NY; Hubert H. Humphrey Cancer Center, Robbinsdale, MN; University of Colorado, Aurora, CO; University of California, San Diego Cancer Center, La Jolla; and University of California, Los Angeles, Los Angeles, CA; Mountainside Hospital, Montclair, NJ; Royal Marsden Hospital, London, United Kingdom; and BioVex, Woburn, MA
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