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Shore ND, Morrow MP, McMullan T, Kraynyak KA, Sylvester A, Bhatt K, Cheung J, Boyer JD, Liu L, Sacchetta B, Rosencranz S, Heath EI, Nordquist L, Cheng HH, Tagawa ST, Appleman LJ, Tutrone R, Garcia JA, Whang YE, Kelly WK, Weiner DB, Bagarazzi ML, Skolnik JM. CD8 + T Cells Impact Rising PSA in Biochemically Relapsed Cancer Patients Using Immunotherapy Targeting Tumor-Associated Antigens. Mol Ther 2020; 28:1238-1250. [PMID: 32208168 DOI: 10.1016/j.ymthe.2020.02.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 02/26/2020] [Indexed: 11/16/2022] Open
Abstract
The management of men with prostate cancer (PCa) with biochemical recurrence following local definitive therapy remains controversial. Early use of androgen deprivation therapy (ADT) leads to significant side effects. Developing an alternative, clinically effective, and well-tolerated therapy remains an unmet clinical need. INO-5150 is a synthetic DNA therapy that includes plasmids encoding for prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA), and INO-9012 is a synthetic DNA plasmid encoding for interleukin-12 (IL-12). This phase 1/2, open-label, multi-center study enrolled men with PCa with rising PSA after surgery and/or radiation therapy. Patients were enrolled into one of four treatment arms: arm A, 2 mg of INO-5150; arm B, 8.5 mg of INO-5150; arm C, 2 mg of INO-5150 + 1 mg of INO-9012; and arm D, 8.5 mg of INO-5150 + 1 mg of INO-9012. Patients received study drug with electroporation on day 0 and on weeks 3, 12, and 24, and they were followed for up to 72 weeks. Sixty-two patients were enrolled. Treatment was well tolerated. 81% (50/62) of patients completed all visits. 85% (53/62) remained progression-free at 72 weeks. PSA doubling time (PSADT) was increased when assessed in patients with day 0 PSADT ≤12 months. Immunogenicity was observed in 76% (47/62) of patients by multiple assessments. Analysis indicated that CD38 and perforin co-positive CD8 T cell frequency correlated with attenuated PSA rise (p = 0.05, n = 50).
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Affiliation(s)
- Neal D Shore
- Carolina Urologic Research Center, Myrtle Beach, SC, USA
| | | | | | | | | | - Khamal Bhatt
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | | | - Jean D Boyer
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | - Li Liu
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | | | | | | | - Luke Nordquist
- GU Research Network LLC/Urology Cancer Center, Omaha, NE, USA
| | - Heather H Cheng
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | - Ronald Tutrone
- Greater Baltimore Medical Center (GBMC), Chesapeake Urology Associates (CUA), Towson, MD, USA
| | | | - Young E Whang
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Paller CJ, Zhou XC, Heath EI, Taplin ME, Mayer T, Stein MN, Bubley GJ, Pili R, Hudson T, Kakarla R, Abbas MM, Anders NM, Dowling D, King S, Bruns AB, Wagner WD, Drake CG, Antonarakis ES, Eisenberger MA, Denmeade SR, Rudek MA, Rosner GL, Carducci MA. Muscadine Grape Skin Extract (MPX) in Men with Biochemically Recurrent Prostate Cancer: A Randomized, Multicenter, Placebo-Controlled Clinical Trial. Clin Cancer Res 2017; 24:306-315. [PMID: 29113986 DOI: 10.1158/1078-0432.ccr-17-1100] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 09/21/2017] [Accepted: 11/01/2017] [Indexed: 01/18/2023]
Abstract
Purpose: MuscadinePlus (MPX), a commercial preparation of pulverized muscadine grape skin, was evaluated as a therapeutic option for men with biochemically recurrent (BCR) prostate cancer wishing to defer androgen deprivation therapy.Experimental Design: This was a 12-month, multicenter, placebo-controlled, two-dose, double-blinded trial of MPX in 125 men with BCR prostate cancer, powered to detect a PSA doubling time (PSADT) difference of 6 months (low dose) and 12 months (high dose) relative to placebo. Participants were stratified (baseline PSADT, Gleason score) and randomly assigned 1:2:2 to receive placebo, 500 mg MPX (low), or 4,000 mg MPX (high) daily. Correlates included superoxide dismutase-2 (SOD2) genotype, lipid peroxidation, and polyphenol pharmacokinetics.Results: The evaluable population included 112 patients, all treated for at least 6 months and 62% treated for 12 months. No significant difference was found in PSADT change between control and treatment arms (P = 0.81): control 0.9 months (n = 20; range, 6.7-83.1), low dose 1.5 months (n = 52; range, 10.3-87.2), high dose 0.9 months (n = 40; range, 27.3-88.1). One high-dose patient experienced objective response. No drug-related CTCAE grade 3-4 adverse events were seen. In a preplanned exploratory analysis, PSADT pre-to-post increase was significant in the 27 (26%) genotyped patients with SOD2 Alanine/Alanine genotype (rs4880 T>C polymorphism) on MPX (pooled treatment arms; 6.4 months, P = 0.02), but not in control (1.8 months, P = 0.25).Conclusions: Compared with placebo, MPX did not significantly prolong PSADT in BCR patients over two different doses. Exploratory analysis revealed a patient population with potential benefit that would require further study. Clin Cancer Res; 24(2); 306-15. ©2017 AACR.
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Affiliation(s)
- Channing J Paller
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland.
| | - Xian C Zhou
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | | | - Tina Mayer
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Mark N Stein
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Glenn J Bubley
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Roberto Pili
- Roswell Park Cancer Institute, New York, New York
| | | | | | | | - Nicole M Anders
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Donna Dowling
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Serina King
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ashley B Bruns
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - William D Wagner
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
- Muscadine Naturals, Inc., Clemmons, North Carolina
| | - Charles G Drake
- New York-Presbyterian/Columbia University Medical Center, New York, New York
| | - Emmanuel S Antonarakis
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mario A Eisenberger
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Samuel R Denmeade
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Michelle A Rudek
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gary L Rosner
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Michael A Carducci
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, Baltimore, Maryland
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Benecchi L, Pieri AM, Destro Pastizzaro C, Potenzoni M. Evaluation of Prostate Specific Antigen Acceleration for Prostate Cancer Diagnosis. J Urol 2011; 185:821-6. [DOI: 10.1016/j.juro.2010.10.077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Indexed: 11/25/2022]
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Swanson GP, Basler JW. Prognostic factors for failure after prostatectomy. J Cancer 2010; 2:1-19. [PMID: 21197260 PMCID: PMC3005550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Accepted: 12/06/2010] [Indexed: 11/24/2022] Open
Abstract
Several randomized studies have been completed in prostate cancer that show a benefit to immediate postoperative treatment in patients undergoing prostatectomy. In one of the studies, there was even a survival advantage. In spite of those positive findings, there has been some reluctance to uniformly offer adjuvant treatment to patients. The perception is that the risk is not really high enough to warrant the risk of toxicity that comes with treatment. There are clearly factors that can help predict who is at the highest risk. Our purpose is to review those factors and identify patients that have a high enough risk justifying immediate treatment.
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Affiliation(s)
- Gregory P. Swanson
- 1. Departments of Radiation Oncology, Radiology and Urology, UT Health Science Center San Antonio, San Antonio, TX 78229, USA.,✉ Corresponding author: Gregory P. Swanson, MD, Associate Professor of Radiation Oncology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive MC7889, San Antonio, TX 78229, USA. Tel: 210-450-1109; Fax: 210-450-5085;
| | - Joseph W. Basler
- 2. Department of Urology, UT Health Science Center San Antonio, San Antonio, TX 78229, USA
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