Oncotarget

Clinical Research Papers:

A phase-1/2 study of adenovirus-p53 transduced dendritic cell vaccine in combination with indoximod in metastatic solid tumors and invasive breast cancer

Hatem Soliman _, Fatema Khambati, Hyo S. Han, Roohi Ismail-Khan, Marilyn M. Bui, Daniel M. Sullivan and Scott Antonia

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Oncotarget. 2018; 9:10110-10117. https://doi.org/10.18632/oncotarget.24118

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Abstract

Hatem Soliman1,2, Fatema Khambati2, Hyo S. Han1, Roohi Ismail-Khan1, Marilyn M. Bui3, Daniel M. Sullivan4 and Scott Antonia2,5

1Breast Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

2Immunology Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

3Anatomic Pathology Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

4Malignant Hematology Department, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

5Thoracic Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

Correspondence to:

Hatem Soliman, email: [email protected]

Keywords: indoximod; adenovirus-p53 transduced dendritic cell vaccine; cancer vaccine; immunotherapy; indoleamine 2,3-dioxygenase

Received: October 03, 2017     Accepted: November 28, 2017     Published: January 10, 2018

ABSTRACT

Background: Indoleamine 2, 3-dioxygenase is an enzyme that causes immunosuppression in tumors. Indoximod inhibits the indoleamine 2, 3-dioxygenase pathway and enhances immunologic responses to dendritic cell (DC) vaccines preclinically. Adenovirus p53 (Ad.p53) is used to generate DC vaccines against p53. A phase-1/2 trial of indoximod with Ad.p53-DC vaccine was conducted.

Materials and Methods: The phase-1 study combined 7 indoximod dose levels with < 6 Ad.p53-DC vaccinations every 2 weeks. Primary endpoints were maximum-tolerated dose in phase 1 and objective response in phase 2. Flow cytometry measured immune responses.

Results: Thirty-nine patients were treated. In combination with Ad.p53-DC vaccine, the maximum-tolerated dose of indoximod was 1600 mg twice daily. Attributable toxicities were grade 1–2. Best response was stable disease in 4 patients. Immunologic responses were detected in 7 out of 23 evaluable patients. Median progression-free survival was 13.3 weeks (95% confidence interval, 12.97–21.85) and median overall survival was 20.71 weeks (95% confidence interval, 25.75–46.15). Nine out of 22 patients (40%) benefitted from chemotherapy after vaccination. Median overall survival in chemotherapy responders was 69.4 weeks (30.1–122.1).

Conclusions: Indoximod 1600 mg twice daily with Ad.p53-DC was well tolerated. There may have been a chemosensitization effect. Future trials should explore combining this treatment with chemotherapy.


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