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First-in-Human Phase 1 Study of a B Cell- and Monocyte-Based Immunotherapeutic Vaccine against HER2-Positive Advanced Gastric Cancer.

Authors
  • Jung, Minkyu1, 2
  • Lee, Jii Bum1
  • Kim, Hyo Song1, 2
  • Kwon, Woo Sun2
  • Kim, Hyun Ok3
  • Kim, Sinyoung3
  • Park, Myunghwan4
  • Kim, Wuhyun4
  • Choi, Ki-Young4
  • Oh, Taegwon4
  • Kang, Chang-Yuil4, 5
  • Chung, Hyun Cheol1, 2
  • Rha, Sun Young1, 2, 6
  • 1 Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University of College of Medicine, Seoul, Korea. , (North Korea)
  • 2 Song-dang Institute for Cancer Research, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
  • 3 Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
  • 4 Cellid, Inc., Seoul, Korea. , (North Korea)
  • 5 Laboratory of Immunology, College of Pharmacy, Seoul National University, Seoul, Korea. , (North Korea)
  • 6 Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea. , (North Korea)
Type
Published Article
Journal
Cancer research and treatment
Publication Date
Jan 01, 2024
Volume
56
Issue
1
Pages
208–218
Identifiers
DOI: 10.4143/crt.2022.1328
PMID: 37402409
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

BVAC-B is an autologous B cell- and monocyte-based immunotherapeutic vaccine that contains cells transfected with a recombinant human epidermal growth factor receptor 2 (HER2) gene and loaded with the natural killer T cell ligand alpha-galactosylceramide. Here, we report the first BVAC-B study in patients with HER2-positive advanced gastric cancer. Patients with advanced gastric cancer refractory to standard treatment with HER2+ immunohistochemistry ≥ 1 were eligible for treatment. Patients were administered low (2.5×107 cells/dose), medium (5.0×107 cells/dose), or high dose (1.0×108 cells/dose) of BVAC-B intravenously four times every 4 weeks. Primary endpoints included safety and maximum tolerated BVAC-B dose. Secondary endpoints included preliminary clinical efficacy and BVAC-B-induced immune responses. Eight patients were treated with BVAC-B at low (n=1), medium (n=1), and high doses (n=6). No dose-limiting toxicity was observed, while treatment-related adverse events (TRAEs) were observed in patients treated with medium and high doses. The most common TRAEs were grade 1 (n=2) and grade 2 (n=2) fever. Out of the six patients treated with high-dose BVAC-B, three had stable disease with no response. Interferon gamma, tumor necrosis factor-α, and interleukin-6 increased after BVAC-B treatment in all patients with medium and high dose, and HER2-specific antibody was detected in some patients. BVAC-B monotherapy had a safe toxicity profile with limited clinical activity; however, it activated immune cells in heavily pretreated patients with HER2-positive gastric cancer. Earlier treatment with BVAC-B and combination therapy is warranted for evaluation of clinical efficacy.

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