Relationship of infusion duration to safety, efficacy, and pharmacodynamics (PD): Second part of a phase I-II study using VSV-IFNβ-NIS (VV1) oncolytic virus in patients with refractory solid tumors.

Authors

null

Jaime R. Merchan

University of Miami, Miami, FL

Jaime R. Merchan , Manish Patel , Timothy P. Cripe , Matthew O. Old , James Fredric Strauss , Amber Thomassen , Rosa M Diaz , Kah Whye Peng , Stephen J. Russell , Luke Russell , Monica Reckner , Erol Wiegert , Alice Susannah Bexon , Steven Francis Powell

Organizations

University of Miami, Miami, FL, University of Minnesota, Department of Medicine, Minneapolis, MN, Nationwide Children's Hospital, Columbus, OH, Ohio State University-Arthur James Cancer Hospital, Columbus, OH, Texas Oncology, Dallas, TX, University of Miami-Sylvester Comprehensive Cancer Center, Miami, FL, Vyriad, Rochester, MN, Vyriad and Mayo Clinic, Rochester, MN, Bexon Clinical Consulting LLC, Montclair, NJ, Bexon Clinical Consulting, Montclair, NJ, Sanford Health, Sioux Falls, SD

Research Funding

Pharmaceutical/Biotech Company
Vyriad

Background: VV1 (Voyager V1) is derived from VSV, an RNA virus with low human seroprevalence, engineered to replicate selectively in and kill human cancer cells. In Part 1 of this study, we demonstrated the safety of intratumoral VV1 and dose-response, using serum IFNβ as a biomarker; we observed viral replication in tumor and concomitant lymphocyte/neutrophil trafficking (SITC 2018). 2 other studies suggested greater efficacy and higher IFNβ levels with IV administration. Longer infusion durations were reported to mitigate infusion reactions (IRRs) for another oncolytic. Methods: We studied 3 different infusion durations of VV1 monotherapy at the recommended phase 2 IV dose (1.7 x 1010 TCID50) in patients with advanced solid tumors. Endpoints included safety, preliminary anti-tumor activity, viral titers, IFNβ PD and shedding. Patients received IV VV1 once on D1 and were monitored for DLT over 21 days with efficacy assessments every 6 weeks. IRRs were classified using Lee 2014 criteria for CRS as either constitutional symptoms only (G1) or involving hypotension (G2). Results: 18 patients were treated at 30, 60 and 180-minute durations (n = 7, 5 and 6, respectively). No DLTs, deaths or G3-4 related IRR AEs were observed. Most pts were female (67%), white (100%), with ECOG PS 0 (61%) and median 4 lines of prior systemic therapy (range 1-14) for colorectal (CRC; 56%), squamous cell carcinoma (11%), pheochromocytoma (11%), sarcoma (11%) or other (11%) cancers. The table shows results (number of patients) by infusion duration. Conclusions: There was no difference in safety between the 3 infusion durations, while efficacy and PD markers suggested better anti-tumor effect with 30-minute infusion. VV1 is safe for caregivers, with no viral shedding. Part 3 of this study will now treat CRC patients with VV1 in combination with a checkpoint inhibitor (avelumab). A 5-arm phase 2 basket study in combination with cemiplimab is proceeding with 30-minute infusions. Clinical trial information: NCT02923466.

Duration (mins)NIRR G1IRR G2Total IRRsRECIST PR/
SD
IFNβ
> 150 pg/mL
Shedding
307437540
605415300
1806235100

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Developmental Therapeutics—Immunotherapy

Track

Developmental Therapeutics—Immunotherapy

Sub Track

New Targets and New Technologies (IO)

Clinical Trial Registration Number

NCT02923466

Citation

J Clin Oncol 38: 2020 (suppl; abstr 3090)

DOI

10.1200/JCO.2020.38.15_suppl.3090

Abstract #

3090

Poster Bd #

154

Abstract Disclosures