A phase I/II clinical trial of autologous CMV-specific T cells in glioblastoma (GBM) patients to reveal a lack of immune effector function.

Authors

null

Shiao-Pei S. Weathers

The University of Texas MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, TX

Shiao-Pei S. Weathers , Marta Penas-Prado , Pinaki Prosad Banerjee , Mustafa Bdiwi , Hila Shaim , Abdullah Alsuliman , Mayra Shanley , James Long , John Frederick De Groot , Barbara Jane O'Brien , Nazanin Majd , Rebecca A. Harrison , Carlos Kamiya-Matsuoka , Gregory N. Fuller , Linda Chi , Ganesh Rao , Frederick F. Lang , Elizabeth J. Shpall , Katayoun Rezvani , Amy B. Heimberger

Organizations

The University of Texas MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, TX, Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, Wayne State University, Detroit, MI, University of Texas Medical Branch, Galveston, TX, King Faisal Specialist Hospital& Research Centre (MBC-03), Riyadh, Saudi Arabia, University of Texas MD Anderson Cancer Center, Houston, TX, Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, The University of Texas, MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, TX, MD Anderson Cancer Center, Houston, TX, The University of Texas MD Anderson Cancer Center, Houston, TX, University of Texas M. D. Anderson Cancer Center, Houston, TX, The University of Texas MD Anderson Cancer Center, Department of Neurosurgery, Houston, TX

Research Funding

Other
MD Anderson Glioblastoma Moon Shots Program, Other Foundation

Background: Cytomegalovirus (CMV) antigens are present in > 90% of GBMs but not in normal brain making it an attractive immunological target. Methods: Highly functional autologous polyclonal CMV pp65 specific T cells were expanded under GMP-compliant conditions from GBM patients and administered after 3 weeks of lymphodepleting dose-dense temozolomide (ddTMZ, 100 mg/m2). The phase I component used a 3+3 design ascending through four dose levels (5 x 106 cells to 1 x 108 cells). Treatment was repeated every 6 weeks for a total of 4 cycles. Dose expansion was conducted in recurrent GBM patients undergoing resection and in newly diagnosed GBM patients following concurrent chemoradiation. In vivo persistence and effector function of the adoptively transferred CMV-specific T cells was determined by dextramer staining and multiparameter flow cytometry in serially-sampled peripheral blood and in the tumor microenvironment. Results: 65 patients were screened, 25 underwent leukapheresis, and 20 completed at least 1 cycle. Median age 48 (27-69), 35% were MGMT methylated, and 10% were IDH mutated. No dose limiting toxicities (DLTs) observed. Complete radiographic response was observed in 1 patient, partial responses in 2, stable disease in 9, and progressive disease in 8. The median PFS time was 1.3 months (95% CI: 0-8.3 months) and the median OS time was 12 months (95% CI: 6 months to not reached). Repeated infusions of CMV-TC were associated with significant increase in circulating CMV+ CD8+ T cells, but cytokine production reflective of effector activity (CD107a, TNFα, IFNγ, IL2) was suppressed in these cells including directly from the GBM microenvironment. Conclusions: Adoptive infusion of CMV-specific T cells after lymphodepleting ddTMZ was well-tolerated. However, effector function of the adoptively transferred T cells was attenuated indicating further modulation of the T cell is required to prevent its dysfunction prior to proceeding to large scale clinical studies. Clinical trial information: NCT02661282.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Discussion Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Central Nervous System Tumors

Clinical Trial Registration Number

NCT02661282

Citation

J Clin Oncol 38: 2020 (suppl; abstr 2515)

DOI

10.1200/JCO.2020.38.15_suppl.2515

Abstract #

2515

Poster Bd #

6

Abstract Disclosures

Similar Abstracts

First Author: Dorota Goplen

First Author: Esma Saada-Bouzid

Abstract

2022 ASCO Annual Meeting

Toxicity of concurrent and adjuvant temozolomide in patients with glioblastoma multiforme (GBM).

First Author: David Mcmahon