在先进固体瘤患者中与ipilimumab结合使用莱菲托利莫德:一期I期试验
Mirella Nardo1, Mohamed A Gouda1, Matthew J Reilley1
1Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Journal of immunotherapy and precision oncology
|February 17, 2025
概括
这一I期试验发现,将莱菲托利莫德 (TLR9激动剂) 与伊皮利马布结合使用对于晚期癌症是安全的. 虽然显示了适度的抗瘤效应,但它诱导了促炎性瘤微环境,表明了基于免疫的癌症治疗的潜力.
科学领域:
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
- 临床试验 临床试验
背景情况:
- 收费类受体9 (TLR9) 激动剂是用于癌症免疫治疗的免疫调节剂.
- 莱菲托利莫德 (MGN1703),一种TLR9激动剂,在临床前和早期临床研究中显示出有前途.
- 将免疫调节剂与检查点抑制剂 (如伊皮利马布) 结合起来,是一种增强抗癌反应的策略.
研究的目的:
- 评估在患有晚期固体瘤的患者中将莱菲托利莫德与伊皮利穆马布联合使用的安全性和初步疗效.
- 评估结合疗法在瘤微环境中的免疫调节作用.
主要方法:
- 一个单中心,开放标签,I期试验,涉及28名患有高级固体瘤的患者.
- 莱菲托利莫德是通过皮下或内注射,用不断升级的剂量,与伊皮利穆马布 (3毫克/公斤) 结合使用.
- 结合的瘤活检通过流细胞计分析,以评估免疫细胞的变化.
主要成果:
- 组合疗法安全且耐受良好,没有剂量限制性毒性或4/5级不良事件.
- 11名患者经历了与治疗相关的不良事件,最常见的是皮疹和疲劳.
- 观察到适度的抗瘤活性,其中8名患者实现了稳定的疾病.
- 活检显示内CD8T细胞的频率和增殖增加,表明免疫激活.
结论:
- 在患有晚期癌症的患者中, lefitolimod 和 ipilimumab 的组合是安全的和可以容忍的.
- 该疗法表现出适度的临床疗效,但在瘤微环境中引起了有利的变化.
- 需要进一步的研究来探索这种组合在癌症免疫治疗中的潜力.
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