Document Type
Article
Publication Date
2019
Publication Title
Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Volume
26
Issue
3
Pages
598-607
DOI
10.1158/1078-0432.CCR-19-0972
Abstract
Purpose: Interleukin-12 (IL12) promotes adaptive type I immunity and has demonstrated antitumor efficacy, but systemic administration leads to severe adverse events (AE), including death. This pilot trial investigated safety, efficacy, and immunologic activity of intratumoral delivery of IL12 plasmid DNA (tavo) via in vivo electroporation (i.t.-tavo-EP) in patients with Merkel cell carcinoma (MCC), an aggressive virus-associated skin cancer.
Experimental Design: Fifteen patients with MCC with superficial injectable tumor(s) received i.t.-tavo-EP on days 1, 5, and 8 of each cycle. Patients with locoregional MCC (cohort A, N = 3) received one cycle before definitive surgery in week 4. Patients with metastatic MCC (cohort B, N = 12) received up to four cycles total, administered at least 6 weeks apart. Serial tumor and blood samples were collected.
Results: All patients successfully completed at least one cycle with transient, mild (grades 1 and 2) AEs and without significant systemic toxicity. Sustained (day 22) intratumoral expression of IL12 protein was observed along with local inflammation and increased tumor-specific CD8+ T-cell infiltration, which led to systemic immunologic and clinical responses. The overall response rate was 25% (3/12) in cohort B, with 2 patients experiencing durable clinical benefit (16 and 55+ months, respectively). Two cohort A patients (1 with pathologic complete remission) were recurrence-free at 44+ and 75+ months.
Conclusions: I.t.-tavo-EP was safe and feasible without systemic toxicity. Sustained local expression of IL12 protein and local inflammation led to systemic immune responses and clinically meaningful benefit in some patients. Gene electrotransfer, specifically i.t.-tavo-EP, warrants further investigation for immunotherapy of cancer.
Original Publication Citation
Bhatia, S., Longino, N. V., Miller, N. J., Kulikauskas, R. M., Iyer, J. G., Ibrani, D., Blom, A., Byrd, D. R., Parvathaneni, U., Twitty, C. G., Campbell, J. S., Le, M. H., Gargosky, S., Pierce, R. H., Heller, R., Daud, A. I., & Nghiem, P. (2019). Intratumoral delivery of plasmid IL12 via electroporation leads to regression of injected and non-injected tumors in Merkel cell carcinoma. Clinical Cancer Research, 26(3), 598-607. https://doi.org/10.1158/1078-0432.CCR-19-0972
Repository Citation
Bhatia, Shailender; Longino, Natalie V.; Miller, Natalie J.; Kulikauskas, Rima; Iyer, Jayasri G.; Ibrani, Dafina; Blom, Astrid; Byrd, David R.; Parvathaneni, Upendra; Twitty, Christopher; Campbell, Jean S.; Le, Mai H.; Gargosky, Sharron; Pierce, Robert H.; Heller, Richard; Daud, Adil; and Nghiem, Paul, "Intratumoral Delivery of Plasmid IL12 Via Electroporation Leads to Regression of Injected and Noninjected Tumors in Merkel Cell Carcinoma" (2019). Bioelectrics Publications. 279.
https://digitalcommons.odu.edu/bioelectrics_pubs/279
ORCID
0000-0003-1899-3859 (Heller)
Included in
Biomedical Engineering and Bioengineering Commons, Cancer Biology Commons, Cell Biology Commons, Oncology Commons