First-in-human evaluation of memory-like NK cells with an IL-15 super-agonist and CTLA-4 blockade in advanced head and neck cancer.

IF 29.5 1区 医学 Q1 HEMATOLOGY
Roman M Shapiro, Michal Sheffer, Matthew A Booker, Michael Y Tolstorukov, Grace C Birch, Moshe Sade-Feldman, Jacy Fang, Shuqiang Li, Wesley Lu, Michela Ansuinelli, Remy Dulery, Mubin Tarannum, Joanna Baginska, Nishant Dwivedi, Ashish Kothari, Livius Penter, Yasmin Z Abdulhamid, Isabel E Kaplan, Dinh Khanhlinh, Ravindra Uppaluri, Robert A Redd, Sarah Nikiforow, John Koreth, Jerome Ritz, Catherine J Wu, Robert J Soiffer, Glenn J Hanna, Rizwan Romee
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引用次数: 0

Abstract

Background: Cytokine induced memory-like natural killer (CIML NK) cells combined with an IL-15 super-agonist (N-803) are a novel modality to treat relapsed/refractory head and neck cancer.

Methods: We report data from a phase I trial of haploidentical CIML NK cells combined with N-803 with or without ipilimumab (IPI) in relapsed/refractory head and neck cancer patients after a median of 6 prior lines of therapy. The trial adhered to a 3 + 3 dose de-escalation design, with primary endpoint being safety. High-resolution immunophenotypic and transcriptional profiling characterized the NK cells and their interacting partners in vivo.

Results: The primary safety endpoint was established, with dose-limiting toxicity in 1/10 patients. A transient disease control rate correlated with donor NK cell expansion, the latter occurring irrespective of IPI. The combination of CIML NK cells with N-803 and IPI was associated with increased early NK cell proliferation, contraction of Treg: Tcon, rapid recovery of recipient CD8+ T cells, and subsequent accelerated rejection of donor NK cells.

Conclusions: CIML NK cells combined with N-803 and ipilimumab to treat head and neck cancer is safe, and associated with a more proliferative NK cell phenotype. However, the combination leads to reduced HLA mismatched NK cell persistence, resulting in an important limitation affecting NK cell combination therapies in clinical trials. These results inform evaluation of CIML NK therapy for advanced malignancies, with considerations for combination with IPI.

Trial registration: NCT04290546.

IL-15超级激动剂和CTLA-4阻断治疗晚期头颈癌的记忆样NK细胞的首次人体评估
背景:细胞因子诱导的记忆样自然杀伤(CIML NK)细胞联合IL-15超级激动剂(N-803)是治疗复发/难治性头颈癌的一种新方式。方法:我们报告了一项I期试验的数据,该试验将单倍体CIML NK细胞与N-803联合使用或不使用ipilimumab (IPI)治疗复发/难治性头颈癌患者,中位既往治疗6线。试验采用3 + 3剂量递减设计,主要终点为安全性。高分辨率的免疫表型和转录谱表征了NK细胞及其在体内的相互作用伙伴。结果:建立了主要安全终点,1/10患者出现剂量限制性毒性。短暂性疾病控制率与供体NK细胞扩增相关,后者与IPI无关。CIML NK细胞与N-803和IPI的结合与早期NK细胞增殖增加、Treg: Tcon收缩、受体CD8+ T细胞快速恢复以及随后供体NK细胞的加速排斥有关。结论:CIML NK细胞联合N-803和ipilimumab治疗头颈癌是安全的,并且与更增殖的NK细胞表型相关。然而,这种组合导致HLA错配NK细胞持久性降低,这是影响临床试验中NK细胞联合治疗的一个重要限制。这些结果为评估CIML NK治疗晚期恶性肿瘤提供了信息,并考虑了与IPI联合治疗。试验注册:NCT04290546。
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来源期刊
CiteScore
48.10
自引率
2.10%
发文量
169
审稿时长
6-12 weeks
期刊介绍: The Journal of Hematology & Oncology, an open-access journal, publishes high-quality research covering all aspects of hematology and oncology, including reviews and research highlights on "hot topics" by leading experts. Given the close relationship and rapid evolution of hematology and oncology, the journal aims to meet the demand for a dedicated platform for publishing discoveries from both fields. It serves as an international platform for sharing laboratory and clinical findings among laboratory scientists, physician scientists, hematologists, and oncologists in an open-access format. With a rapid turnaround time from submission to publication, the journal facilitates real-time sharing of knowledge and new successes.
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