放疗后普那布林增强树突状细胞成熟和检查点抑制剂对复发/难治性癌症的再治疗。

IF 12.8 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Med Pub Date : 2025-06-25 DOI:10.1016/j.medj.2025.100752
Steven H Lin, Vivek Subbiah, Evan N Cohen, Ziyi Li, Yingjuan June Lu, Ye Lin Son, Yue Lyu, Hui Gao, Gitanjali Jayachandran, Shinya Neri, Amrish Sharma, Penny Fang, Daniel Karp, David Hong, Jordi Rodon, Hao Yu, Jing Peng, G Kenneth Lloyd, James R Tonra, James M Reuben, Lan Huang, Siqing Fu
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引用次数: 0

摘要

背景:普林布林通过细胞骨架中解聚微管蛋白释放鸟嘌呤核苷酸交换因子(GEF)-H1发挥免疫调节活性,导致树突状细胞(DC)活化。临床前研究表明,照射增强了plinabulin诱导的DC成熟,当与免疫检查点抑制剂(ici)联合使用时,通过增加肿瘤浸润性DC和T细胞,触发了体外抗肿瘤反应。方法:以原发性终点(安全性、耐受性和客观肿瘤反应率)和继发性终点(疾病控制率[DCR])为终点,对pci复发/难治性癌症进行放射治疗(RT)开始后plinabulin加ICIs的1期转化研究(NCT04902040)。结果:这种三联疗法是安全的,在大多数重度预处理患者中,DCR达到54%(3/13部分缓解[PR]和4/13疾病稳定[SD])。有反应的肿瘤包括非小细胞肺癌(2/2 PR + SD)、头颈部鳞状细胞癌(2/3 PR + SD)和霍奇金淋巴瘤(既往12或16次治疗后患者的2/2 PR)。与进展性疾病患者相比,PR + SD患者在预处理/基线时外周血和瘤内GEF-H1免疫激活评分以及治疗后DC激活/T细胞克隆扩增评分均显著高于进展性疾病患者。结论:这些初步结果为在未来ICI失败后的验证性试验中测试RT/plinabulin/ICI组合提供了理论依据。资助:本研究由BeyondSpring制药公司资助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Plinabulin following radiation enhances dendritic cell maturation and checkpoint inhibitor retreatment of relapsed/refractory cancers.

Background: Plinabulin exerts immunomodulatory activity through guanine nucleotide exchange factor (GEF)-H1 release from depolymerizing tubulin in the cytoskeleton, leading to dendritic cell (DC) activation. Preclinical studies demonstrated that irradiation potentiates plinabulin-induced DC maturation and, when combined with immune checkpoint inhibitors (ICIs), triggers an abscopal antitumor response via increased tumor-infiltrating DCs and T cells.

Methods: A phase 1 translational study (NCT04902040) of plinabulin plus ICIs after radiation therapy (RT) initiation was conducted in ICI-relapsed/refractory cancers with primary (safety, tolerability, and objective tumor response rate) and secondary (disease control rate [DCR]) endpoints.

Findings: This triple regimen was safe and achieved a DCR of 54% (3/13 partial response [PR] and 4/13 stable disease [SD]) in mostly heavily pretreated patients. Responding tumors included non-small cell lung cancer (2/2 PR + SD), head-and-neck squamous cell carcinoma (2/3 PR + SD), and Hodgkin's lymphoma (2/2 PR in patients after 12 or 16 prior lines of therapy). PR + SD patients had significantly higher GEF-H1 immune-activation scores in peripheral blood and intratumorally at pretreatment/baseline and DC activation/T cell clonal expansion post-treatment compared with progressive disease patients.

Conclusions: These preliminary results provide a rationale for testing RT/plinabulin/ICI combination in future post-ICI-failure confirmatory trials.

Funding: This study was funded by BeyondSpring Pharmaceuticals, Inc.

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来源期刊
Med
Med MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
17.70
自引率
0.60%
发文量
102
期刊介绍: Med is a flagship medical journal published monthly by Cell Press, the global publisher of trusted and authoritative science journals including Cell, Cancer Cell, and Cell Reports Medicine. Our mission is to advance clinical research and practice by providing a communication forum for the publication of clinical trial results, innovative observations from longitudinal cohorts, and pioneering discoveries about disease mechanisms. The journal also encourages thought-leadership discussions among biomedical researchers, physicians, and other health scientists and stakeholders. Our goal is to improve health worldwide sustainably and ethically. Med publishes rigorously vetted original research and cutting-edge review and perspective articles on critical health issues globally and regionally. Our research section covers clinical case reports, first-in-human studies, large-scale clinical trials, population-based studies, as well as translational research work with the potential to change the course of medical research and improve clinical practice.
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