Phase 1/2a, dose-escalation, safety, pharmacokinetic and preliminary efficacy study of intratumoral administration of BC-819 in patients with unresectable pancreatic cancer

Hanna, Nader; Ohana, Patricia; Konikoff, Fred M.; Leichtmann, G; Hubert, Ayala; Appelbaum, Liat; Kopelman, Yael; Czerniak, Abraham; Hochberg, Avraham

doi:10.1038/cgt.2012.10

Cited by 134 publications

(89 citation statements)

References 23 publications

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Section: Clinical Trials Completed and Ongoingmentioning

confidence: 87%

“…The CPA/CYP2B1 GDEPT did give encouraging results in a trial involving 14 patients [39] but still needs confirmation. The same statement can be done for the use of the diphtheria toxin A chain published recently [64].Increasing immune system approaches were not more successful in delivering evidence of efficacy. The viral transfer of CEA and B7.1 into T cells was tested in a phase I trial but the results were not spectacular with only 3 out of 12 stable disease [65].…”

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confidence: 84%

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Gene Therapy of Pancreatic Cancer

Dabernat¹,

Lafitte²,

Bedel³

et al. 2013

J Genet Syndr Gene Ther

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Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive tumors with a 5-year survival rate of less than 5%. The poor prognosis of the disease is associated with late diagnosis and a high degree of drug resistance has not been overcome during the past decades. Gemcitabine-based regimens are the first line therapy for advanced pancreatic cancer but are not curative. Recent new combination chemotherapies achieved significant benefits but toxicity makes their use controversial. Novel approaches are currently being developed; in particular cancer gene therapies are undergoing preclinical and clinical validation and are the topic of the present review. We will present different ways to design gene therapy against pancreatic cancers that have been validated in preclinical studies. We also reviewed the clinical trials already published or still ongoing.Citation: Dabernat S, Lafitte M, Bedel A, de Verneuil H, Moreau-Gaudry F (2013) Gene Therapy of Pancreatic Cancer. J Genet Syndr Gene Ther 4: 138. doi:10.4172/2157-7412.1000138 Page 2 of 6Volume 4 • Issue 4 • 1000138 Suicide Gene Therapy of Cancer J Genet Syndr Gene Ther ISSN: 2157-7412 JGSGT, an open access journal gene restoration efficiency [12]. Restoring a wild type SMAD4 did not always block tumor cells [13] rendering the use of this tumor suppressor controversial [14]. Many oncogenes can be deregulated and/or mutated in pancreatic cancers. Among them, mutations in the KRAS oncogene occur in almost all pancreatic adenorcinomas [9]. Thus, it is tempting to use direct anti-KRAS strategies to inhibit tumor growth (Figure 1b), since disappointing results have been obtained with inhibition of farnesyl transferases [1]. RNAi directed against mutated KRAS showed anti-tumor activity [15], limited the aggressive phenotype of the tumor cells [16] and potentiated gemcitabine antitumor activity [17]. Preclinical studies showed encouraging results with viral delivery systems such as oncolytic adenovirus [18]. However, this strategy has not been further tested in phase I clinical trials.In fact, pancreatic adenocarcinomas present very complex genetic alterations profiles. The Pancreatic Cancer Genome project has analyzed 23,219 transcripts and identified an average of 63 somatic mutations per PDAC affecting 12 core signaling pathways and the overexpression of 500 different genes in 24 tumors [19]. These highly versatile and unpredictable molecular patterns can explain the failure of single gene/pathway targeted adjuvant therapies. It is now critical to test therapies targeting several pathways or therapies that induce specific tumor cell death. Delivering a Suicide GeneWith the suicide gene approach, a gene that encodes a protein triggering tumor cell death is delivered to the tumor cells ( Figure 1c). The expression of the therapeutic gene can directly kill the cells (diphtheria toxin, [20]), or can render the cells sensitive to certain otherwise non toxic prodrugs (Gene Directed Enzyme Prodrug Therapy, GDEPT,[21]), or based on gemcitabine association ...

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Section: Clinical Trials Completed and Ongoingmentioning

confidence: 87%

mentioning

confidence: 84%

Gene Therapy of Pancreatic Cancer

Dabernat¹,

Lafitte²,

Bedel³

et al. 2013

J Genet Syndr Gene Ther

View full text Add to dashboard Cite

show abstract

“…In pancreatic cells overexpressing H19, toxin expression is initi-A B ated and results in selective destruction of the malignant cells. 4,76 A Phase I/IIa trial in 6 patients with locally advanced and unresectable pancreatic cancer administered BC-819 via EUS-guided FNI. 76 Several patients had concurrent chemotherapy or radiation.…”

Section: Onyx-015mentioning

confidence: 99%

“…4,76 A Phase I/IIa trial in 6 patients with locally advanced and unresectable pancreatic cancer administered BC-819 via EUS-guided FNI. 76 Several patients had concurrent chemotherapy or radiation. Notably, a partial response was met in three patients; two patients achieved progression-free disease with one down staged to undergo surgical resection.…”

Section: Onyx-015mentioning

confidence: 99%