In a phase I clinical trial, 39 patients with advanced NY-ESO-1+ sarcoma or other solid tumors were intradermally treated with LV305, a lentivirus-based vaccine that selectively induces expression of NY-ESO-1 in DCs via DC-specific lectin receptor DC-SIGN. Treatment was well tolerated. Disease control rate was 56.4% overall (1 PR, 1 unconfirmed PR, 20 SD) and 62.5% in sarcoma patients. 52% of all evaluable patients and 57% of evaluable sarcoma patients exhibited induction of anti-NY-ESO-1-specific CD4+ and/or CD8+ T cells, which was associated with improved 1-year survival. Increased T cell clonality in post-treatment PBMCs correlated with longer OS.

PURPOSE: LV305 is a modified, third generation, non-replicating, integration-deficient lentivirus-based vector designed to selectively transduce dendritic cells in vivo LV305 induces expression of the NY-ESO-1 cancer testis antigen in dendritic cells, promoting immune responses against NY-ESO-1-expressing tumors. This phase 1 study evaluated the safety, immunogenicity, and preliminary efficacy of LV305 in patients with sarcoma or other solid tumors. EXPERIMENTAL DESIGN: Adults with previously-treated, advanced, NY-ESO-1-positive solid tumors and limited tumor burden were eligible. LV305 was administered every 3 weeks by intradermal injection in four dose cohorts (Cohort 1: 10(8) vector genomes (vg) x 3 doses; Cohorts 1A, 2, and 3: 10(8) vg, 10(9) vg, 10(10) vg x 4 doses). RESULTS: Thirty-nine patients were enrolled: 3 patients each in Cohorts 1, 1A, and 2, and 30 patients in Cohort 3. No dose-limiting toxicities were observed. Tumor types included sarcoma (n=24), ovarian (n=8), melanoma (n=6), and lung cancer (n=1). All treatment-related adverse events were grade 1 or 2. Common treatment-related adverse events were fatigue (49%), injection-site reactions (46%), and myalgia (21%). The disease control rate was 56.4% in all patients and 62.5% in sarcoma patients. One patient with synovial sarcoma achieved a partial response lasting >36 months. Anti-NY-ESO-1-specific CD4(+) and/or CD8(+) T cells were induced in 57% of evaluable sarcoma patients. Induction of an anti-NY-ESO-1 immune response was associated with improved 1-year survival in an exploratory analysis. CONCLUSIONS: This first-in-class, first-in-human study of LV305 demonstrated a favorable safety profile, induction of antigen-specific responses, and potential clinical activity in patients with advanced cancer.

Author Info: (1) Department of Sarcoma Medical Oncology, University of Texas MD Anderson Cancer Center NSomaiah@mdanderson.org. (2) Medical Oncology, Mayo Clinic. (3) Department of Medicine, Ya

Author Info: (1) Department of Sarcoma Medical Oncology, University of Texas MD Anderson Cancer Center NSomaiah@mdanderson.org. (2) Medical Oncology, Mayo Clinic. (3) Department of Medicine, Yale University. (4) Department of Medical Oncology, Dana-Farber Cancer Institute. (5) Early Drug Development Center, Dana-Farber Cancer Institute. (6) Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center. (7) Internal Medicine, Yale University. (8) Royal Marsden Hospital. (9) Research, Immune Design. (10) Research, Immune Design. (11) Immune Design Corp. (12) Immune Design Corp. (13) Clinical, Immune Design. (14) Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai. (15) Clinical Research, Fred Hutchinson Cancer Center.