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Immunological response and overall survival in a subset of advanced renal cell carcinoma patients from a randomized phase 2/3 study of naptumomab estafenatox plus IFN-α versus IFN-α.

Abstract
Naptumomab estafenatox/ABR-217620/ANYARA (Nap) has been evaluated in clinical phase 1 and 2/3 studies. RCC patients in the phase 2/3 trial were randomized 1:1 in an open label study to receive Nap+IFN-α or IFN-α. In this study, we analyzed the UK patients for their immunological response in relation to prolonged overall survival (OS). We found that Nap-specific T cells were reduced after 3 treatment days in patients' peripheral blood. Levels of both Nap-specific CD4+ and CD8+ T cells were significantly higher 8 days after the first treatment. Patients with such pattern of reduction and expansion of Nap-binding T cells also showed increased levels of IL-2 and IFN-γ in plasma 3 hours after the first Nap treatment. In addition, Nap caused an increase of IL-6, IL-10 and TNF-α. The patients in the UK subset showed a tendency of OS benefit after Nap treatment. Most Nap treated patients with long OS had low baseline IL-6 and normal levels of anti-SEA/E-120 antibodies. Furthermore, patients with pronounced Nap induced IL-2 and T cell expansion had long OS. In conclusion, patients with low baseline IL-6 and normal anti-SEA/E-120 may respond well to Nap by T cell activation and expansion paving the way for anti-tumour effects.
AuthorsEyad Elkord, Deborah J Burt, Anette Sundstedt, Örjan Nordle, Gunnar Hedlund, Robert E Hawkins
JournalOncotarget (Oncotarget) Vol. 6 Issue 6 Pg. 4428-39 (Feb 28 2015) ISSN: 1949-2553 [Electronic] United States
PMID25669986 (Publication Type: Clinical Trial, Phase II, Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial)
Chemical References
  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Enterotoxins
  • IL6 protein, human
  • Immunoconjugates
  • Interferon-alpha
  • Interleukin-6
  • naptumomab estafenatox
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal (therapeutic use)
  • Antineoplastic Agents (therapeutic use)
  • Carcinoma, Renal Cell (drug therapy, immunology, mortality)
  • Enterotoxins (therapeutic use)
  • Female
  • Flow Cytometry
  • Humans
  • Immunoconjugates (therapeutic use)
  • Interferon-alpha (therapeutic use)
  • Interleukin-6 (blood)
  • Kaplan-Meier Estimate
  • Kidney Neoplasms (drug therapy, immunology, mortality)
  • Male
  • Middle Aged
  • T-Lymphocyte Subsets (drug effects)
  • T-Lymphocytes (drug effects)
  • Young Adult

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