A trial of intrapleural adenoviral-mediated Interferon-α2b gene transfer for malignant pleural mesothelioma

Am J Respir Crit Care Med. 2011 Dec 15;184(12):1395-9. doi: 10.1164/rccm.201103-0554CR. Epub 2011 Jun 3.

Abstract

New therapeutic strategies are needed for malignant pleural mesothelioma (MPM). We conducted a single-center, open-label, nonrandomized, pilot and feasibility trial using two intrapleural doses of an adenoviral vector encoding human IFN-α (Ad.IFN-α2b). Nine subjects were enrolled at two dose levels. The first three subjects had very high pleural and systemic IFN-α concentrations resulting in severe "flu-like" symptoms necessitating dose de-escalation. The next six patients had reduced (but still significant) pleural and serum IFN-α levels, but with tolerable symptoms. Repeated vector administration appeared to prolong IFN-α expression levels. Anti-tumor humoral immune responses against mesothelioma cell lines were seen in seven of the eight subjects evaluated. No clinical responses were seen in the four subjects with advanced disease. However, evidence of disease stability or tumor regression was seen in the remaining five patients, including one dramatic example of partial tumor regression at sites not in contiguity with vector infusion. These data show that Ad.IFN-α2b has potential therapeutic benefit in MPM and that it generates anti-tumor immune responses that may induce anatomic and/or metabolic reductions in distant tumor. Clinical trial registered with www.clinicaltrials.gov (NCT 01212367).

Trial registration: ClinicalTrials.gov NCT01212367.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoviridae
  • Aged
  • Aged, 80 and over
  • Feasibility Studies
  • Female
  • Gene Transfer Techniques
  • Genetic Therapy* / adverse effects
  • Genetic Vectors
  • Humans
  • Immunologic Factors / administration & dosage*
  • Immunologic Factors / genetics
  • Interferon alpha-2
  • Interferon-alpha / administration & dosage*
  • Interferon-alpha / genetics
  • Male
  • Mesothelioma / diagnostic imaging
  • Mesothelioma / immunology
  • Mesothelioma / therapy*
  • Middle Aged
  • Multimodal Imaging
  • Pilot Projects
  • Pleural Neoplasms / diagnostic imaging
  • Pleural Neoplasms / immunology
  • Pleural Neoplasms / therapy*
  • Positron-Emission Tomography
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / genetics
  • Tomography, X-Ray Computed

Substances

  • Immunologic Factors
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins

Associated data

  • ClinicalTrials.gov/NCT01212367