A randomized double-blind placebo-controlled phase II trial of dendritic cell vaccine ICT-107 in newly diagnosed patients with glioblastoma

  • Patrick Y. Wen
  • , David A. Reardon
  • , Terri S. Armstrong
  • , Surasak Phuphanich
  • , Robert D. Aiken
  • , Joseph C. Landolfi
  • , William T. Curry
  • , Jay Jiguang Zhu
  • , Michael Glantz
  • , David M. Peereboom
  • , James M. Markert
  • , Renato LaRocca
  • , Donald M. O'Rourke
  • , Karen Fink
  • , Lyndon Kim
  • , Michael Gruber
  • , Glenn J. Lesser
  • , Edward Pan
  • , Santosh Kesari
  • , Alona Muzikansky
  • Clemencia Pinilla, Radleigh G. Santos, John S. Yu

Research output: Contribution to journalArticlepeer-review

215 Scopus citations

Abstract

Purpose: To evaluate the results of the randomized, double-blind, placebo-controlled phase II clinical trial of ICT-107 in patients with newly diagnosed glioblastoma. Patients and Methods: We conducted a double-blinded randomized phase II trial of ICT-107 in newly diagnosed patients with glioblastoma (GBM) and tested efficacy, safety, quality of life (QoL), and immune response. HLA-A1þ and/or -A2þ–resected patients with residual tumor ≤1 cm3 received radiotherapy and concurrent temozolomide. Following completion of radiotherapy, 124 patients, randomized 2:1, received ICT-107 [autologous dendritic cells (DC) pulsed with six synthetic peptide epitopes targeting GBM tumor/stem cell–associated antigens MAGE-1, HER-2, AIM-2, TRP-2, gp100, and IL13Ra2] or matching control (unpulsed DC). Patients received induction ICT-107 or control weekly x 4 followed by 12 months of adjuvant temozolomide. Maintenance vaccinations occurred at 1, 3, and 6 months and every 6 months thereafter. Results: ICT-107 was well tolerated, with no difference in adverse events between the treatment and control groups. The primary endpoint, median overall survival (OS), favored ICT-107 by 2.0 months in the intent-to-treat (ITT) population but was not statistically significant. Progression-free survival (PFS) in the ITT population was significantly increased in the ICT-107 cohort by 2.2 months (P ¼ 0.011). The frequency of HLA-A2 primary tumor antigen expression was higher than that for HLA-A1 patients, and HLA-A2 patients had higher immune response (via Elispot). HLA-A2 patients achieved a meaningful therapeutic benefit with ICT-107, in both the MGMT methylated and unmethylated prespecified subgroups, whereas only HLA-A1 methylated patients had an OS benefit. Conclusions: PFS was significantly improved in ICT-107–treated patients with maintenance of QoL. Patients in the HLA-A2 subgroup showed increased ICT-107 activity clinically and immunologically.

Original languageEnglish (US)
Pages (from-to)5799-5807
Number of pages9
JournalClinical Cancer Research
Volume25
Issue number19
DOIs
StatePublished - Oct 1 2019

All Science Journal Classification (ASJC) codes

  • General Medicine

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