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  • Long term survivors and immune biomarker analysis of Phase IIa, randomized study of GVAX pancreas and crs-207 immunotherapy in patients with metastatic pancreatic cancer

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Poster Presentation
Long term survivors and immune biomarker analysis of Phase IIa, randomized study of GVAX pancreas and crs-207 immunotherapy in patients with metastatic pancreatic cancer
  1. Nitya Nair1,
  2. Ed Lemmens1,
  3. Amanda Enstrom1,
  4. Shih-Yu Chen2,
  5. Serena Chang2,
  6. Dung Le3,
  7. Elizabeth M Jaffee4,
  8. Holden Maecker2,
  9. Aimee L Murphy1,
  10. Dirk G Brockstedt1 and
  11. Chan Whiting1
  1. Aff1 grid.417411.6Aduro BioTech, Inc. Berkeley CA USA
  2. Aff2 grid.168010.e0000000419368956Stanford University Stanford CA USA
  3. Aff3 grid.21107.350000000121719311Johns Hopkins University Baltimore MD USA
  4. Aff4 grid.21107.350000000121719311The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Baltimore MD USA

https://doi.org/10.1186/2051-1426-3-S2-P102

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    Meeting abstracts

    Background

    Non-clinical and clinical combination studies with GVAX and live-attenuated, double-deleted (LADD) Listeria monocytogenes strains engineered to express tumor-associated antigens resulted in survival benefit and induction of cellular mediated immune responses.

    Methods

    In a Phase IIa randomized study, patients with metastatic pancreatic ductal adenocarcinoma (PDA) treated sequentially with two vaccine-based immunotherapies demonstrated extended overall survival (OS) with tolerable side effects. Treatment included low-dose cyclophosphamide (CY) followed by GVAX pancreas, an irradiated GM-CSF-secreting allogeneic PDA cell vaccine, and subsequent administrations of CRS-207, a LADD vaccine engineered to express mesothelin. Study inclusion criteria were diagnosis of metastatic PDA, refusal or receipt of > 1 prior chemotherapy, ECOG 1 and adequate organ function. 90 patients were randomized 2:1 to receive 2 doses of CY/GVAX followed by 4 doses of CRS-207 (Arm A, median OS 6.1 months) or 6 doses of CY/GVAX (Arm B, median OS 3.9 months) (HR=0.54, one-sided p=0.011).

    Results

    As of June 2015, 7 patients remain alive. Two patients continue on treatment: 1 original Arm A treatment (35.6 months on treatment); 1 Arm B on the 4th course of rollover treatment (32 months on treatment). Five patients are currently in follow-up (Arm A) with a median time since first treatment of 36.1 months (range, 30.0 to 39.5 months). Peripheral blood mononuclear cells and serum were collected at baseline and over the course of treatment for immune monitoring and biomarker analysis. Here we report systematic cellular immunophenotyping and serum protein profiling in a sub-cohort of 38 PDA patients enrolled in this study. Mass cytometry and Luminex analysis of this sub-cohort revealed candidate biomarkers at baseline that were predictive of clinical outcome. Analysis of longitudinal time points using mass cytometry, flow cytometry, Luminex, Western blotting and ELISA are ongoing to identify mechanistic biomarkers that correlate with survival.

    Conclusions

    These findings may inform future efforts to identify patients with productive responses that are most likely to benefit from immune-based therapy.

    Clinical trial information NCT01417000