Results of a phase I/IIa trial of SV-BR-1-GM inoculation with low-dose cyclophosphamide and interferon alpha (Bria-IMT) in metastatic breast cancer

This Phase I/IIa open-label, single-arm clinical trial addressing advanced, refractory, metastatic breast cancer was conducted at six medical centers in the United States. We repeated inoculations with irradiated SV-BR-1-GM, a breast cancer cell line with antigen-presenting activity engineered to re...

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Main Authors: Charles L. Wiseman, Jarrod P. Holmes, Carmen Calfa, Shaker R. Dakhil, Saveri Bhattacharya, George E. Peoples, Markus D. Lacher, Miguel Lopez-Lago, Alex Kharazi, Giuseppe Del Priore, Mingjin Chang, Daniel L. Adams, William V. Williams
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Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Human Vaccines & Immunotherapeutics
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Online Access:https://www.tandfonline.com/doi/10.1080/21645515.2024.2379864
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author Charles L. Wiseman
Jarrod P. Holmes
Carmen Calfa
Shaker R. Dakhil
Saveri Bhattacharya
George E. Peoples
Markus D. Lacher
Miguel Lopez-Lago
Alex Kharazi
Giuseppe Del Priore
Mingjin Chang
Daniel L. Adams
William V. Williams
author_facet Charles L. Wiseman
Jarrod P. Holmes
Carmen Calfa
Shaker R. Dakhil
Saveri Bhattacharya
George E. Peoples
Markus D. Lacher
Miguel Lopez-Lago
Alex Kharazi
Giuseppe Del Priore
Mingjin Chang
Daniel L. Adams
William V. Williams
author_sort Charles L. Wiseman
collection DOAJ
description This Phase I/IIa open-label, single-arm clinical trial addressing advanced, refractory, metastatic breast cancer was conducted at six medical centers in the United States. We repeated inoculations with irradiated SV-BR-1-GM, a breast cancer cell line with antigen-presenting activity engineered to release granulocyte-macrophage colony-stimulating factor (GM-CSF), with pre-dose low-dose cyclophosphamide and post-dose local interferon alpha. Twenty-six patients were enrolled; 23 (88.5%) were inoculated, receiving a total of 79 inoculations. There were six Grade 4 and one Grade 5 adverse events noted (judged unrelated to SV-BR-1-GM). Disease control (stable disease [SD]) occurred in 8 of 16 evaluable patients; 4 showed objective regression of metastases, including 1 patient with near-complete regressions in 20 of 20 pulmonary lesions. All patients with regressions had human leukocyte antigen (HLA) matches with SV-BR-1-GM; non-responders were equally divided between matching and nonmatching (p = .01, Chi-squared), and having ≥2 HLA matches with SV-BR-1-GM (n = 6) correlated with clinical benefit. Delayed-type hypersensitivity (DTH) testing to candida antigen and SV-BR-1-GM generated positive responses (≥5 mm) in 11 (42.3%) and 13 (50%) patients, respectively. Quantifying peripheral circulating tumor cells (CTCs) and cancer-associated macrophage-like cells (CAMLs) showed that a drop in CAMLs was significantly correlated with an improvement in progression-free survival (PFS; 4.1 months vs. 1.8 months, p = .0058). Eight of 10 patients significantly upregulated programmed cell death ligand 1 (PD-L1) on CTCs/CAMLs with treatment (p = .0012). These observations support the safety of the Bria-IMT regimen, demonstrate clinical regressions, imply a role for HLA matching, and identify a possible value for monitoring CAMLs in peripheral blood.
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spelling doaj-art-67922cae6ff54870900ebf2a5b42091c2025-08-20T02:16:49ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2024-12-0120110.1080/21645515.2024.2379864Results of a phase I/IIa trial of SV-BR-1-GM inoculation with low-dose cyclophosphamide and interferon alpha (Bria-IMT) in metastatic breast cancerCharles L. Wiseman0Jarrod P. Holmes1Carmen Calfa2Shaker R. Dakhil3Saveri Bhattacharya4George E. Peoples5Markus D. Lacher6Miguel Lopez-Lago7Alex Kharazi8Giuseppe Del Priore9Mingjin Chang10Daniel L. Adams11William V. Williams12Development, BriaCell Therapeutics Corp, Philadelphia, PA, USAHematology Oncology, Providence Medical Group Santa Rosa - Cancer Center, Santa Rosa, CA, USAMedical Oncology, University of Miami, Miami, FL, USAMedical Oncology, Cancer Center of Kansas, Wichita, KS, USAAbramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USAOncology, Lumabridge, San Antonio, TX, USADevelopment, BriaCell Therapeutics Corp, Philadelphia, PA, USADevelopment, BriaCell Therapeutics Corp, Philadelphia, PA, USADevelopment, BriaCell Therapeutics Corp, Philadelphia, PA, USADevelopment, BriaCell Therapeutics Corp, Philadelphia, PA, USADevelopment, BriaCell Therapeutics Corp, Philadelphia, PA, USADiscovery, Creatv MicroTech, Inc., Rockville, MD, USADevelopment, BriaCell Therapeutics Corp, Philadelphia, PA, USAThis Phase I/IIa open-label, single-arm clinical trial addressing advanced, refractory, metastatic breast cancer was conducted at six medical centers in the United States. We repeated inoculations with irradiated SV-BR-1-GM, a breast cancer cell line with antigen-presenting activity engineered to release granulocyte-macrophage colony-stimulating factor (GM-CSF), with pre-dose low-dose cyclophosphamide and post-dose local interferon alpha. Twenty-six patients were enrolled; 23 (88.5%) were inoculated, receiving a total of 79 inoculations. There were six Grade 4 and one Grade 5 adverse events noted (judged unrelated to SV-BR-1-GM). Disease control (stable disease [SD]) occurred in 8 of 16 evaluable patients; 4 showed objective regression of metastases, including 1 patient with near-complete regressions in 20 of 20 pulmonary lesions. All patients with regressions had human leukocyte antigen (HLA) matches with SV-BR-1-GM; non-responders were equally divided between matching and nonmatching (p = .01, Chi-squared), and having ≥2 HLA matches with SV-BR-1-GM (n = 6) correlated with clinical benefit. Delayed-type hypersensitivity (DTH) testing to candida antigen and SV-BR-1-GM generated positive responses (≥5 mm) in 11 (42.3%) and 13 (50%) patients, respectively. Quantifying peripheral circulating tumor cells (CTCs) and cancer-associated macrophage-like cells (CAMLs) showed that a drop in CAMLs was significantly correlated with an improvement in progression-free survival (PFS; 4.1 months vs. 1.8 months, p = .0058). Eight of 10 patients significantly upregulated programmed cell death ligand 1 (PD-L1) on CTCs/CAMLs with treatment (p = .0012). These observations support the safety of the Bria-IMT regimen, demonstrate clinical regressions, imply a role for HLA matching, and identify a possible value for monitoring CAMLs in peripheral blood.https://www.tandfonline.com/doi/10.1080/21645515.2024.2379864SV-BR-1-GMbreast cancerimmunotherapytherapeutic cancer vaccinehistocompatibility markersTrial registration
spellingShingle Charles L. Wiseman
Jarrod P. Holmes
Carmen Calfa
Shaker R. Dakhil
Saveri Bhattacharya
George E. Peoples
Markus D. Lacher
Miguel Lopez-Lago
Alex Kharazi
Giuseppe Del Priore
Mingjin Chang
Daniel L. Adams
William V. Williams
Results of a phase I/IIa trial of SV-BR-1-GM inoculation with low-dose cyclophosphamide and interferon alpha (Bria-IMT) in metastatic breast cancer
Human Vaccines & Immunotherapeutics
SV-BR-1-GM
breast cancer
immunotherapy
therapeutic cancer vaccine
histocompatibility markers
Trial registration
title Results of a phase I/IIa trial of SV-BR-1-GM inoculation with low-dose cyclophosphamide and interferon alpha (Bria-IMT) in metastatic breast cancer
title_full Results of a phase I/IIa trial of SV-BR-1-GM inoculation with low-dose cyclophosphamide and interferon alpha (Bria-IMT) in metastatic breast cancer
title_fullStr Results of a phase I/IIa trial of SV-BR-1-GM inoculation with low-dose cyclophosphamide and interferon alpha (Bria-IMT) in metastatic breast cancer
title_full_unstemmed Results of a phase I/IIa trial of SV-BR-1-GM inoculation with low-dose cyclophosphamide and interferon alpha (Bria-IMT) in metastatic breast cancer
title_short Results of a phase I/IIa trial of SV-BR-1-GM inoculation with low-dose cyclophosphamide and interferon alpha (Bria-IMT) in metastatic breast cancer
title_sort results of a phase i iia trial of sv br 1 gm inoculation with low dose cyclophosphamide and interferon alpha bria imt in metastatic breast cancer
topic SV-BR-1-GM
breast cancer
immunotherapy
therapeutic cancer vaccine
histocompatibility markers
Trial registration
url https://www.tandfonline.com/doi/10.1080/21645515.2024.2379864
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