CD8+ T Cells Impact Rising PSA in Biochemically Relapsed Cancer Patients Using Immunotherapy Targeting Tumor-Associated Antigens

Mol Ther. 2020 May 6;28(5):1238-1250. doi: 10.1016/j.ymthe.2020.02.018. Epub 2020 Mar 3.

Abstract

The management of men with prostate cancer (PCa) with biochemical recurrence following local definitive therapy remains controversial. Early use of androgen deprivation therapy (ADT) leads to significant side effects. Developing an alternative, clinically effective, and well-tolerated therapy remains an unmet clinical need. INO-5150 is a synthetic DNA therapy that includes plasmids encoding for prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA), and INO-9012 is a synthetic DNA plasmid encoding for interleukin-12 (IL-12). This phase 1/2, open-label, multi-center study enrolled men with PCa with rising PSA after surgery and/or radiation therapy. Patients were enrolled into one of four treatment arms: arm A, 2 mg of INO-5150; arm B, 8.5 mg of INO-5150; arm C, 2 mg of INO-5150 + 1 mg of INO-9012; and arm D, 8.5 mg of INO-5150 + 1 mg of INO-9012. Patients received study drug with electroporation on day 0 and on weeks 3, 12, and 24, and they were followed for up to 72 weeks. Sixty-two patients were enrolled. Treatment was well tolerated. 81% (50/62) of patients completed all visits. 85% (53/62) remained progression-free at 72 weeks. PSA doubling time (PSADT) was increased when assessed in patients with day 0 PSADT ≤12 months. Immunogenicity was observed in 76% (47/62) of patients by multiple assessments. Analysis indicated that CD38 and perforin co-positive CD8 T cell frequency correlated with attenuated PSA rise (p = 0.05, n = 50).

Keywords: CD8; DNA; cytotoxic lymphocyte; immune response; immunotherapy; prostate cancer.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antigens, Surface / genetics
  • Antigens, Surface / immunology
  • Follow-Up Studies
  • Genetic Therapy / methods*
  • Glutamate Carboxypeptidase II / genetics
  • Glutamate Carboxypeptidase II / immunology
  • Humans
  • Immunity*
  • Immunotherapy / methods*
  • Interleukin-12 / genetics
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / chemically induced
  • Neoplasm Recurrence, Local / immunology*
  • Neoplasm Recurrence, Local / therapy*
  • Plasmids / genetics
  • Plasmids / therapeutic use
  • Progression-Free Survival
  • Prostate-Specific Antigen / blood
  • Prostate-Specific Antigen / genetics
  • Prostate-Specific Antigen / immunology*
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / immunology*
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / therapy*
  • T-Lymphocytes, Cytotoxic / immunology*

Substances

  • Antigens, Surface
  • Interleukin-12
  • FOLH1 protein, human
  • Glutamate Carboxypeptidase II
  • Prostate-Specific Antigen