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Author: Reisæter, Lars Anders ; Halvorsen, Ole Johan ; Førde, Kristina ; Biermann, Martin ; Azeem, Waqas ; Gjertsen, Bjørn T. ; Riethdorf, Sabine ; Melve, Guro Kristin ; Kristoffersen, Einar Kleboe ; Kalland, Karl-Henning ; Thomsen, Liv Cecilie Vestrheim ; Almås, Bjarte ; Bahn, Duke ; Helle, Svein Inge ; Pantel, Klaus ; Ragde, Haakon ; Beisland, Christian ; Honoré, Alfred ; Øyan, Anne Margrete ; Akslen, Lars

3029 Background: Dendritic cell (DC)-based cryoimmunotherapy (CryoIT) was used to treat metastatic castration-resistant prostate cancer in a Phase I clinical trial. Primary objective was safety of treatment. Secondarily, clinical, radiological and immunological treatment responses were investigated. Methods: In 18 patients cryoablation by a freeze-thaw process under general anesthesia was performed, followed by intratumoral autologous immature DC injection. In the last 9 patients checkpoint inhibition of either CTLA-4 or PD-1 was added. Subjects had minimum 46 weeks follow-up. Adverse events (AEs) and blood analyses were registered at all visits. Disease progression was determined by three imaging modalities according to (i)RECISTv1.1 and progression-free survival (PFS) by Kaplan-Meier method. Circulating tumor cells (CTC/7.5 mL, CellSearch) and ultradeep T-cell receptor (TCR) b-chain sequences (TCRSafe) were enumerated. Patients were separated by CTC into none (n=10), 1-4 (n=4) and ≥ 5 (n=4). Health related quality of life (HRQoL) measured by EORTC-QLQ C30 questionnaire were answered at inclusion, and 10, 22 and 46 weeks post CryoIT. Scores were calculated according to the EORTC manual. Results: Subjects progressing within 22 weeks had higher PSA (p=0.03). AE profile of the total cohort (n=18) was comparable with interim reports (n=13); of 20 possible DC-related AEs one was severe (urinary retention) and 19 mild-to-moderate, and spread independent of treatment regime. Maximum tolerated dose of DC was not reached. By 46 weeks, imaging showed 6 patients partial response or stable disease. Median PFS was 150 days in total cohort. Pretreatment CTC counts ≥5 indicated higher progression rates and recurring CTC. Ultradeep TCR-sequencing showed more prevalent and higher expressed (>5-fold) new TCR clonotypes at 2-6 weeks in men without progression. Participants reported high and stable HRQoL scores throughout the study. However, presence of CTC was associated with worse HRQoL scores at week 10 (p=0.031) and 22 (p=0.005). Conclusions: DC treatment seems safe and well tolerated, also combined with checkpoint inhibitors. Effect is indicated in subjects with moderate pre-treatment PSA levels. Immune responses are suggested by higher number of novel TCR clonotypes in men with non-progressive disease. Clinical trial information: NCT02423928 .

20 May 2018·Journal of Clinical Oncology

Dendritic cell (DC) based cryoimmunotherapy (CryoIT) in a prospective phase I trial of metastatic castration resistant prostate cancer (mCRPC): Interim analysis.

Author: Kalland, Karl-Henning ; Gjertsen, Bjorn T. ; Ragde, Haakon ; Haslerud, Torjan ; Frugård, Jannicke ; Kristoffersen, Einar Kleboe ; Honoré, Alfred ; Reisæter, Lars Anders ; Bahn, Duke ; Almås, Bjarte ; Melve, Guro Kristin ; Beisland, Christian ; Halvorsen, Ole Johan ; Helle, Svein Inge ; Biermann, Martin ; Oyan, Anne Margrete ; Kvalheim, Gunnar ; Thomsen, Liv Cecilie Vestrheim ; Pantel, Klaus ; Rørvik, Jarle Tor

e17014Background: Interim analysis data are presented for 13 pts with mCRPC treated with DC based CryoIT and at least 3 months follow-up (FU). CryoIT exposes tumor antigens in cryoablated tissue to...

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