Anti-GD2 antibody 3F8 and barley-derived (1 → 3),(1 → 4)-β-D-glucan: A Phase I study in patients with chemoresistant neuroblastoma Journal Article
| Authors: | Modak, S.; Kushner, B. H.; Kramer, K.; Vickers, A.; Cheung, I. Y.; Cheung, N. K. V. |
| Article Title: | Anti-GD2 antibody 3F8 and barley-derived (1 → 3),(1 → 4)-β-D-glucan: A Phase I study in patients with chemoresistant neuroblastoma |
| Abstract: | β-glucans are complex, naturally-occurring polysaccharides that prime leukocyte dectin and complement receptor 3. Based on our preclinical findings, indicating that oral barley-derived (1 → 3),(1 → 4)-β-D-glucan (BG) synergizes with the murine anti-GD2 antibody 3F8 against neuroblastoma, we conducted a Phase I clinical study to evaluate the safety of this combinatorial regimen in patients affected by chemoresistant neuroblastoma. In this setting, four cohorts of six heavilypre-treated patients bearing recurrent or refractory advanced-stage neuroblastoma were treated with 3F8 plus BG. Each cycle consisted of intravenous 3F8 at a fixed dose of 10 mg/m2/day plus concurrent oral BG, dose-escalated from 10 to 80 mg/Kg/day, for 10 d. Patients who didnot develop human anti-mouse antibodies could be treated for up to 4 cycles. Twenty-four patients completed 50 cycles of therapy. All patients completed at least one cycle and were evaluable for the assessment of toxicity and responses. The maximum tolerated dose of BG was not reached, but two patients developed dose-limiting toxicities. Theseindividuals developed grade 4 thrombocytopenia after one cycle of BG at doses of 20 mg/Kg/day and 40 mg/Kg/day, respectively. Platelet counts recovered following the administration of idiopathic thrombocytopenic purpura therapy. There were no other toxicities of grade > 2. Eleven and 13 patients manifested stable and progressive disease, respectively. Thirteen out of 22 patients with pretreatment positive 123I-MIBG scans demonstrated clinical improvement on semiquantitative scoring. Responses did not correlate with BG dose or with invitro cytotoxicity. In summary, 3F8 plus BG is well tolerated and shows antineoplastic activity in recurrent or refractory advanced-stage neuroblastoma patients. Further clinical investigation of this novel combinatorial immunotherapeutic regimen is warranted. © 2013 Landes Bioscience. |
| Keywords: | adolescent; adult; cancer survival; child; clinical article; preschool child; school child; unclassified drug; overall survival; clinical trial; drug tolerability; cancer combination chemotherapy; dose response; drug efficacy; drug potentiation; drug safety; drug withdrawal; cancer staging; recurrent cancer; progression free survival; multiple cycle treatment; thrombocytopenia; cohort analysis; dexamethasone; vincristine; antineoplastic activity; in vitro study; monoclonal antibody; drug dose escalation; drug fever; survival time; immunotherapy; immunoglobulin g; neuroblastoma; (3 iodobenzyl)guanidine i 123; single drug dose; injection site pain; phase 1 clinical trial; drug cytotoxicity; beta glucan; antibody; peritoneum mesothelioma; antibody production; urticaria; monoclonal antibody 3f8; 3f8; β-glucan; barley derived (1-3),(1-4) beta dextro glucan; rhesus d antibody |
| Journal Title: | OncoImmunology |
| Volume: | 2 |
| Issue: | 3 |
| ISSN: | 2162-4011 |
| Publisher: | Landes Bioscience |
| Date Published: | 2013-03-01 |
| Start Page: | e23402 |
| Language: | English |
| DOI: | 10.4161/onci.23402 |
| PROVIDER: | scopus |
| PMCID: | PMC3661165 |
| PUBMED: | 23802080 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 December 2013" - "Source: Scopus" |
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