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Clinical Activity of Combined Telomerase Vaccination and Pembrolizumab in Advanced Melanoma: Results from a Phase I Trial
Journal article   Open access   Peer reviewed

Clinical Activity of Combined Telomerase Vaccination and Pembrolizumab in Advanced Melanoma: Results from a Phase I Trial

Espen B. Ellingsen, Steven O'Day, Artur Mezheyeuski, Agnieszka Gromadka, Trevor Clancy, Timothy S. Kristedja, Mohammed Milhem and Yousef Zakharia
Clinical cancer research, Vol.29(16), pp.3026-3036
08/15/2023
DOI: 10.1158/1078-0432.CCR-23-0416
PMCID: PMC10425723
PMID: 37378632
url
https://doi.org/10.1158/1078-0432.CCR-23-0416View
Published (Version of record) Open Access

Abstract

Purpose: Cancer vaccines represent a novel treatment modality with a complementary mode of action addressing a crucial bottle-neck for checkpoint inhibitor (CPI) efficacy. CPIs are expected to release brakes in T-cell responses elicited by vaccination, leading to more robust immune responses. Increased antitumor T-cell responses may confer increased antitumor activity in patients with less immunogenic tumors, a subgroup expected to achieve reduced benefit from CPIs alone. In this trial, atelomerase-based vaccine was combined with pembrolizumab to assess the safety and clinical activity in patients with melanoma. Patients and Methods: Thirty treatment-na ⠂eurove patients with advanced melanoma were enrolled. Patients received intradermal injections of UV1 with adjuvant GM-CSF at two dose levels, and pembrolizumab according to the label. Blood samples were assessed for vaccine-induced T-cell responses, and tumor tissues were collected for translational analyses. The primary endpoint was safety, with secondary objectives including progression-free sur-vival (PFS), overall survival (OS), and objective response rate (ORR).Results: The combination was considered safe and well-tolerat-ed. Grade 3 adverse events were observed in 20% of patients, with no grade 4 or 5 adverse events reported. Vaccination-related adverse events were mostly mild injection site reactions. The median PFS was 18.9 months, and the 1-and 2-year OS rates were 86.7% and 73.3%, respectively. The ORR was 56.7%, with 33.3% achieving complete responses. Vaccine-induced immune responses were observed in evaluable patients, and inflammatory changes were detected in posttreatment biopsies.Conclusions: Encouraging safety and preliminary efficacy were observed. Randomized phase II trials are currently ongoing.
Oncology Life Sciences & Biomedicine Science & Technology

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