Adenovirus-mediated wild-type p53 gene transfer in patients receiving chemotherapy for advanced non-small-cell lung cancer

Results of a multicenter phase II study

M. Schuler, R. Herrmann, J. L P De Greve, Alexander Keith Stewart, U. Gatzemeier, D. J. Stewart, L. Laufman, R. Gralla, J. Kuball, R. Buhl, C. P. Heussel, F. Kommoss, A. P. Perruchoud, F. A. Shepherd, M. A. Fritz, J. A. Horowitz, C. Huber, C. Rochlitz

Research output: Contribution to journalArticle

194 Citations (Scopus)

Abstract

Purpose: To study the additional benefit from adenoviral p53 gene therapy in patients undergoing first-line chemotherapy for advanced non-small-cell lung cancer (NSCLC). Patients and Methods: Twenty-five patients with nonresectable NSCLC were enrolled in an open-label, multicenter phase II study of three cycles of regimen A, carboplatin (area under the curve, 6; day 1) plus paclitaxel (175 mg/m2, day 1), or regimen B, cisplatin (100 mg/m2, day 1) plus vinorelbine (25 mg/m2, days 1, 8, 15, and 22) in combination with intratumoral injection of 7.5 × 1012 particles of SCH 58500 (rAd/p53, day 1). Responses of individual tumor lesions were assessed after each cycle, and gene transfer was examined in posttreatment tumor biopsies using reverse transcriptase polymerase chain reaction. Results: There was no difference between the response rate of lesions treated with p53 gene therapy in addition to chemotherapy (52% objective responses) and lesions treated with chemotherapy alone (48% objective responses). Subgroup analysis according to the chemotherapy regimens revealed evidence for increased mean local tumor regressions in response to additional p53 gene therapy in patients receiving regimen B, but not in patients receiving regimen A. There was no survival difference between the two chemotherapy regimens, and the median survival of the cohort was 10.5 months (1-year survival, 44%). Transgene expression was confirmed in tumor samples from 68% of patients, and toxicities attributable to gene therapy were mild to moderate. Conclusion: Intratumoral adenoviral p53 gene therapy appears to provide no additional benefit in patients receiving an effective first-line chemotherapy for advanced NSCLC.

Original languageEnglish (US)
Pages (from-to)1750-1758
Number of pages9
JournalJournal of Clinical Oncology
Volume19
Issue number6
StatePublished - Mar 15 2001
Externally publishedYes

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Patient Transfer
p53 Genes
Adenoviridae
Non-Small Cell Lung Carcinoma
Genetic Therapy
Drug Therapy
Survival
Neoplasms
Carboplatin
Paclitaxel
Reverse Transcriptase Polymerase Chain Reaction
Transgenes
Cisplatin
Area Under Curve
Biopsy
Injections
Genes

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Adenovirus-mediated wild-type p53 gene transfer in patients receiving chemotherapy for advanced non-small-cell lung cancer : Results of a multicenter phase II study. / Schuler, M.; Herrmann, R.; De Greve, J. L P; Stewart, Alexander Keith; Gatzemeier, U.; Stewart, D. J.; Laufman, L.; Gralla, R.; Kuball, J.; Buhl, R.; Heussel, C. P.; Kommoss, F.; Perruchoud, A. P.; Shepherd, F. A.; Fritz, M. A.; Horowitz, J. A.; Huber, C.; Rochlitz, C.

In: Journal of Clinical Oncology, Vol. 19, No. 6, 15.03.2001, p. 1750-1758.

Research output: Contribution to journalArticle

Schuler, M, Herrmann, R, De Greve, JLP, Stewart, AK, Gatzemeier, U, Stewart, DJ, Laufman, L, Gralla, R, Kuball, J, Buhl, R, Heussel, CP, Kommoss, F, Perruchoud, AP, Shepherd, FA, Fritz, MA, Horowitz, JA, Huber, C & Rochlitz, C 2001, 'Adenovirus-mediated wild-type p53 gene transfer in patients receiving chemotherapy for advanced non-small-cell lung cancer: Results of a multicenter phase II study', Journal of Clinical Oncology, vol. 19, no. 6, pp. 1750-1758.
Schuler, M. ; Herrmann, R. ; De Greve, J. L P ; Stewart, Alexander Keith ; Gatzemeier, U. ; Stewart, D. J. ; Laufman, L. ; Gralla, R. ; Kuball, J. ; Buhl, R. ; Heussel, C. P. ; Kommoss, F. ; Perruchoud, A. P. ; Shepherd, F. A. ; Fritz, M. A. ; Horowitz, J. A. ; Huber, C. ; Rochlitz, C. / Adenovirus-mediated wild-type p53 gene transfer in patients receiving chemotherapy for advanced non-small-cell lung cancer : Results of a multicenter phase II study. In: Journal of Clinical Oncology. 2001 ; Vol. 19, No. 6. pp. 1750-1758.
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abstract = "Purpose: To study the additional benefit from adenoviral p53 gene therapy in patients undergoing first-line chemotherapy for advanced non-small-cell lung cancer (NSCLC). Patients and Methods: Twenty-five patients with nonresectable NSCLC were enrolled in an open-label, multicenter phase II study of three cycles of regimen A, carboplatin (area under the curve, 6; day 1) plus paclitaxel (175 mg/m2, day 1), or regimen B, cisplatin (100 mg/m2, day 1) plus vinorelbine (25 mg/m2, days 1, 8, 15, and 22) in combination with intratumoral injection of 7.5 × 1012 particles of SCH 58500 (rAd/p53, day 1). Responses of individual tumor lesions were assessed after each cycle, and gene transfer was examined in posttreatment tumor biopsies using reverse transcriptase polymerase chain reaction. Results: There was no difference between the response rate of lesions treated with p53 gene therapy in addition to chemotherapy (52{\%} objective responses) and lesions treated with chemotherapy alone (48{\%} objective responses). Subgroup analysis according to the chemotherapy regimens revealed evidence for increased mean local tumor regressions in response to additional p53 gene therapy in patients receiving regimen B, but not in patients receiving regimen A. There was no survival difference between the two chemotherapy regimens, and the median survival of the cohort was 10.5 months (1-year survival, 44{\%}). Transgene expression was confirmed in tumor samples from 68{\%} of patients, and toxicities attributable to gene therapy were mild to moderate. Conclusion: Intratumoral adenoviral p53 gene therapy appears to provide no additional benefit in patients receiving an effective first-line chemotherapy for advanced NSCLC.",
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T1 - Adenovirus-mediated wild-type p53 gene transfer in patients receiving chemotherapy for advanced non-small-cell lung cancer

T2 - Results of a multicenter phase II study

AU - Schuler, M.

AU - Herrmann, R.

AU - De Greve, J. L P

AU - Stewart, Alexander Keith

AU - Gatzemeier, U.

AU - Stewart, D. J.

AU - Laufman, L.

AU - Gralla, R.

AU - Kuball, J.

AU - Buhl, R.

AU - Heussel, C. P.

AU - Kommoss, F.

AU - Perruchoud, A. P.

AU - Shepherd, F. A.

AU - Fritz, M. A.

AU - Horowitz, J. A.

AU - Huber, C.

AU - Rochlitz, C.

PY - 2001/3/15

Y1 - 2001/3/15

N2 - Purpose: To study the additional benefit from adenoviral p53 gene therapy in patients undergoing first-line chemotherapy for advanced non-small-cell lung cancer (NSCLC). Patients and Methods: Twenty-five patients with nonresectable NSCLC were enrolled in an open-label, multicenter phase II study of three cycles of regimen A, carboplatin (area under the curve, 6; day 1) plus paclitaxel (175 mg/m2, day 1), or regimen B, cisplatin (100 mg/m2, day 1) plus vinorelbine (25 mg/m2, days 1, 8, 15, and 22) in combination with intratumoral injection of 7.5 × 1012 particles of SCH 58500 (rAd/p53, day 1). Responses of individual tumor lesions were assessed after each cycle, and gene transfer was examined in posttreatment tumor biopsies using reverse transcriptase polymerase chain reaction. Results: There was no difference between the response rate of lesions treated with p53 gene therapy in addition to chemotherapy (52% objective responses) and lesions treated with chemotherapy alone (48% objective responses). Subgroup analysis according to the chemotherapy regimens revealed evidence for increased mean local tumor regressions in response to additional p53 gene therapy in patients receiving regimen B, but not in patients receiving regimen A. There was no survival difference between the two chemotherapy regimens, and the median survival of the cohort was 10.5 months (1-year survival, 44%). Transgene expression was confirmed in tumor samples from 68% of patients, and toxicities attributable to gene therapy were mild to moderate. Conclusion: Intratumoral adenoviral p53 gene therapy appears to provide no additional benefit in patients receiving an effective first-line chemotherapy for advanced NSCLC.

AB - Purpose: To study the additional benefit from adenoviral p53 gene therapy in patients undergoing first-line chemotherapy for advanced non-small-cell lung cancer (NSCLC). Patients and Methods: Twenty-five patients with nonresectable NSCLC were enrolled in an open-label, multicenter phase II study of three cycles of regimen A, carboplatin (area under the curve, 6; day 1) plus paclitaxel (175 mg/m2, day 1), or regimen B, cisplatin (100 mg/m2, day 1) plus vinorelbine (25 mg/m2, days 1, 8, 15, and 22) in combination with intratumoral injection of 7.5 × 1012 particles of SCH 58500 (rAd/p53, day 1). Responses of individual tumor lesions were assessed after each cycle, and gene transfer was examined in posttreatment tumor biopsies using reverse transcriptase polymerase chain reaction. Results: There was no difference between the response rate of lesions treated with p53 gene therapy in addition to chemotherapy (52% objective responses) and lesions treated with chemotherapy alone (48% objective responses). Subgroup analysis according to the chemotherapy regimens revealed evidence for increased mean local tumor regressions in response to additional p53 gene therapy in patients receiving regimen B, but not in patients receiving regimen A. There was no survival difference between the two chemotherapy regimens, and the median survival of the cohort was 10.5 months (1-year survival, 44%). Transgene expression was confirmed in tumor samples from 68% of patients, and toxicities attributable to gene therapy were mild to moderate. Conclusion: Intratumoral adenoviral p53 gene therapy appears to provide no additional benefit in patients receiving an effective first-line chemotherapy for advanced NSCLC.

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