Literature DB >> 17575227

An open-label, two-arm, phase I trial of recombinant human interleukin-21 in patients with metastatic melanoma.

Ian D Davis1, Birte K Skrumsager, Jonathan Cebon, Theo Nicholaou, John W Barlow, Niels Peter Hundahl Moller, Kresten Skak, Dorthe Lundsgaard, Klaus Stensgaard Frederiksen, Peter Thygesen, Grant A McArthur.   

Abstract

PURPOSE: Human interleukin-21 (IL-21) is a pleiotropic class I cytokine that activates CD8(+) T cells and natural killer cells. We report a phase 1 study of recombinant human IL-21 in patients with surgically incurable metastatic melanoma. The primary objective was to investigate safety and tolerability by determining dose-limiting toxicity (DLT). The secondary objectives were to identify a dose response for various biomarkers in the peripheral blood, estimate the minimum biologically effective dose, determine the pharmacokinetics of IL-21, determine if anti-IL-21 antibodies were induced during therapy, and measure effects on tumor size according to Response Evaluation Criteria in Solid Tumors. EXPERIMENTAL
DESIGN: Open-label, two-arm, dose escalation trial of IL-21 administered by i.v. bolus injection at dose levels from 1 to 100 microg/kg using two parallel treatment regimens: thrice weekly for 6 weeks (3/wk) or three cycles of daily dosing for 5 days followed by 9 days of rest (5+9).
RESULTS: Twenty-nine patients entered the study. IL-21 was generally well tolerated and no DLTs were observed at the 1, 3, and 10 microg/kg dose levels. In the 3/wk regimen, DLTs were increased in alanine aminotransferase, neutropenia, and lightheadedness with fever and rigors. DLTs in the 5+9 regimen were increased in aspartate aminotransferase and alanine aminotransferase, neutropenia, fatigue, and thrombocytopenia. The maximum tolerated dose was declared to be 30 microg/kg for both regimens. Effects on biomarkers were observed at all dose levels, including increased levels of soluble CD25 and up-regulation of perforin and granzyme B mRNA in CD8(+) cells. One partial tumor response observed after treatment with IL-21 for 2 x 6 weeks (3/wk) became complete 3 months later.
CONCLUSIONS: IL-21 is biologically active at all dose levels administered and is generally well tolerated, and phase 2 studies have commenced using 30 microg/kg in the 5+9 regimen.

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Year:  2007        PMID: 17575227     DOI: 10.1158/1078-0432.CCR-07-0410

Source DB:  PubMed          Journal:  Clin Cancer Res        ISSN: 1078-0432            Impact factor:   12.531


  53 in total

1.  IL-21 Enhances Natural Killer Cell Response to Cetuximab-Coated Pancreatic Tumor Cells.

Authors:  Elizabeth L McMichael; Alena Cristina Jaime-Ramirez; Kristan D Guenterberg; Eric Luedke; Lakhvir S Atwal; Amanda R Campbell; Zhiwei Hu; Armika S Tatum; Sri Vidya Kondadasula; Xiaokui Mo; Susheela Tridandapani; Mark Bloomston; E Christopher Ellison; Terence M Williams; Tanios Bekaii-Saab; William E Carson
Journal:  Clin Cancer Res       Date:  2016-07-19       Impact factor: 12.531

2.  Activation of the FcgammaReceptorIIIa on human natural killer cells leads to increased expression of functional interleukin-21 receptor.

Authors:  Elizabeth L McMichael; Nicholas B Courtney; Megan C Duggan; Robert Wesolowski; Dionisia Quiroga; Sri Vidya Kondadasula; Lakhvir S Atwal; Neela Bhave; Eric Luedke; Alena Cristina Jaime-Ramirez; Amanda R Campbell; Xiaokui Mo; John C Byrd; William E Carson Iii
Journal:  Oncoimmunology       Date:  2017-05-02       Impact factor: 8.110

Review 3.  Functions of γC cytokines in immune homeostasis: current and potential clinical applications.

Authors:  Willem W Overwijk; Kimberly S Schluns
Journal:  Clin Immunol       Date:  2009-05-09       Impact factor: 3.969

Review 4.  Strategies to enhance NK cell function for the treatment of tumors and infections.

Authors:  Jacquelyn Freund-Brown; Leilani Chirino; Taku Kambayashi
Journal:  Crit Rev Immunol       Date:  2018       Impact factor: 2.214

5.  Cytokines as Adjuvants for Vaccine and Cellular Therapies for Cancer.

Authors:  Christian M Capitini; Terry J Fry; Crystal L Mackall
Journal:  Am J Immunol       Date:  2009-01-01

Review 6.  Interleukin-21: a double-edged sword with therapeutic potential.

Authors:  Rosanne Spolski; Warren J Leonard
Journal:  Nat Rev Drug Discov       Date:  2014-04-22       Impact factor: 84.694

7.  Dissociation of its opposing immunologic effects is critical for the optimization of antitumor CD8+ T-cell responses induced by interleukin 21.

Authors:  Sascha Ansén; Marcus O Butler; Alla Berezovskaya; Andrew P Murray; Kristen Stevenson; Lee M Nadler; Naoto Hirano
Journal:  Clin Cancer Res       Date:  2008-10-01       Impact factor: 12.531

8.  IL-21 augments natural killer effector functions in chronically HIV-infected individuals.

Authors:  Natasa Strbo; Lesley de Armas; Huanliang Liu; Michael A Kolber; Mathias Lichtenheld; Savita Pahwa
Journal:  AIDS       Date:  2008-08-20       Impact factor: 4.177

9.  Interleukin-21 can efficiently restore impaired antibody-dependent cell-mediated cytotoxicity in patients with oesophageal squamous cell carcinoma.

Authors:  M Watanabe; K Kono; Y Kawaguchi; Y Mizukami; K Mimura; T Maruyama; H Fujii
Journal:  Br J Cancer       Date:  2009-12-22       Impact factor: 7.640

10.  Interleukin-21 induces the differentiation of human umbilical cord blood CD34-lineage- cells into pseudomature lytic NK cells.

Authors:  Giuseppina Bonanno; Andrea Mariotti; Annabella Procoli; Maria Corallo; Giovanni Scambia; Luca Pierelli; Sergio Rutella
Journal:  BMC Immunol       Date:  2009-08-27       Impact factor: 3.615

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