Faculty, Staff and Student Publications

Publication Date

1-1-2023

Journal

Nature Medicine

Abstract

Affinity-optimized T cell receptors can enhance the potency of adoptive T cell therapy. Afamitresgene autoleucel (afami-cel) is a human leukocyte antigen-restricted autologous T cell therapy targeting melanoma-associated antigen A4 (MAGE-A4), a cancer/testis antigen expressed at varying levels in multiple solid tumors. We conducted a multicenter, dose-escalation, phase 1 trial in patients with relapsed/refractory metastatic solid tumors expressing MAGE-A4, including synovial sarcoma (SS), ovarian cancer and head and neck cancer ( NCT03132922 ). The primary endpoint was safety, and the secondary efficacy endpoints included overall response rate (ORR) and duration of response. All patients (N = 38, nine tumor types) experienced Grade ≥3 hematologic toxicities; 55% of patients (90% Grade ≤2) experienced cytokine release syndrome. ORR (all partial response) was 24% (9/38), 7/16 (44%) for SS and 2/22 (9%) for all other cancers. Median duration of response was 25.6 weeks (95% confidence interval (CI): 12.286, not reached) and 28.1 weeks (95% CI: 12.286, not reached) overall and for SS, respectively. Exploratory analyses showed that afami-cel infiltrates tumors, has an interferon-γ-driven mechanism of action and triggers adaptive immune responses. In addition, afami-cel has an acceptable benefit-risk profile, with early and durable responses, especially in patients with metastatic SS. Although the small trial size limits conclusions that can be drawn, the results warrant further testing in larger studies.

Keywords

Male, Humans, Antigens, Neoplasm, Neoplasm Proteins, Head and Neck Neoplasms, HLA-A Antigens, Cell- and Tissue-Based Therapy, Immunotherapy, Adoptive, Cancer immunotherapy, Head and neck cancer, Sarcoma, Ovarian cancer, T cells

DOI

10.1038/s41591-022-02128-z

PMID

36624315

PMCID

PMC9873554

PubMedCentral® Posted Date

1-9-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

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