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ATIM-03. ANTI-TGFß2 RNA THERAPEUTIC OT-101 INDUCES DURABLE OBJECTIVE RESPONSES IN PATIENTS WITH RECURRENT/REFRACTORY (R/R) GLIOBLASTOMA MULTIFORME (GBM, WHO GRADE 4) OR ANAPLASTIC ASTROCYTOMA (AA, WHO GRADE 3)

ABSTRACT: Abstract BACKGROUND High-grade gliomas (HGG) are characterized by a T-cell exhaustion signature and pronounced T-cell hyporesponsiveness of their tumor microenvironment (TME). Transforming growth factor beta 2 (TGF-ß2) has been implicated as a key contributor to the immunosuppressive landscape of the TME in HGG. OT-101 is a first-in-class RNA therapeutic designed to abrogate the immunosuppressive actions of TGF-ß2. Here we report the single-agent activity of OT-101 in adult patients with R/R HGG. METHODS In this phase 2 clinical trial (NCT00431561), OT-101 was administered with an intratumoral catheter using a convection enhanced delivery (CED) system. 77 patients received 4–11 cycles of OT-101 via continuous infusion over 7d. Response determinations were based on central review of MRI scans by an independent review committee according to standard and modified McDonald criteria. Standard statistical methods were applied for the analysis of data. RESULTS The median progression-free survival (PFS) and overall survival (OS) were 86d and 432d, respectively. 26 patients (33.8%) had marked reductions of their tumor volume after receiving OT-101: 19 achieved durable objective responses (CR: 3, PR: 16). The median time for 90% reduction of the baseline tumor volume was 11.7 months (Range: 4.9–57.7 months). The mean log reduction of the tumor volume was 2.2 ± 0.4 (Median = 1.4: Range: 0.4–4.5) logs. 7 had stable disease (SD) lasting > 6 months. The median PFS (1109d [95% CI: 992 - > 1423] vs. 37d [95% CI: 35 – 59] (Log-rank Chi Square = 69.9, P-value < 0.0001) and OS (1280d [95% CI: 1116- > 1743] vs. 240d [95% CI: 169 – 361] (Log-rank Chi Square = 47.0, P-value < 0.0001) of these 26 patients was significantly better than the PFS or OS of the remaining 51 patients. CONCLUSION Anti-TGFß2 RNA therapeutic OT-101 exhibits clinically meaningful single-agent activity and induces durable CR/PR/SD in R/R HGG patients.

SUBMITTER: Uckun F

PROVIDER: S-EPMC6847412 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Project description:Anaplastic astrocytoma (AA) and its more aggressive counterpart, glioblastoma multiforme (GBM), are the most common intrinsic brain tumors in adults and are almost universally fatal. A deeper understanding of the molecular relationship of these tumor types is necessary to derive insights into the diagnosis, prognosis, and treatment of gliomas. Although genomewide profiling of expression levels with microarrays can be used to identify differentially expressed genes between these tumor types, comparative studies so far have resulted in gene lists that show little overlap.To achieve a more accurate and stable list of the differentially expressed genes and pathways between primary GBM and AA, we performed a meta-analysis using publicly available genome-scale mRNA data sets. There were four data sets with sufficiently large sample sizes of both GBMs and AAs, all of which coincidentally used human U133 platforms from Affymetrix, allowing for easier and more precise integration of data. After scoring genes and pathways within each data set, we combined the statistics across studies using the nonparametric rank sum method to identify the features that differentiate GBMs and AAs. We found >900 statistically significant probe sets after correction for multiple testing from the >22,000 tested. We also used the rank sum approach to select >20 significant Biocarta pathways after correction for multiple testing out of >175 pathways examined. The most significant pathway was the hypoxia-inducible factor (HIF) pathway. Our analysis suggests that many of the most statistically significant genes work together in a HIF1A/VEGF-regulated network to increase angiogenesis and invasion in GBM when compared to AA.We have performed a meta-analysis of genome-scale mRNA expression data for 289 human malignant gliomas and have identified a list of >900 probe sets and >20 pathways that are significantly different between GBM and AA. These feature lists could be utilized to aid in diagnosis, prognosis, and grade reduction of high-grade gliomas and to identify genes that were not previously suspected of playing an important role in glioma biology. More generally, this approach suggests that combined analysis of existing data sets can reveal new insights and that the large amount of publicly available cancer data sets should be further utilized in a similar manner.

Dataset Information

ATIM-03. ANTI-TGFß2 RNA THERAPEUTIC OT-101 INDUCES DURABLE OBJECTIVE RESPONSES IN PATIENTS WITH RECURRENT/REFRACTORY (R/R) GLIOBLASTOMA MULTIFORME (GBM, WHO GRADE 4) OR ANAPLASTIC ASTROCYTOMA (AA, WHO GRADE 3)

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