A Pilot Trial Using Lymphocytes Genetically Engineered with an NY-ESO-1–Reactive T-cell Receptor: Long-term Follow-up and Correlates with Response

TLDR

Adoptive cell therapy is highly effective for melanoma but its use in other solid tumors has been limited. This first‑in‑man trial aimed to assess the safety and efficacy of autologous T cells retrovirally transduced with an NY‑ESO‑1–reactive T‑cell receptor in heavily pretreated metastatic synovial cell sarcoma and melanoma patients. HLA‑A*0201 patients with NY‑ESO‑1‑positive metastatic synovial cell sarcoma or melanoma received lymphodepleting chemotherapy followed by infusion of TCR‑transduced T cells, with responses evaluated by RECIST and immunologic correlates. Eleven of 18 synovial cell sarcoma patients (61%) and 11 of 20 melanoma patients (55%) achieved objective responses, with 3‑ and 5‑year overall survival rates of 38%/14% for sarcoma and 33% for melanoma, indicating that the therapy can be effective for some refractory patients. Clin Cancer Res 21(5):1019–27; ©2014 AACR.

Abstract

Abstract Purpose: Although adoptive cell therapy can be highly effective for the treatment of patients with melanoma, the application of this approach to the treatment of other solid tumors has been limited. The observation that the cancer germline (CG) antigen NY-ESO-1 is expressed in 70% to 80% and in approximately 25% of patients with synovial cell sarcoma and melanoma, respectively, prompted us to perform this first-in-man clinical trial using the adoptive transfer of autologous peripheral blood mononuclear cells that were retrovirally transduced with an NY-ESO-1–reactive T-cell receptor (TCR) to heavily pretreated patients bearing these metastatic cancers. Experimental Design: HLA-*0201 patients with metastatic synovial cell sarcoma or melanoma refractory to standard treatments and whose cancers expressed NY-ESO-1 received autologous TCR-transduced T cells following a lymphodepleting preparative chemotherapy. Response rates using Response Evaluation Criteria in Solid Tumors (RECIST), as well as immunologic correlates of response, are presented in this report. Results: Eleven of 18 patients with NY-ESO-1+ synovial cell sarcomas (61%) and 11 of 20 patients with NY-ESO-1+ melanomas (55%) who received autologous T cells transduced with an NY-ESO-1–reactive TCR demonstrated objective clinical responses. The estimated overall 3- and 5-year survival rates for patients with synovial cell sarcoma were 38% and 14%, respectively, whereas the corresponding estimated survival rates for patients with melanoma were both 33%. Conclusions: The adoptive transfer of autologous T cells transduced with a retrovirus encoding a TCR against an HLA-A*0201 restricted NY-ESO-1 epitope can be an effective therapy for some patients bearing synovial cell sarcomas and melanomas that are refractory to other treatments. Clin Cancer Res; 21(5); 1019–27. ©2014 AACR.