100%患者获临床缓解的CAR-T疗法；晚期癌症疾病控制率达92%的TCR-T疗法…… | 一周盘点

▎药明康德内容团队编辑

本期看点

1. T细胞受体T细胞（TCR-T）疗法IMA203在一项1b期临床试验中令92%转移性黑色素瘤患者的疾病获得控制，且患者的中位缓解持续时间（DOR）超过一年。

2. B细胞成熟抗原（BCMA）靶向自体嵌合抗原受体（CAR）-T细胞疗法Ribrecabtagene autoleucel（DRL-1801）用于治疗复发/难治性多发性骨髓瘤患者的1期临床试验结果亮眼，首批8名接受治疗的患者均获得了临床缓解。

3. 用于治疗胶质母细胞瘤（GBM）的树突状细胞疫苗DOC1021相比于标准治疗（SOC）有望大幅延长患者的中位总生存期（OS）。

药明康德内容团队整理

IMA203：公布1b期临床试验数据

Immatics公布了其在研TCR-T疗法IMA203用以治疗转移性黑色素瘤患者的最新，这些患者先前接受过大量治疗。IMA203是由Immatics专有的ACTengine平台所开发的TCR-T细胞疗法，靶向由HLA-A*02呈递的黑素瘤抗原PRAME。PRAME是一种在各种实体瘤中经常表达的蛋白质，因此IMA203具潜力治疗广泛的癌症患者群体。

此次公布的结果显示，92%患者的疾病获得控制且患者的中位DOR超过一年。根据此积极数据，Immatics预定在今年12月启动SUPRAME注册性3期试验，预计病患招募将于2026年完成，并在2026年初进行预定的中期分析。

Ribrecabtagene autoleucel（DRL-1801）：公布1期临床试验数据

Aurigene Oncology公司宣布其新型BCMA靶向自体CAR-T细胞疗法Ribrecabtagene autoleucel（DRL-1801）用于治疗复发/难治性多发性骨髓瘤的1期临床试验中首批8名患者的初步结果。所有患者都接受过大量的前期治疗，中位治疗线数为5.5线。大多数患者此前也曾接受过移植手术，并在移植后出现疾病进展。结果显示，100%的患者获得了临床缓解，其中有5名（62.5%）患者获得了严格的完全缓解（CR）。安全性方面，所有患者均未出现高级别的细胞因子释放综合征（CRS）或神经毒性。

DOC1021：公布1期临床试验的中期数据

Diakonos Oncology公司公布了其树突状细胞疫苗DOC1021用于治疗胶质母细胞瘤患者的1期开放标签试验的中期分析结果。该公司的树突状细胞疫苗由患者自身的免疫细胞与从肿瘤样本中提取的RNA和蛋白质结合制成。这种独特的方法可以靶向完整的癌症抗原谱，而无需进行任何基因修饰。通过利用天然的免疫信号通路，这种策略使免疫系统能将癌细胞视同受病毒感染的细胞一样进行识别和清除。

此次公布的结果显示，15例患有挑战性肿瘤、MGMT未甲基化（通常预后不良）患者中有14例存活超过12个月。目前，中位随访时间为16个月，中位OS尚未达到。Kaplan-Meier（KM）分析将接受DOC1021治疗的患者与接受完整SOC的年龄匹配历史对照组患者进行比较，两组在统计学上具有差异（p=0.03）。KM预测接受DOC1021治疗的患者的OS为19.7个月，而接受SOC的未甲基化GBM患者的预期OS为12.7个月。安全性方面，没有剂量限制性毒性或令人担忧的严重不良事件（SAE）。

VIP943：公布1期临床试验数据

Vincerx Pharma公司公布了其抗体偶联药物（ADC）VIP943治疗复发/难治性急性髓系白血病（AML）、高危骨髓增生异常综合征（HR-MDS）和B细胞急性淋巴细胞白血病（B-ALL）的1期临床试验的结果。VIP943由抗CD123抗体、一种在细胞内切割的独特连接子和一种新型驱动蛋白纺锤体蛋白抑制剂（KSPi）有效载荷组成。Vincerx的CellTrapper技术可确保KSPi有效载荷积聚在靶细胞中，限制非靶细胞、非分裂细胞的吸收，从而减少非特异性释放。

该1期剂量递增研究共招募了22名患者，他们很少对单一疗法产生应答。9名患者（6名AML患者和3名HR-MDS患者）至少接受了3次有效剂量的VIP943治疗。截至目前，1名复发性AML患者获得了完全缓解伴血液学不完全恢复（CRi），1名HR-MDS患者获得了完全缓解伴较少血液学恢复（CRL）。截至2024年8月的数据，VIP943显示出良好的安全性和耐受性，没有报告剂量限制性毒性，SAE与预期一致。

VK0214：公布1b期临床试验数据

Viking Therapeutics公司公布了其新型甲状腺激素受体β（TRβ）小分子激动剂VK0214在X-连锁肾上腺白质营养不良（X-ALD）患者中进行的1b期临床试验的积极数据。X-ALD是一种罕见的致命代谢性疾病，由ABCD1基因突变引起，这种突变会导致肾上腺脑白质营养不良蛋白（ALDP）功能障碍，从而引起脂肪酸的异常累积。临床前研究表明，甲状腺激素受体β型可以调节ABCD2相关基因的表达，ABCD2能够编码一种称为肾上腺脑白质营养不良相关蛋白（ADLRP）的代偿转运体，通过增加ABCD2表达可以使特定脂肪酸水平恢复正常。

此次公布的研究结果表明，在为期28天的研究期间，VK0214每天用药一次的安全性和耐受性良好。此外，与安慰剂相比，接受VK0214治疗患者血浆中的超长链脂肪酸（VLCFAs）和其他血脂水平明显降低。

▲VK0214治疗28天后患者的VLCFA与基线相比的变化（图片来源：参考资料[5]）

▲VK0214治疗28天后患者的其他血脂与基线相比的变化（图片来源：参考资料[5]）

Paxalisib：公布1期临床试验的新数据

Kazia Therapeutics公司公布其口服PI3K/mTOR双抑制剂paxalisib联用放射疗法治疗PI3K通路突变实体瘤脑转移（BM）或软脑膜转移（LM）患者的1期临床试验的数据。此次公布的结果显示，paxalisib联用放疗总体耐受性良好。研究中最常报告的不良反应是恶心、呕吐和高血糖。接受45 mg paxalisib联用放疗患者中有67%获得了部分缓解（PR），接受最大耐受剂量治疗的患者中有超过三分之二的人获得了颅内缓解，这与单独使用全脑放疗的历史缓解率相比毫不逊色。

ELVN-001：公布1期临床试验的新数据

Enliven Therapeutics公司公布其小分子激酶抑制剂ELVN-001治疗复发/难治性或对现有酪氨酸激酶抑制剂（TKI）不耐受的慢性髓系白血病（CML）患者的1期临床试验的积极数据。ELVN-001是一种强效、高选择性、潜在“best-in-class”的小分子激酶抑制剂，专门针对CML患者的致癌驱动因子BCR-ABL融合蛋白。ELVN-001还具有针对耐药性最强的BCR-ABL1耐药突变体T315I和其他已知耐药突变体的活性。

截至2024年6月25日的数据，ELVN-001的耐受性保持良好，没有患者减少剂量，未报告≥3级治疗相关的非血液学毒性反应。第24周时，患者的初始累积主要分子缓解（MMR）率为44%（8/18），与已获批的BCR-ABL1酪氨酸激酶抑制剂在1期临床试验中的数据相比具有优势。

Camonsertib：公布1期联合治疗试验数据

Repare Therapeutics公司公布了潜在”best-in-class”口服小分子ATR抑制剂camonsertib结合姑息性放疗，治疗携带ATM突变转移性肿瘤的1期临床试验数据。该试验纳入了17例携带ATM突变的转移性肿瘤患者，其中12人携带致病性ATM基因突变，5人携带ATM基因突变的意义不明变异（VUS）。这些患者的原发性癌症组织学来源包括胃肠道（n=5）、胰腺（n=5）、乳腺癌（n=2）、肺（n=2）、膀胱（n=2）和甲状腺（n=1）。

此次公布的结果显示，2个月时，致病性ATM突变组有2例CR、5例PR和4例疾病稳定（SD）患者，而VUS组有1例PR和4例SD患者。6个月时，在9名可评估患者中，致病性ATM突变组有2例CR、4例PR和1例SD患者，而VUS组有1例SD和1例疾病进展患者。该早期临床数据表明camonsertib联合放疗治疗有可能对携带致病性ATM突变的肿瘤患者进行放射增敏，从而获得更高的临床益处。

Misetionamide：公布1期临床试验的中期数据

Panavance Therapeutics公司公布了其小分子疗法misetionamide（GP-2250）联用吉西他滨治疗晚期不可切除或转移性胰腺导管腺癌患者1期临床试验的中期数据。Misetionamide具有独特的作用机制，可抑制两种致癌转录因子c-MYC和NFκB。此次公布的结果显示，与单独使用吉西他滨的历史结果相比，接受misetionamide联用吉西他滨治疗患者的无进展生存期更长，约40%的患者达到PR或SD。此外，misetionamide联用吉西他滨的安全性良好。

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参考资料（可上下滑动查看）

[1] Vincerx Reports Positive Initial Clinical Data from Ongoing VIP943 Phase 1 Dose-Escalation Study and Provides Pipeline and Corporate Updates. Retrieved October 11, 2024, from https://www.globenewswire.com/news-release/2024/10/07/2959307/0/en/Vincerx-Reports-Positive-Initial-Clinical-Data-from-Ongoing-VIP943-Phase-1-Dose-Escalation-Study-and-Provides-Pipeline-and-Corporate-Updates.html

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[4] Kazia Therapeutics Announces Presentation of Promising Phase I Data Evaluating Concurrent Paxalisib and Radiation Therapy in Patients with Solid Tumor Brain Metastases or Leptomeningeal Metastases Harboring PI3K Pathway Mutations at the American Society for Radiation Oncology 66th Annual Meeting. Retrieved October 11, 2024, from https://www.prnewswire.com/news-releases/kazia-therapeutics-announces-presentation-of-promising-phase-i-data-evaluating-concurrent-paxalisib-and-radiation-therapy-in-patients-with-solid-tumor-brain-metastases-or-leptomeningeal-metastases-harboring-pi3k-pathway-mutations--302265538.html

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