You have accessJournal of UrologyProstate Cancer: Localized (VII)1 Apr 20131504 RANDOMIZED, CONTROLLED, PHASE 2 TRIAL OF ONCOLYTIC ADENOVIRUS-MEDIATED SUICIDE GENE THERAPY PLUS IMRT VERSUS IMRT ALONE IN NEWLY DIAGNOSED, INTERMEDIATE-RISK PROSTATE CANCER james peabody, Svend Freytag, Hans Stricker, Mohamed Elshaikh, Mei Lu, Nilesh Gupta, Zhaoli Lane, Theodore DeWeese, Ron Rodriguez, and Benjamin Movsas james peabodyjames peabody Detroit, MI More articles by this author , Svend FreytagSvend Freytag Detroit, MI More articles by this author , Hans StrickerHans Stricker Detroit, MI More articles by this author , Mohamed ElshaikhMohamed Elshaikh Detroit, MI More articles by this author , Mei LuMei Lu Detroit, MI More articles by this author , Nilesh GuptaNilesh Gupta Detroit, MI More articles by this author , Zhaoli LaneZhaoli Lane Detroit, MI More articles by this author , Theodore DeWeeseTheodore DeWeese Baltimore, Macedonia More articles by this author , Ron RodriguezRon Rodriguez Baltimore, Macedonia More articles by this author , and Benjamin MovsasBenjamin Movsas Detroit, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2983AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We developed a multi-modal, gene therapy-based approach for treatment of cancer using a replication-competent, oncolytic adenovirus to deliver a pair of therapeutic suicide genes to the tumor. The virus generates an anti-tumor effect by replicating in, and destroying, human cancer cells. Two suicide gene systems [cytosine deaminase (CD)/5-fluorocytosine (5-FC) and herpes simplex virus thymidine kinase (HSV-1 TK)/valganciclovir (vGCV)] sensitize malignant cells to specific pharmacological agents and sensitize them to ionizing radiation ), resulting in tumor cell destruction and release of tumor antigens, which may foster the development of anti-tumor immunity. We describe interim results of a randomized, controlled, phase 2 trial in newly diagnosed, intermediate-risk prostate cancer. METHODS 43 men with intermediate-risk prostate cancer were randomized to receive gene therapy plus intensity modulated radiation therapy (IMRT) (Arm 1) versus IMRT alone (Arm 2). Men in Arm 1 received a single intraprostatic injection of the Ad5-yCD/mutTKSR39rep-ADP adenovirus (1 × 1012 viral particles) followed by 2 weeks of 5-FC + GCV prodrug therapy and 40 × 2 Gy fractions (80 Gy) of IMRT. Men in Arm 2 received only the IMRT. Hormone therapy was not allowed. Endpoints include freedom from biochemical/clinical failure, toxicity, prostate biopsy (12 core) at 2 years, freedom from metastases, cause-specific and overall survival, and quality of life (QOL). RESULTS Median follow-up is 2.0 years. The two arms were balanced with respect to age, race, tumor stage, Gleason score, number of positive biopsy cores, PSA levels, and EPIC/EQ5D scores. Men in Arm 1 who received the gene therapy had more flu-like symptoms, transaminitis, and thrombocytopenia relative to men in Arm 2. There was no significant difference in genitourinary (GU) or gastrointestinal (GI) events between the arms. 35 of 43 (81%) patients had the 2-year biopsy. Five of 17 (29%) men in Arm 1 were biopsy-positive versus 11 of 18 (61%) in Arm 2, a 52% relative reduction in biopsy positivity on the gene therapy/IMRT arm. One patient in each arm has had biochemical failure and none have developed metastases or died. QOL was similar between the two arms. CONCLUSIONS Combining oncolytic adenovirus-mediated suicide gene therapy with modern doses of IMRT does not exacerbate the most common side effects of prostate radiotherapy and reduces by half the percentage of men with biopsy-positive cancer at 2 years in intermediate-risk prostate cancer. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e616-e617 Peer Review Report Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information james peabody Detroit, MI More articles by this author Svend Freytag Detroit, MI More articles by this author Hans Stricker Detroit, MI More articles by this author Mohamed Elshaikh Detroit, MI More articles by this author Mei Lu Detroit, MI More articles by this author Nilesh Gupta Detroit, MI More articles by this author Zhaoli Lane Detroit, MI More articles by this author Theodore DeWeese Baltimore, Macedonia More articles by this author Ron Rodriguez Baltimore, Macedonia More articles by this author Benjamin Movsas Detroit, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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