In the last decade, immunotherapy has become the cornerstone in the management of patients with melanoma, the foremost cause of skin-cancer-related death in the USA. The emergence of immune checkpoint blockade as a crucial element in current immunotherapy and combination strategies has significantly transformed the treatments of resectable and advanced (unresectable or metastatic) melanoma. This paper reviews the landmark clinical trials that formed the basis of management of melanoma in the perioperative and metastatic setting. Furthermore, we discuss the rationale for the applications of PD-1 blockade and its combination with anti-CTLA-4 and anti-LAG-3. The review also explores new experimental combinations of PD-1 blockade with other immunomodulatory agents, including targeted therapies, anti-TIGIT antibodies, TLR-9 agonists, antiangiogenic agents, and mRNA vaccines.

2024-01-01·Critical reviews in oncology/hematology

Preoperative therapy in melanoma: Evolving perspectives in clinical trials

Review

作者: Xu, Kevin ; Loftus, Alexander W ; Mangla, Ankit ; Ahmed, Fasih A ; Elshami, Mohamedraed ; Rothermel, Luke D ; Ammori, John B ; Kakish, Hanna ; Hoehn, Richard S

We reviewed phase II and III trials beginning after 2010 studying preoperative therapy in melanoma (61 trials). Compared to standard adjuvant treatment, neoadjuvant immune checkpoint inhibitors (ICIs) show improved outcomes with approximately 70-80% recurrence free survival at 2 years. Several biomarkers demonstrate predictive value for pathological response (higher PD-L1 expression) and survival (IFN-γ signatures, CD8 + cell density). A number of 'non-standard' treatment mechanisms are being studied in combination with ICI therapies such as TLR-9 agonists, and anti-LAG3 checkpoint inhibitors, which show promise for alternative therapy options in the neoadjuvant setting. Finally, trials for advanced unresectable melanomas show improved survival compared to definitive systemic treatment when upfront systemic therapies lead to resectability. To conclude, in the preoperative setting for melanoma, ICIs have potential to improve outcomes for patients, and will likely change the standard treatment approach for advanced resectable disease.

2023-05-01·Annals of the rheumatic diseases

Role of CD14+ monocyte-derived oxidised mitochondrial DNA in the inflammatory interferon type 1 signature in juvenile dermatomyositis

Article

作者: Otto, Georg W ; Papadopoulou, Charalampia ; Castellano, Sergi ; Wilkinson, Meredyth G Ll ; Rosser, Elizabeth C ; Wedderburn, Lucy R ; Wincup, Chris ; McDonnell, Thomas C R ; Kelberman, Daniel ; Orford, Michael ; Restuadi, Restuadi ; Ting, Joanna Y J ; Moulding, Dale ; Eaton, Simon ; Deakin, Claire T

Objectives:

To define the host mechanisms contributing to the pathological interferon (IFN) type 1 signature in Juvenile dermatomyositis (JDM).

Methods:

RNA-sequencing was performed on CD4+, CD8+, CD14+and CD19+cells sorted from pretreatment and on-treatment JDM (pretreatment n=10, on-treatment n=11) and age/sex-matched child healthy-control (CHC n=4) peripheral blood mononuclear cell (PBMC). Mitochondrial morphology and superoxide were assessed by fluorescence microscopy, cellular metabolism by13C glucose uptake assays, and oxidised mitochondrial DNA (oxmtDNA) content by dot-blot. Healthy-control PBMC and JDM pretreatment PBMC were cultured with IFN-α, oxmtDNA, cGAS-inhibitor, TLR-9 antagonist and/orn-acetyl cysteine (NAC). IFN-stimulated gene (ISGs) expression was measured by qPCR. Total numbers of patient and controls for functional experiments, JDM n=82, total CHC n=35.

Results:

Dysregulated mitochondrial-associated gene expression correlated with increased ISG expression in JDM CD14+ monocytes. Altered mitochondrial-associated gene expression was paralleled by altered mitochondrial biology, including ‘megamitochondria’, cellular metabolism and a decrease in gene expression of superoxide dismutase (SOD)1. This was associated with enhanced production of oxidised mitochondrial (oxmt)DNA. OxmtDNA induced ISG expression in healthy PBMC, which was blocked by targeting oxidative stress and intracellular nucleic acid sensing pathways. Complementary experiments showed that, under in vitro experimental conditions, targeting these pathways via the antioxidant drug NAC, TLR9 antagonist and to a lesser extent cGAS-inhibitor, suppressed ISG expression in pretreatment JDM PBMC.

Conclusions:

These results describe a novel pathway where altered mitochondrial biology in JDM CD14+ monocytes lead to oxmtDNA production and stimulates ISG expression. Targeting this pathway has therapeutical potential in JDM and other IFN type 1-driven autoimmune diseases.

项与 Napa9-SPG 相关的新闻（医药）

2024-03-07

·Business Wire

TriSalus Life Sciences Receives Approval from the World Health Organization and the American Medical Association’s Adopted Name Council for “Nelitolimod” as the Nonproprietary Drug Name for SD-101

DENVER--( BUSINESS WIRE )-- TriSalus Life Sciences ® Inc. (Nasdaq: TLSI), an oncology company integrating its novel delivery technology with immunotherapy to transform treatment for patients with liver and pancreatic tumors, today announced that the International Nonproprietary Names (INN) Expert Committee of the World Health Organization (WHO) and the United States Adopted Names (USAN) Council have approved the use of the nonproprietary name of " nelitolimod " for SD-101, a class C TLR-9 agonist. Nelitolimod is the Company’s novel lead drug candidate that is currently being studied in three Phase 1/1b trials for the treatment of uveal melanoma with liver metastases, hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and locally advanced pancreatic ductal adenocarcinoma. “The WHO INN and USAN approval of nelitolimod is an important milestone in the continued progress we are making with our nelitolimod program,” said Mary Szela, Chief Executive Officer and President of TriSalus. “This accomplishment, along with the recent assignment of a new technology HCPCS Code for our TriNav ® Infusion System, further positions TriSalus to deliver on our mission to overcome key treatment barriers in liver and pancreatic tumors and make a meaningful difference in the lives of patients suffering from cancer.” TriSalus’ unique approach leverages its innovative delivery device together with its immunotherapeutic drug to overcome the mechanical and biologic barriers present in the tumor microenvironment. This approach has the potential to enable more durable responses by patients to other immunotherapeutics, thereby facilitating better patient outcomes. Data from TriSalus’ Phase 1/1b trials indicates that the Company’s approach in liver and pancreatic tumors is well tolerated with encouraging efficacy and immune signals, with evidence of nelitolimod being delivered by the TriNav system into difficult to reach tumors, potentially overcoming limitations posed by intravenous or direct needle injection approaches. Information on nelitolimod will be posted on the USAN website ( www.ama-assn.org/go/usan ) and will be published in the Chemical Abstracts Service and in the U.S. Pharmacopeia. The WHO provides the INN to the Organization's Member States (at present 191), to national pharmacopoeia commissions, and to other bodies designated by WHO’s Member States. The name, nelitolimod, is ready for use in labelling and publications. It will serve to identify SD-101 during its lifetime worldwide. Going forward, TriSalus will use the name in publications and public statements, at conferences and other forums, and in corporate-related materials. About TriSalus Life Sciences TriSalus Life Sciences is an oncology company integrating novel delivery technology with immunotherapy to transform treatment for patients with liver and pancreatic tumors. The Company’s platform includes devices that utilize a proprietary drug delivery technology and a clinical-stage investigational immunotherapy. The Company’s two FDA-cleared devices use its proprietary Pressure-Enabled Drug Delivery™ (PEDD™) approach to deliver a range of therapeutics: the TriNav ® Infusion System for hepatic arterial infusion of liver tumors and the Pancreatic Retrograde Venous Infusion System for pancreatic tumors. PEDD is a novel delivery approach designed to address the anatomic limitations of arterial infusion to the pancreas. The PEDD approach modulates pressure and flow in a manner that delivers more therapeutic to the tumor and is designed to reduce undesired delivery to normal tissue, bringing the potential to improve patient outcomes. SD-101, the Company’s investigational immunotherapeutic candidate, is designed to improve patient outcomes by treating the immunosuppressive environment created by many tumors, which can make current immunotherapies ineffective in the liver and pancreas. Patient data generated during Pressure-Enabled Regional Immuno-Oncology™ (PERIO) clinical trials support the hypothesis that SD-101 delivered via PEDD may have favorable immune effects within the liver and systemically. The target for SD-101, TLR9, is expressed across cancer types and the mechanical barriers addressed by PEDD are commonly present as well. SD-101 delivered by PEDD will be studied across several indications in an effort to address immune dysfunction and overcome drug delivery barriers in the liver and pancreas. In partnership with leading cancer centers across the country – and by leveraging deep immuno-oncology expertise and inventive technology development – TriSalus is committed to advancing innovation that improves outcomes for patients. Learn more at trisaluslifesci.com and follow us on X (formerly Twitter) and LinkedIn .

免疫疗法临床研究上市批准

2024-03-06

·GlobeNewswire-Health Care

ACTG CROI Presentation Demonstrates Superiority of HepB-CpG Vaccine Over Conventional Hepatitis B Vaccine Among People Living With HIV Who Have Not Previously Responded to Vaccination

LOS ANGELES, March 06, 2024 (GLOBE NEWSWIRE) -- ACTG, a global clinical trials network focused on HIV and other infectious diseases, today made the oral presentation “HepB-CpG Vaccine is Superior to HepB-alum in People with HIV and Prior Vaccine Non-Response (A5379)” at the Conference on Retroviruses and Opportunistic Infections (CROI 2024) in Denver, Colorado. These data demonstrated that the HepB-CpG vaccine achieved up to 99 percent protection among people living with HIV who had previously not responded to conventional hepatitis B vaccines, a noteworthy increase compared to the protection achieved by conventional vaccines. People living with HIV, especially those with lower CD4 counts, often do not develop protective antibodies after receiving conventional hepatitis B vaccines. The HepB-CpG (HEPLISAV-B®) vaccine includes a TLR-9 agonist adjuvant (CpG 1018® adjuvant) and is known to achieve high protection against hepatitis B among people living with HIV, but until now there have been limited data about its protection among people living with HIV who have not responded to conventional hepatitis B vaccines. “Hepatitis B remains a significant issue for people living with HIV, as having both viruses increases the likelihood of liver complications,” said ACTG Chair Judith Currier, M.D., M.Sc., University of California Los Angeles. “Today’s presentation demonstrated extremely high rates of protection among those receiving the HepB-CpG vaccine and are likely to change clinical practice.” A5379 is an ongoing, open-label study that compares protection of the HepB-CpG vaccine to the conventional hepatitis B vaccine among people living with HIV who had not responded to prior hepatitis B vaccination and are on antiretroviral therapy (ART). Of the 561 eligible participants enrolled at 41 sites in 10 countries, 64 percent were male, 42 percent were Black, 35 percent were White, 17 percent were Asian, 22 percent were Hispanic, and the median age was 46 years old. They were equally randomized to one of three groups, receiving either: Two doses of HepB-CpG intramuscularly at week 0 and week 4Three doses of HepB-CpG intramuscularly at week 0, week 4, and week 24Three doses of HepB-alum (conventional hepatitis B vaccine) intramuscularly at week 0, week 4, and week 24 Today’s analysis showed that 93 percent of participants receiving two doses of the HepB-CpG vaccine and 99 percent receiving three doses of the HepB-CpG vaccine achieved protection against hepatitis B, compared to 81 percent receiving three doses of the conventional hepatitis B vaccine. The most frequently reported adverse events were vaccination site pain, fatigue, headache, malaise, and myalgia. No unexpected safety issues were observed. “In all of our HIV clinics, we see large numbers of people living with HIV who have been vaccinated against hepatitis B but show no evidence of a vaccine response,” said Lead Author and Protocol Co-Chair Kristen Marks, M.D., Weill Cornell Medicine. “Today’s remarkable findings are game changing for those individuals and offer them a potential path toward protection against hepatitis B.” A5379 is led by Kenneth Sherman, M.D., Ph.D., University of Cincinnati and Massachusetts General Hospital (Protocol Chair) and Dr. Marks. ACTG is led by Dr. Currier and Joseph J. Eron, M.D., University of North Carolina (ACTG Vice-Chair). It is sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (which also funds ACTG) under award numbers UM1 AI068636, UM1 AI107716, and UM1 AI068634. HEPLISAV-B® was provided by Dynavax Technologies Corporation. About ACTGACTG is the world’s largest and longest running clinical trials network focused on HIV and other infectious diseases and the people living with them. It is funded by NIAID and collaborating NIH Institutes. Founded in 1987, ACTG conducts research to improve the management of HIV and its comorbidities; develop a cure for HIV; and innovate treatments for tuberculosis, hepatitis B, and emerging infectious diseases. It comprises thousands of dedicated researchers, staff, and community members who are pursuing research into novel treatments and cures for infectious diseases at 65 locations across four continents, with the ultimate goal of advancing science that meaningfully impacts the lives of the people we serve. Disclaimer: This content is solely the responsibility of ACTG and does not necessarily represent the official views of the NIH. Media Contact:Rachel Reiss, ACTGRLReiss@mednet.ucla.edu

临床结果疫苗临床研究

2023-11-04

·BioSpace

Late-Breaking Phase 1 Liver Metastasis Data from TriSalus Presented at SITC 2023 Supports Development of Innovative Immuno-oncology Approach for Liver and Pancreas Indications

New data from PERIO-01 clinical trial indicates PEDD™ method resulted in modulation of the tumor microenvironment by enabling performance of the TLR9 agonist, SD-101, in metastatic uveal melanoma, consistent with an earlier presentation from pancreatic adenocarcinoma trial Median Progression-Free Survival was 11.7 months, with an 81% Disease Control Rate with the optimal biologic dose of SD-101 (2 mg) in combination with nivolumab DENVER & SAN DIEGO--(BUSINESS WIRE)-- TriSalus Life Sciences® Inc., (Nasdaq: TLSI), an oncology company integrating its novel delivery technology with immunotherapy to transform treatment for patients with liver and pancreatic tumors, today presented additional Phase 1 clinical data during the late-breaker oral presentation session at the Society of Immunotherapy for Cancer (SITC) 2023 Annual Meeting. The PERIO-01 Phase 1 study for uveal melanoma with liver metastases (UMLM), studied SD-101 delivered via PEDD with the TriNav® Infusion System in combination with intravenous checkpoint inhibitors. The data presented today at SITC demonstrate that SD-101 is well tolerated when given by the PEDD method and is associated with immunologic effects both within the liver and systemically, which may enable better outcomes with systemic checkpoint inhibition. The Progression-Free Survival (PFS), Disease Control Rate (DCR), and ctDNA molecular response data in PERIO-01 patients in combination with nivolumab are encouraging for UMLM and for other indications under development. At the optimal biologic dose of SD-101 (2 mg) in combination with nivolumab (n=7), the median PFS was 11.7 months with an 81% DCR. “We are encouraged to see that SD-101 is well tolerated when given by PEDD, in association with immunologic effects within the liver and systemically, which may enable better outcomes with systemic checkpoint inhibition,” said Steven C. Katz, M.D., FACS, Chief Medical Officer at TriSalus. “The PFS and ctDNA molecular response data in PERIO-01 patients in combination with nivolumab are promising for UMLM and as well as for other indications that we are pursuing.” “The results of PERIO-01 highlight the importance of getting the biology right and not just pushing a drug to its maximum tolerated dose. The biological effects of SD-101 are best at the lowest dose tested, revealing tumor microenvironment reprogramming and inflammatory cell trafficking from normal to metastatic liver tumors,” said Sapna Patel, M.D., director of the uveal melanoma program at The University of Texas MD Anderson Cancer Center. “This is not seen at higher doses of SD-101, and these findings ensure we are entering the next phase with the optimal dose in combination with checkpoint inhibition, for patients with metastatic uveal melanoma.” PERIO-01 is an open-label, first-in-human Phase 1 trial of SD-101, administered by hepatic arterial infusion with TriNav using PEDD in UMLM. The study consists of dose-escalation cohorts of SD-101 (2, 4, or 8 mg) alone or with immune checkpoint inhibition. At the data cutoff as of September 29, 2023, 56 patients were enrolled, with each having received at least one dose of SD-101. Of the patients with available data, 16 patients (29%) were treatment-naïve and 40 (71%) had failed at least one prior line of therapy, including 8 patients (14%) on 3rd or greater line of treatment. SD-101 infused via PEDD in combination with systemic checkpoint inhibition was well tolerated, with an overall serious grade 3/4 adverse event rate related to treatment of 11% (n=56), and no such events at the optimal SD-101 dose level of 2 mg in combination with nivolumab (n=7). The most common adverse events overall were gastrointestinal (41%), fatigue (30%), and skin toxicity (27%), with the majority being minor. Encouraging early efficacy signals were noted in the UMLM patients treated in PERIO-01. Overall, the ctDNA molecular response rate was 65% using specified time points (n=20), and 82% when analyzing the best on-treatment response (n=26). Clearance of ctDNA was noted in 59% of subjects when assessing the best on-treatment response. There was an 81% disease control rate at 2 mg SD-101 via PEDD with nivolumab (n=7). Across all subjects, two partial responses (≥30% decrease) and five minor responses (10-29% decrease) were documented as the best on-treatment response. The median progression free survival at the optimal dose of SD-101 via PEDD (2 mg) in combination with nivolumab was 11.7 months with a 1-year overall survival rate of 86% (n=7). Among PERIO-01 patients who received SD-101 via PEDD in combination with intravenous nivolumab, there was evidence of increases in CD8+ T cells, CD4+ T cells, and natural killer cells within their liver metastases. Gene expression analysis by Nanostring revealed increased TLR signaling, interferon signaling, cytokine signaling, Th1 T cell activation, and lymphocyte activation. At the optimal SD-101 dose of 2 mg in combination with nivolumab, decreases in monocytic myeloid derived suppressor cells (MDSC), M2 macrophages, and regulatory T cells were found in liver metastases. Along with predicted immune changes within liver metastases, encouraging peripheral immune signals were detected. Increases in IFNγ, soluble IL2-receptor, IL-15, IL-18, T cell activation, and NK cell proliferation were found in the blood. Dr. Katz added, “These data reflect additional validation of our innovative immunotherapy approach for liver and pancreas tumors. SD-101 was selected based on its mechanism of action, which has the potential to reverse immunosuppression in the liver and pancreas through depletion of MDSC in concert with broad stimulation of immune cells in the tumor microenvironment. TriSalus delivery systems, which use the PEDD method, are designed to overcome mechanical barriers to immunotherapy success, which may be underappreciated factors in limiting performance of TLR agonists in liver and pancreas tumors.” Overall, the data emerging from the PERIO-01 and PERIO-03 also presented at SITC indicate immunologic changes are occurring within the liver and pancreas, with favorable safety pro Patients with liver metastases in the PERIO-01 study have had favorable outcomes despite pre-treatment. All TriSalus presentations from SITC is available here following their respective sessions. About Pressure-Enabled Regional Immuno-Oncology (PERIO) clinical trials The Pressure-Enabled Regional Immuno-Oncology (PERIO) clinical trials are studying an investigational class C toll-like receptor-9 agonist, SD-101, delivered intravascularly by TriSalus’ TriNav® Infusion System (TriNav) using the Company’s proprietary Pressure-Enabled Drug Delivery™ (PEDD™) method of administration in three Phase 1 trials. The PERIO-01 Phase 1 clinical study for uveal melanoma with liver metastases (UMLM), is studying SD-101 delivered via PEDD with the TriNav in combination with intravenous checkpoint inhibitors. The PERIO-02 trial is evaluating whether this same platform approach (PERIO-01) with SD-101 and PEDD can improve the performance of systemic checkpoint inhibitors in treating patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma. The PERIO-03 study is an open-label, Phase 1/1b study of the pressure-enabled intrapancreatic infusion of SD-101, a TLR 9 agonist, alone or in combination with intravenous checkpoint blockade in adults with locally advanced pancreatic cancer. About TriSalus Life Sciences TriSalus Life Sciences® is an oncology company integrating novel delivery technology with immunotherapy to transform treatment for patients with liver and pancreatic tumors. The Company’s platform includes devices that utilize a proprietary drug delivery technology and a clinical stage investigational immunotherapy. The Company’s two FDA-cleared devices use its proprietary Pressure-Enabled Drug Delivery™ (PEDD™) approach to deliver a range of therapeutics: the TriNav® Infusion System for hepatic arterial infusion of liver tumors and the Pancreatic Retrograde Venous Infusion System™ for pancreatic tumors. PEDD is a novel delivery approach designed to address the anatomic limitations of arterial infusion for the pancreas. The PEDD approach modulates pressure and flow in a manner that delivers more therapeutic to the tumor and is designed to reduce undesired delivery to normal tissue, bringing the potential to improve patient outcomes. SD-101, the Company’s investigational immunotherapeutic candidate, is designed to improve patient outcomes by treating the immunosuppressive environment created by many tumors and that can make current immunotherapies ineffective in the liver and pancreas. Patient data generated during Pressure-Enabled Regional Immuno-Oncology™ (PERIO) clinical trials support the hypothesis that SD-101 delivered via PEDD may have favorable immune effects within the liver and systemically. The target for SD-101, TLR9, is expressed across cancer types and the mechanical barriers addressed by PEDD are commonly present as well. SD-101 delivered by PEDD will be studied across several indications in an effort to address immune dysfunction and overcome drug delivery barriers in the liver and pancreas. In partnership with leading cancer centers across the country – and by leveraging deep immuno-oncology expertise and inventive technology development – TriSalus is committed to advancing innovation that improves outcomes for patients. Learn more at trisaluslifesci.com and follow us on Twitter and LinkedIn. For Patients To learn more about the clinical trial treatment protocol and enrollment, visit or and search NCT04935229, NCT05220722, and NCT05607953. Forward Looking Statements Statements made in this press release regarding matters that are not historical facts are “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Because such statements are subject to risks and uncertainties, actual results may differ materially from those expressed or implied by such forward-looking statements. Such statements include, but are not limited to, statements regarding the benefits and potential benefits of the Company’s PEDD drug delivery technology and SD-101 investigational immunotherapy. Risks that could cause actual results to differ from those expressed in these forward-looking statements include risks associated with clinical development and regulatory approval of drug delivery and pharmaceutical product candidates, including that future clinical results may not be consistent with patient data generated during the Company’s PERIO clinical trials, and other risks described in the Company’s filings with the Securities and Exchange Commission under the heading “Risk Factors.” All forward-looking statements contained in this press release speak only as of the date on which they were made and are based on management’s assumptions and estimates as of such date. The Company undertakes no obligation to update such statements to reflect events that occur or circumstances that exist after the date on which they were made except as required by law. View source version on businesswire.com: Contacts For Media and Investor Inquiries: Argot Partners 212.600.1902 TriSalus@argotpartners.com Source: TriSalus Life Sciences Inc. View this news release online at:

临床结果临床1期免疫疗法ASCO会议AACR会议

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