title: A phase I trial of immunotherapy with intratumoral adenovirus-interferon-gamma (TG1041) in patients with malignant melanoma.
abstract: OBJECTIVE
  Interferon-gamma (IFN-gamma) has been shown to upregulate MHC class I and II expression, and to promote generation of specific antitumor immune responses. We hypothesized that intratumoral administration of an IFN-gamma gene transfer vector facilitates its enhanced local production and may activate effector cells locally. We conducted a phase I dose-escalation study of a replication-deficient adenovirus-interferon-gamma construct (TG1041) to determine safety and tolerability of intratumoral administration, in advanced or locally recurrent melanoma.
  
  
  METHODS
  Patients were enrolled at four successive dose levels: 10(7) infectious units (iu) (n=3), 10(8) iu (n=3), 10(9) iu (n=3), and 10(10) iu (n=2) per injection per week for 3 weeks. TG1041 was injected in the same tumor nodule weekly in each patient. Safety, toxicity, local and distant tumor responses and biologic correlates were evaluated.
  
  
  RESULTS
  A total of 11 patients were enrolled and received the planned three injections per cycle. One patient with stable disease received a second cycle of treatment. A maximum tolerated dose was not reached in this study. No grade 4 toxicities were observed. Two grade 3 toxicities, fever and deep venous thrombosis were observed in one patient. The most frequently reported toxicities were grade 1 pain and redness at the injected site (n=8), and grade 1 fatigue (n=5) patients. Clinical changes observed at the local injected tumor site included erythema (n=5), a minor decrease in size of the injected lesion (n=5) and significant central necrosis by histopathology (n=1). Systemic effects included stable disease in one patient. Correlative studies did not reveal evidence of immunologic activity.
  
  
  CONCLUSIONS
  Weekly intratumoral administration of TG1041 appears to be safe and well tolerated in patients with advanced melanoma.
authors.affiliation: James P. Wilmot Cancer Center, University of Rochester, Rochester, NY, USA.
authors.forename: Alok A
authors.initials: AA
authors.lastname: Khorana
authors.forename: J D
authors.initials: JD
authors.lastname: Rosenblatt
authors.forename: D M
authors.initials: DM
authors.lastname: Sahasrabudhe
authors.forename: T
authors.initials: T
authors.lastname: Evans
authors.forename: M
authors.initials: M
authors.lastname: Ladrigan
authors.forename: D
authors.initials: D
authors.lastname: Marquis
authors.forename: K
authors.initials: K
authors.lastname: Rosell
authors.forename: T
authors.initials: T
authors.lastname: Whiteside
authors.forename: S
authors.initials: S
authors.lastname: Phillippe
authors.forename: B
authors.initials: B
authors.lastname: Acres
authors.forename: P
authors.initials: P
authors.lastname: Slos
authors.forename: P
authors.initials: P
authors.lastname: Squiban
authors.forename: M
authors.initials: M
authors.lastname: Ross
authors.forename: K
authors.initials: K
authors.lastname: Kendra
mesh_terms: D000256:Adenoviridae / Q000235:genetics*; D000328:Adult; D000368:Aged; D005260:Female; D015316:Genetic Therapy / Q000009:adverse effects; D005822:Genetic Vectors / Q000008:administration & dosage; D006801:Humans; D015552:Injections, Intralesional; D007371:Interferon-gamma / Q000235:genetics*; D015850:Interleukin-6 / Q000097:blood / Q000378:metabolism; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D008875:Middle Aged; D001613:beta 2-Microglobulin / Q000378:metabolism
chemical_list: D015850:Interleukin-6; D001613:beta 2-Microglobulin; D007371:Interferon-gamma