title: Phase 1 study of intratumoral Pexa-Vec (JX-594), an oncolytic and immunotherapeutic vaccinia virus, in pediatric cancer patients.
abstract: Pexa-Vec (pexastimogene devacirepvec, JX-594) is an oncolytic and immunotherapeutic vaccinia virus designed to destroy cancer cells through viral lysis and induction of granulocyte-macrophage colony-stimulating factor (GM-CSF)-driven tumor-specific immunity. Pexa-Vec has undergone phase 1 and 2 testing alone and in combination with other therapies in adult patients, via both intratumoral and intravenous administration routes. We sought to determine the safety of intratumoral administration in pediatric patients. In a dose-escalation study using either 10(6) or 10(7) plaque-forming units per kilogram, we performed one-time injections in up to three tumor sites in five pediatric patients and two injections in one patient. Ages at study entry ranged from 4 to 21 years, and their cancer diagnoses included neuroblastoma, hepatocellular carcinoma, and Ewing sarcoma. All toxicities were ≤ grade 3. The most common side effects were sinus fever and sinus tachycardia. All three patients at the higher dose developed asymptomatic grade 1 treatment-related skin pustules that resolved within 3-4 weeks. One patient showed imaging evidence suggestive of antitumor biological activity. The two patients tested for cellular immunoreactivity to vaccinia antigens showed strong responses. Overall, our study suggests Pexa-Vec is safe to administer to pediatric patients by intratumoral administration and could be studied further in this patient population.
authors.affiliation: Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Cripe
authors.affiliation: Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Minhtran C
authors.initials: MC
authors.lastname: Ngo
authors.affiliation: Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
authors.forename: James I
authors.initials: JI
authors.lastname: Geller
authors.affiliation: Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Chrystal U
authors.initials: CU
authors.lastname: Louis
authors.affiliation: Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Currier
authors.affiliation: Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Racadio
authors.affiliation: Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Towbin
authors.affiliation: Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Cliona M
authors.initials: CM
authors.lastname: Rooney
authors.affiliation: SillaJen, Inc, Seoul, South Korea.
authors.forename: Adina
authors.initials: A
authors.lastname: Pelusio
authors.affiliation: SillaJen, Inc, Seoul, South Korea.
authors.forename: Anne
authors.initials: A
authors.lastname: Moon
authors.affiliation: SillaJen, Inc, Seoul, South Korea.
authors.forename: Tae-Ho
authors.initials: TH
authors.lastname: Hwang
authors.affiliation: SillaJen, Inc, Seoul, South Korea.
authors.forename: James M
authors.initials: JM
authors.lastname: Burke
authors.affiliation: Ottawa Health Research Institute and University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: John C
authors.initials: JC
authors.lastname: Bell
authors.affiliation: SillaJen, Inc, Seoul, South Korea.
authors.forename: David H
authors.initials: DH
authors.lastname: Kirn
authors.affiliation: SillaJen, Inc, Seoul, South Korea.
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Breitbach
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols; D001859:Bone Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy; D001932:Brain Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy; D019496:Cancer Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006528:Carcinoma, Hepatocellular / Q000276:immunology / Q000473:pathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005720:Gamma Rays; D005822:Genetic Vectors / Q000008:administration & dosage / Q000276:immunology; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D015552:Injections, Intralesional; D008113:Liver Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy; D008297:Male; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000276:immunology / Q000473:pathology / Q000628:therapy; D050130:Oncolytic Virotherapy / Q000379:methods*; D012512:Sarcoma, Ewing / Q000276:immunology / Q000473:pathology / Q000628:therapy; D014611:Vaccination; D014616:Vaccinia virus / Q000235:genetics / Q000276:immunology*; D055815:Young Adult
chemical_list: D019496:Cancer Vaccines