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. 2017 Sep 16;8(46):80156-80166.
doi: 10.18632/oncotarget.20964. eCollection 2017 Oct 6.

Treatment of advanced gastrointestinal cancer with genetically modified autologous mesenchymal stem cells - TREAT-ME-1 - a phase I, first in human, first in class trial

Jobst C von Einem  1 , Sylvia Peter  2 , Christine Günther  2 , Hans-Dieter Volk  3 , Gerald Grütz  3 , Christoph Salat  4 , Oliver Stoetzer  4 , Peter J Nelson  5 , Marlies Michl  1 , Dominik P Modest  1 , Julian W Holch  1 , Martin Angele  6 , Christiane Bruns  7 , Hanno Niess #  6 , Volker Heinemann #  1
Affiliations

Treatment of advanced gastrointestinal cancer with genetically modified autologous mesenchymal stem cells - TREAT-ME-1 - a phase I, first in human, first in class trial

Jobst C von Einem et al. Oncotarget. .

Abstract

Purpose: This phase I, first in human, first in class clinical study aimed at evaluating the safety, tolerability and efficacy of treatment with genetically modified mesenchymal stromal cells (MSC) in combination with ganciclovir (GCV). MSC_apceth_101 are genetically modified autologous MSCs used as vehicles for a cell-based gene therapy in patients with advanced gastrointestinal adenocarcinoma.

Experimental design: The study design consisted of a dose-escalation 3 + 3 design. All patients (n = 6) were treated with up to three applications of MSC_apceth_101, followed by GCV infusions given on three consecutive days starting 48 hours after injection of MSC_apceth_101. Three of six patients received a total dose of 1.5 × 106 cells/kg. Two patients received three doses of 1 × 106 cells/kg, while one patient received only two doses of 1 × 106 cells/kg due to a SADR.

Results: Six patients received MSC_apceth_101. No IMP-related serious adverse events occurred. Adverse-events related to IMP-injection were increased creatinine, cough, fever, and night sweat. TNF, IL-6, IL-8, IL-10 and sE-Selectin, showed that repeated application is immunologically safe, but induces a switch of the functional properties of monocytes to an inflammatory phenotype. Treatment induced stable disease in 4/6 patients, and progressive disease in 2/6 patients.

Conclusion: Treatment with MSC_apceth_101 in combination with GCV demonstrated acceptable safety and tolerability in patients with advanced gastrointestinal adenocarcinoma.

Keywords: CCC; CRC; GDEPT; gastrointestinal cancer; mesenchymal stem cells.

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Conflict of interest statement

CONFLICTS OF INTEREST Jobst C. von Einem, Hans-Dieter Volk, Gerald Grütz, Christoph Salat, Oliver Stoetzer, Marlies Michl, Dominik P. Modest, Julian W. Holch, Martin Angele, Christiane Bruns and Hanno Niess: These authors declare no potential conflicts of interest. Sylvia Peter and Christine Guenther hold shares of apceth GmbH & Co. KG. Peter J. Nelson: The author performed contract research for apceth GmbH & Co. KG, Munich, Germany. Volker Heinemann has received financial grants to undertake this study from apceth GmbH & Co. KG.

Figures

Figure 1
Figure 1. Application scheme
Figure 2
Figure 2. Fold change of Monocytes excreting TNF alpha and IL-10 after Lipopolysaccharide induced cytokine release
Enhanced TNF/IL-10 ratio in four patients analyzed showing pro-inflammatory potency (TNF release) of peripheral blood monocytes following TLR-4 stimulation increased over the observation time while the anti-inflammatory potency (IL-10 release) decreased (mean: 3.73 fold, range 1,32 - 6,01 fold).
See this image and copyright information in PMC

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