PMID- 29801474 OWN - NLM STAT- MEDLINE DCOM- 20190114 LR - 20240102 IS - 1471-2407 (Electronic) IS - 1471-2407 (Linking) VI - 18 IP - 1 DP - 2018 May 25 TI - A Phase I clinical trial of EUS-guided intratumoral injection of the oncolytic virus, HF10 for unresectable locally advanced pancreatic cancer. PG - 596 LID - 10.1186/s12885-018-4453-z [doi] LID - 596 AB - BACKGROUND: Prognosis of pancreatic cancer is poor with a 5-year survival rate of only 7%. Although several new chemotherapy treatments have shown promising results, all patients will eventually progress, and we need to develop newer chemotherapy treatments to improve response rates and overall survival (OS). HF10 is a spontaneously mutated oncolytic virus derived from a herpes simplex virus-1, and it has potential to show strong antitumor effect against malignancies without damaging normal tissue. We aimed to evaluate the safety and anti-tumor effectiveness in phase I dose-escalation trial of direct injection of HF10 into unresectable locally advanced pancreatic cancer under endoscopic ultrasound (EUS)-guidance in combination with erlotinib and gemcitabine administration. The mid-term results have been previously reported and here we report the final results of our study. METHODS: This was a single arm, open-label Phase I trial. HF10 was injected once every 2 weeks and continued up to four times in total unless dose-limiting toxicity (DLT) appears. A total of nine subjects in three Cohorts with dose-escalation were planned to be enrolled in this trial. The primary endpoint was the safety assessment and the secondary endpoint was the efficacy assessment. RESULTS: Twelve patients enrolled in this clinical trial, and ten subjects received this therapy. Five patients showed Grade III myelosuppression and two patients developed serious adverse events (AEs) (perforation of duodenum, hepatic dysfunction). However, all of these events were judged as AEs unrelated to HF10. Tumor responses were three partial responses (PR), four stable diseases (SD), and two progressive diseases (PD) out of nine subjects who completed the treatment. Target lesion responses were three PRs and six SDs. The median progression free survival (PFS) was 6.3 months, whereas the median OS was 15.5 months. Two subjects from Cohort 1 and 2 showed downstaging and finally achieved surgical complete response (CR). CONCLUSIONS: HF10 direct injection under EUS-guidance in combination with erlotinib and gemcitabine was a safe treatment for locally advanced pancreatic cancer. Combination therapy of HF10 and chemotherapy should be explored further in large prospective studies. TRIAL REGISTRATION: This study was prospectively registered in UMIN-CTR (UMIN000010150) on March 4th, 2013. FAU - Hirooka, Yoshiki AU - Hirooka Y AD - Department of Endoscopy, Nagoya University Hospital, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan. hirooka@med.nagoya-u.ac.jp. FAU - Kasuya, Hideki AU - Kasuya H AD - Cancer Immune Therapy Research Center, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Ishikawa, Takuya AU - Ishikawa T AD - Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Kawashima, Hiroki AU - Kawashima H AD - Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Ohno, Eizaburo AU - Ohno E AD - Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Villalobos, Itzel B AU - Villalobos IB AD - Cancer Immune Therapy Research Center, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Naoe, Yoshinori AU - Naoe Y AD - Cancer Immune Therapy Research Center, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Ichinose, Toru AU - Ichinose T AD - Cancer Immune Therapy Research Center, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Koyama, Nobuto AU - Koyama N AD - Takara Bio Inc., Otsu, Japan. FAU - Tanaka, Maki AU - Tanaka M AD - Takara Bio Inc., Otsu, Japan. FAU - Kodera, Yasuhiro AU - Kodera Y AD - Department of Surgery II, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Goto, Hidemi AU - Goto H AD - Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan. LA - eng PT - Clinical Trial, Phase I PT - Journal Article PT - Pragmatic Clinical Trial DEP - 20180525 PL - England TA - BMC Cancer JT - BMC cancer JID - 100967800 RN - 0W860991D6 (Deoxycytidine) RN - DA87705X9K (Erlotinib Hydrochloride) RN - 0 (Gemcitabine) SB - IM MH - Adult MH - Aged MH - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use MH - Combined Modality Therapy/adverse effects/methods MH - Deoxycytidine/analogs & derivatives/therapeutic use MH - Endosonography MH - Erlotinib Hydrochloride/therapeutic use MH - Female MH - Herpesvirus 1, Human/*genetics MH - Humans MH - Injections, Intralesional/methods MH - Male MH - Middle Aged MH - Mutation MH - Oncolytic Virotherapy/adverse effects/*methods MH - Oncolytic Viruses/*genetics MH - Pancreas/diagnostic imaging/pathology MH - Pancreatic Neoplasms/mortality/pathology/*therapy MH - Progression-Free Survival MH - Survival Rate MH - Treatment Outcome MH - Ultrasonography, Interventional MH - Young Adult MH - Gemcitabine PMC - PMC5970460 OTO - NOTNLM OT - EUS-guidance OT - HF10 OT - Oncolytic virus OT - Pancreatic cancer COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: This study was approved by the Ethical Committee of Nagoya University Hospital (Reference number: 3299). Written informed consents to participate were obtained from all the patients in this study. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/05/29 06:00 MHDA- 2019/01/15 06:00 PMCR- 2018/05/25 CRDT- 2018/05/27 06:00 PHST- 2017/11/13 00:00 [received] PHST- 2018/04/30 00:00 [accepted] PHST- 2018/05/27 06:00 [entrez] PHST- 2018/05/29 06:00 [pubmed] PHST- 2019/01/15 06:00 [medline] PHST- 2018/05/25 00:00 [pmc-release] AID - 10.1186/s12885-018-4453-z [pii] AID - 4453 [pii] AID - 10.1186/s12885-018-4453-z [doi] PST - epublish SO - BMC Cancer. 2018 May 25;18(1):596. doi: 10.1186/s12885-018-4453-z.