Jeffrey P. Ward, MD, PhD
A single-arm, phase I clinical trial is exploring the safety and tolerability of a T-cell receptor therapy for patients with advanced non–small cell lung cancer (NSCLC).
NY-ESO-1 TCR (TAEST16001) engineered autologous T-cell therapy is being administered in patients with NSCLC whose tumors have NY-ESO-1 antigen expression and who have received at least 1 standard therapy (NCT03029273). NY-ESO-1 is expressed on 10% to 50% of cells in melanoma, lung cancer, ovarian cancer, liver cancer, esophageal cancer, breast cancer, prostate cancer, and bladder cancer cases.
In the study, an estimated 20 patients will receive treatment with cyclophosphamide 3 days prior to treatment with NY-ESO-1 therapy at 1 g daily for 2 days. After NY-ESO-1 treatment, which will be a single intravenous dose of 5 x 109
anti-NY-ESO-1 TCR transduced T cells, patients will remain in the hospital for safety monitoring and frequent follow-up will be conducted. Subcutaneous injections of interleukin-2 will also be administered concomitantly for 14 days.
This trial is 1 of several that are testing the potential of T-cell therapy beyond hematologic malignancies and into solid tumors, such as NSCLC.
Jeffrey P. Ward, MD, PhD, an instructor in the Department of Medicine, Oncology Division, Medical Oncology, Washington University School of Medicine in St. Louis, lectured on immunotherapy and vaccines in NSCLC during the 2017 OncLive®
State of the Science Summit on Advanced Non–Small Cell Lung Cancer. In an interview, he discussed the questions researchers still face about targeting the immune system and exactly what role TCR therapy could play in the treatment of patients with NSCLC.
OncLive: Please provide an overview of your presentation at the State of the Science Summit.
Cancer immunotherapy is really the next generation of treatments that will be really effective for patients with lung cancer. I gave an overview of how the immune system works—a really nuts-and-bolts talk—and of some novel therapies that are either in clinical practice or in clinical trials, or in the next generation of things that are coming.
There has been a lot of research on immunotherapy in cancer. Is there anything with the immune system and how it works that we still don’t know?
Honestly, there is probably more that we don't know than we do at this point. We think we understand a lot of small details, but we are constantly surprised.
Specifically, what are some obstacles in the field we can overcome in the near future?
The thing to understand about PD-L1 is that it is still a big, moving target. There is a lot of controversy and it is 1 of the biggest topics we talk about as oncologists, as we define who is going to respond and who is not going to respond. PD-L1 is 1 piece of the puzzle, but as I talked about, there are multiple different subpoints that decide whether the immune system is going to do something or if it is going to remain inert. designing a targeted therapy, designing a vaccine that we can then vaccinate a patient with after they progress on other therapies.