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LOCL-04 SAFETY AND FEASIBILITY OF RHENIUM-186 NANOLIPOSOME (186RNL) IN LEPTOMENINGEAL METASTASES [LM] PHASE 1/2A DOSE ESCALATION TRIAL

BACKGROUND: LM is a devastating subarachnoid (SA) complication most commonly from breast, lung, melanoma, and gastrointestinal malignancies affecting 110,000 in the USA. Common therapies are radiation and SA/IV chemotherapy. Without treatment, survival is short with limited treatment options and bet...

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Autores principales: Brenner, Andrew, Youssef, Michael, LaFrance, Norman, Hedrick, Marc, Bao, Ande, Phillips, William, Patel, Torel, Weinberg, Jeffrey, Floyd, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354230/
http://dx.doi.org/10.1093/noajnl/vdac078.046
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author Brenner, Andrew
Youssef, Michael
LaFrance, Norman
Hedrick, Marc
Bao, Ande
Phillips, William
Patel, Torel
Weinberg, Jeffrey
Floyd, John
author_facet Brenner, Andrew
Youssef, Michael
LaFrance, Norman
Hedrick, Marc
Bao, Ande
Phillips, William
Patel, Torel
Weinberg, Jeffrey
Floyd, John
author_sort Brenner, Andrew
collection PubMed
description BACKGROUND: LM is a devastating subarachnoid (SA) complication most commonly from breast, lung, melanoma, and gastrointestinal malignancies affecting 110,000 in the USA. Common therapies are radiation and SA/IV chemotherapy. Without treatment, survival is short with limited treatment options and better options urgently needed. 186RNL emits beta particles (with gamma-rays) with low dose rate and high radiation density. We report first results of the enrolling ReSPECT-LM phase 1/2a 186RNL-LM dose escalation trial. MATERIAL AND METHODS: Preclinical syngeneic rat model animals were 186RNLtreated at day15 with intraventricular186RNL(0.689 mCi) providing mean CSF-radiation absorbed dose=1,136 ±226Gy. 50% control animals[unloaded liposomes] and 100%186RNL treated animals were alive at 14days. At 4 weeks, 75% control animals and 37.5% treated animals had died. Based on this preclinical data and 186RNL recurrent glioma human experience, a phase I/2a dose escalation ReSPECT-LM Trial was initiated to characterize safety/tolerability of a single intrathecal(IT) 186RNL administration. Following, to identify maximum tolerated/feasible doses, 186RNL anti-tumor activity as a single agent in LM patients (breast and NSCLC), characterize 186RNL pK & dosimetry via Ommaya delivery, determine the overall response rate (ORR) for 186RNL treated patients based on CSF/radiographic findings, and describe survival distribution. RESULTS: ReSPECT-LM is enrolling and 1st patient dosed (6.6 mCi186RNL, 5ml) via Ommaya reservoir. The dose was well-tolerated with no complaints/AEs as of Day 28 following treatment. Imaging and CSF tumor cell assays at pre &post-dose were performed. 186RNL gamma imaging confirmed rapid, complete and durable SA dose distribution through168hours. Pre-dose CSF tumor cell count was 70.77 cells/ml and following treatment, 39.79 cells/ml at 24, and ~6 cells/ml at both 48 &168hours. CONCLUSION: 186RNL’s unique formulation and characteristics may have promise for LM patients. An update of the ReSPECT-LM clinical trial will be provided.
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spelling pubmed-93542302022-08-09 LOCL-04 SAFETY AND FEASIBILITY OF RHENIUM-186 NANOLIPOSOME (186RNL) IN LEPTOMENINGEAL METASTASES [LM] PHASE 1/2A DOSE ESCALATION TRIAL Brenner, Andrew Youssef, Michael LaFrance, Norman Hedrick, Marc Bao, Ande Phillips, William Patel, Torel Weinberg, Jeffrey Floyd, John Neurooncol Adv Supplement Abstracts BACKGROUND: LM is a devastating subarachnoid (SA) complication most commonly from breast, lung, melanoma, and gastrointestinal malignancies affecting 110,000 in the USA. Common therapies are radiation and SA/IV chemotherapy. Without treatment, survival is short with limited treatment options and better options urgently needed. 186RNL emits beta particles (with gamma-rays) with low dose rate and high radiation density. We report first results of the enrolling ReSPECT-LM phase 1/2a 186RNL-LM dose escalation trial. MATERIAL AND METHODS: Preclinical syngeneic rat model animals were 186RNLtreated at day15 with intraventricular186RNL(0.689 mCi) providing mean CSF-radiation absorbed dose=1,136 ±226Gy. 50% control animals[unloaded liposomes] and 100%186RNL treated animals were alive at 14days. At 4 weeks, 75% control animals and 37.5% treated animals had died. Based on this preclinical data and 186RNL recurrent glioma human experience, a phase I/2a dose escalation ReSPECT-LM Trial was initiated to characterize safety/tolerability of a single intrathecal(IT) 186RNL administration. Following, to identify maximum tolerated/feasible doses, 186RNL anti-tumor activity as a single agent in LM patients (breast and NSCLC), characterize 186RNL pK & dosimetry via Ommaya delivery, determine the overall response rate (ORR) for 186RNL treated patients based on CSF/radiographic findings, and describe survival distribution. RESULTS: ReSPECT-LM is enrolling and 1st patient dosed (6.6 mCi186RNL, 5ml) via Ommaya reservoir. The dose was well-tolerated with no complaints/AEs as of Day 28 following treatment. Imaging and CSF tumor cell assays at pre &post-dose were performed. 186RNL gamma imaging confirmed rapid, complete and durable SA dose distribution through168hours. Pre-dose CSF tumor cell count was 70.77 cells/ml and following treatment, 39.79 cells/ml at 24, and ~6 cells/ml at both 48 &168hours. CONCLUSION: 186RNL’s unique formulation and characteristics may have promise for LM patients. An update of the ReSPECT-LM clinical trial will be provided. Oxford University Press 2022-08-05 /pmc/articles/PMC9354230/ http://dx.doi.org/10.1093/noajnl/vdac078.046 Text en © The Author(s) 2022. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Supplement Abstracts
Brenner, Andrew
Youssef, Michael
LaFrance, Norman
Hedrick, Marc
Bao, Ande
Phillips, William
Patel, Torel
Weinberg, Jeffrey
Floyd, John
LOCL-04 SAFETY AND FEASIBILITY OF RHENIUM-186 NANOLIPOSOME (186RNL) IN LEPTOMENINGEAL METASTASES [LM] PHASE 1/2A DOSE ESCALATION TRIAL
title LOCL-04 SAFETY AND FEASIBILITY OF RHENIUM-186 NANOLIPOSOME (186RNL) IN LEPTOMENINGEAL METASTASES [LM] PHASE 1/2A DOSE ESCALATION TRIAL
title_full LOCL-04 SAFETY AND FEASIBILITY OF RHENIUM-186 NANOLIPOSOME (186RNL) IN LEPTOMENINGEAL METASTASES [LM] PHASE 1/2A DOSE ESCALATION TRIAL
title_fullStr LOCL-04 SAFETY AND FEASIBILITY OF RHENIUM-186 NANOLIPOSOME (186RNL) IN LEPTOMENINGEAL METASTASES [LM] PHASE 1/2A DOSE ESCALATION TRIAL
title_full_unstemmed LOCL-04 SAFETY AND FEASIBILITY OF RHENIUM-186 NANOLIPOSOME (186RNL) IN LEPTOMENINGEAL METASTASES [LM] PHASE 1/2A DOSE ESCALATION TRIAL
title_short LOCL-04 SAFETY AND FEASIBILITY OF RHENIUM-186 NANOLIPOSOME (186RNL) IN LEPTOMENINGEAL METASTASES [LM] PHASE 1/2A DOSE ESCALATION TRIAL
title_sort locl-04 safety and feasibility of rhenium-186 nanoliposome (186rnl) in leptomeningeal metastases [lm] phase 1/2a dose escalation trial
topic Supplement Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354230/
http://dx.doi.org/10.1093/noajnl/vdac078.046
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