1. ¹University of California, Comprehensive Cancer Center San Francisco, San Francisco, CA 94143, USA
2. ²Prostate Cancer Program at the Kimmel Cancer Center at Johns Hopkins, Baltimore, MD 21231, USA
3. ³Cell Genesys, Inc., Division of Clinical Research, South San Francisco, CA 94080, USA
4. ⁴Department of Medical Oncology, University of Wisconsin, WI 53705, USA
5. ⁵Department of Pharmacology, Oxford University, OX2 6DP Oxford, UK

Correspondence: James M. Burke, Fax: +1 650 266 3020. E-mail: james.burke@cellgenesys.com

Received 16 January 2006; Revised 22 February 2006; Accepted 22 February 2006.

Abstract

CG7870 is a replication-selective oncolytic adenovirus genetically engineered to replicate preferentially in prostate tissue. In a previous phase I/II clinical trial of intraprostatic delivery of CG7870 for locally recurrent prostate cancer this virus was well tolerated. In this phase I study CG7870 was administered as a single intravenous infusion in a group-sequential dose escalation design (1 10¹⁰ to 6 10¹² viral particles (vp)) to 23 patients with hormone-refractory metastatic prostate cancer. Flulike symptoms (fever, fatigue, rigors, nausea, and/or vomiting) were the most common adverse events. Three therapy-related grade 3 adverse events were reported, one of which (fatigue) was serious. At doses greater than 10¹² vp all five patients experienced asymptomatic grade 1 to 2 transaminitis and/or isolated D-dimer elevations starting on day 2 through 8; dose escalation was therefore halted at 6 10¹² vp. All tested patients had CG7870 genomes present in the peripheral blood for at least 90 minutes after infusion; patients in the highest dose group had persistence of genomes through 29 days. A "secondary" or "delayed" peak in plasma CG7870 genome copies (defined as a >10-fold increase in CG7870 genomes from nadir concentration) suggestive of active viral replication and shedding into the bloodstream was detected in 16/23 (70%) patients. CG7870 was detected in the saliva of 3 patients, whereas all urine samples tested negative. All patients developed antibodies to CG7870. Dose-related increases in interleukins 6 and 10 (IL-6, IL-10) blood levels were detected. The peak IL-6 concentration after CG7870 treatment was associated with a transient, asymptomatic decrease in blood pressure. No partial or complete prostate-specific antigen (PSA) responses were observed; however, 5 patients had a decrease in serum PSA of 25% to 49% following a single treatment, including 3 of 8 patients at the highest dose levels.