Intravenous administration of Reolysin®, a live replication competent RNA virus is safe in patients with advanced solid tumors

Radharani Gollamudi, Mohammad H. Ghalib, Kavita K. Desai, Imran Chaudhary, Benny Wong, Mark Einstein, Matthew Coffey, George M. Gill, Karl Mettinger, John M. Mariadason, Sridhar Mani, Sanjay Goel

Research output: Contribution to journalArticle

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Abstract

Summary: Background Reolysin® is reovirus serotype 3-Dearing strain, a double-stranded replication-competent RNA non-enveloped icosahedral virus. It induces cytopathic and anti-cancer effects in cells with an activated ras pathway due to inhibition of the dsRNA-activated protein kinase. Methods This was a single center dose escalation trial of Reolysin administered intravenously every 4 weeks in doses ranging from 1×108 to 3×10 10 tissue culture infective dose (TCID)50. Serum for neutralizing antibody, and serum, stool, saliva, and urine for viral shedding were collected. Tumor samples were analyzed for activating mutations in the ras and braf oncogenes. Results Eighteen patients received 27 doses of Reolysin in 6 dose cohorts accomplishing a 300 fold dose escalation without a protocol-defined dose limiting toxicity. Drug related grade 2 toxicities included fatigue and fever (1 patient each). All patients developed neutralizing antibody during the course of the study. Viral shedding was observed in 6 patients. One patient with anthracycline and taxane refractory breast cancer experienced a partial response (PR) and her tumor had a ras G12A mutation. Biopsy from her chest wall mass showed evidence of necrosis and viral replication by electron microscopy. Overall clinical benefit (1 PR + 7 stable disease) rate was 45%, and appeared higher in patients with viral shedding (67%) than those without (33%). Conclusion Reolysin administered monthly as a one-hour infusion is safe and well-tolerated even in multiple doses. Reolysin has anti-tumor activity as a single agent warranting further evaluation, including in combination with chemotherapy. Viral shedding may suggest intrapatient replication yielding a benefit and should be studied carefully in future studies.

Original languageEnglish (US)
Pages (from-to)641-649
Number of pages9
JournalInvestigational New Drugs
Volume28
Issue number5
DOIs
StatePublished - Oct 2010

Fingerprint

RNA Viruses
Intravenous Administration
Virus Shedding
Neoplasms
Neutralizing Antibodies
Mammalian orthoreovirus 3
Mutation
ras Genes
Anthracyclines
Thoracic Wall
Combination Drug Therapy
Serum
Saliva
Protein Kinases
Fatigue
Electron Microscopy
Fever
Necrosis
Urine
RNA

Keywords

  • Clinical trials
  • Neutralizing antibody
  • Phase I
  • Reolysin®
  • Reovirus

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Oncology
  • Medicine(all)

Cite this

Intravenous administration of Reolysin®, a live replication competent RNA virus is safe in patients with advanced solid tumors. / Gollamudi, Radharani; Ghalib, Mohammad H.; Desai, Kavita K.; Chaudhary, Imran; Wong, Benny; Einstein, Mark; Coffey, Matthew; Gill, George M.; Mettinger, Karl; Mariadason, John M.; Mani, Sridhar; Goel, Sanjay.

In: Investigational New Drugs, Vol. 28, No. 5, 10.2010, p. 641-649.

Research output: Contribution to journalArticle

Gollamudi, R, Ghalib, MH, Desai, KK, Chaudhary, I, Wong, B, Einstein, M, Coffey, M, Gill, GM, Mettinger, K, Mariadason, JM, Mani, S & Goel, S 2010, 'Intravenous administration of Reolysin®, a live replication competent RNA virus is safe in patients with advanced solid tumors', Investigational New Drugs, vol. 28, no. 5, pp. 641-649. https://doi.org/10.1007/s10637-009-9279-8
Gollamudi, Radharani ; Ghalib, Mohammad H. ; Desai, Kavita K. ; Chaudhary, Imran ; Wong, Benny ; Einstein, Mark ; Coffey, Matthew ; Gill, George M. ; Mettinger, Karl ; Mariadason, John M. ; Mani, Sridhar ; Goel, Sanjay. / Intravenous administration of Reolysin®, a live replication competent RNA virus is safe in patients with advanced solid tumors. In: Investigational New Drugs. 2010 ; Vol. 28, No. 5. pp. 641-649.
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abstract = "Summary: Background Reolysin{\circledR} is reovirus serotype 3-Dearing strain, a double-stranded replication-competent RNA non-enveloped icosahedral virus. It induces cytopathic and anti-cancer effects in cells with an activated ras pathway due to inhibition of the dsRNA-activated protein kinase. Methods This was a single center dose escalation trial of Reolysin administered intravenously every 4 weeks in doses ranging from 1×108 to 3×10 10 tissue culture infective dose (TCID)50. Serum for neutralizing antibody, and serum, stool, saliva, and urine for viral shedding were collected. Tumor samples were analyzed for activating mutations in the ras and braf oncogenes. Results Eighteen patients received 27 doses of Reolysin in 6 dose cohorts accomplishing a 300 fold dose escalation without a protocol-defined dose limiting toxicity. Drug related grade 2 toxicities included fatigue and fever (1 patient each). All patients developed neutralizing antibody during the course of the study. Viral shedding was observed in 6 patients. One patient with anthracycline and taxane refractory breast cancer experienced a partial response (PR) and her tumor had a ras G12A mutation. Biopsy from her chest wall mass showed evidence of necrosis and viral replication by electron microscopy. Overall clinical benefit (1 PR + 7 stable disease) rate was 45{\%}, and appeared higher in patients with viral shedding (67{\%}) than those without (33{\%}). Conclusion Reolysin administered monthly as a one-hour infusion is safe and well-tolerated even in multiple doses. Reolysin has anti-tumor activity as a single agent warranting further evaluation, including in combination with chemotherapy. Viral shedding may suggest intrapatient replication yielding a benefit and should be studied carefully in future studies.",
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AU - Chaudhary, Imran

AU - Wong, Benny

AU - Einstein, Mark

AU - Coffey, Matthew

AU - Gill, George M.

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