Tadalafil has biologic activity in human melanoma: results of a pilot trial with Tadalafil in patients with metastatic Melanoma (TaMe)

Myeloid-derived suppressor cells (MDSCs) are known to play a critical role in the suppression of T cell antitumor responses. Our preclinical data showed that the phosphodiesterase (PDE)-5 inhibitor sildenafil impaired MDSC functions, enhanced intratumoral T cell activity and prolonged survival of me...

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Hauptverfasser: Hassel, Jessica C. (VerfasserIn) , Bender, Carolin (VerfasserIn) , Winkler, Julia K. (VerfasserIn) , Halama, Niels (VerfasserIn) , Dimitrakopoulou-Strauss, Antonia (VerfasserIn) , Haefeli, Walter E. (VerfasserIn) , Jäger, Dirk (VerfasserIn) , Enk, Alexander (VerfasserIn) , Utikal, Jochen (VerfasserIn) , Umansky, Viktor (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 24 Aug 2017
In: OncoImmunology
Year: 2017, Jahrgang: 6, Heft: 9
ISSN:2162-402X
DOI:10.1080/2162402X.2017.1326440
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1080/2162402X.2017.1326440
Verlag, Volltext: https://doi.org/10.1080/2162402X.2017.1326440
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Verfasserangaben:Jessica C. Hassel, Huanhuan Jiang, Carolin Bender, Julia Winkler, Alexandra Sevko, Ivan Shevchenko, Niels Halama, Antonia Dimitrakopoulou-Strauss, Walter E. Haefeli, Dirk Jäger, Alexander Enk, Jochen Utikal, and Viktor Umansky

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520 |a Myeloid-derived suppressor cells (MDSCs) are known to play a critical role in the suppression of T cell antitumor responses. Our preclinical data showed that the phosphodiesterase (PDE)-5 inhibitor sildenafil impaired MDSC functions, enhanced intratumoral T cell activity and prolonged survival of melanoma-bearing mice. In this study, we evaluated biologic effects, safety and efficacy of palliative treatment with the PDE-5 inhibitor tadalafil in metastatic melanoma patients. We conducted an open-label, dose de-escalation trial with tadalafil in pretreated metastatic melanoma patients. Tumor and peripheral blood samples were taken before and 4 weeks after the start of treatment. Samples were investigated by immunohistochemistry and FACS analysis, for different immune subsets with numbers of CD8+ tumor-infiltrating lymphocytes (TIL) as primary end point. Stable disease was achieved in 3/12 patients (25%). Median progression-free survival was 4.6 mo (range 0.7-7.1), median overall survival (OS) 8.5 mo (range 2.7-23.7). The treatment was well tolerated. Stable patients displayed significantly higher numbers of CD8+ TIL in the center of metastases before treatment as compared with progressive patients. Upon the therapy, they showed increased expression of ζ-chain (used as a marker of T cell activation) in CD8+ and CD4+TILs and CD8+T cells in the peripheral blood as compared with baseline. Our study suggests that the PDE-5 inhibitor tadalafil can improve clinical outcome of advanced melanoma patients by enhancing antitumor immunity and highlights its potential application in combined melanoma immunotherapy. 
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