L-RNA aptamer-based CXCL12 inhibition combined with radiotherapy in newly-diagnosed glioblastoma: dose escalation of the phase I/II GLORIA trial

The chemokine CXCL12 promotes glioblastoma (GBM) recurrence after radiotherapy (RT) by facilitating vasculogenesis. Here we report outcomes of the dose-escalation part of GLORIA (NCT04121455), a phase I/II trial combining RT and the CXCL12-neutralizing aptamer olaptesed pegol (NOX-A12; 200/400/600 m...

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Hauptverfasser: Giordano, Frank Anton (VerfasserIn) , Layer, Julian (VerfasserIn) , Leonardelli, Sonia (VerfasserIn) , Friker, Lea L. (VerfasserIn) , Turiello, Roberta (VerfasserIn) , Corvino, Dillon (VerfasserIn) , Zeyen, Thomas (VerfasserIn) , Schaub, Christina (VerfasserIn) , Müller, Wolf (VerfasserIn) , Sperk, Elena (VerfasserIn) , Schmeel, Christopher (VerfasserIn) , Sahm, Katharina (VerfasserIn) , Oster, Christoph (VerfasserIn) , Kebir, Sied (VerfasserIn) , Hambsch, Peter (VerfasserIn) , Pietsch, Torsten (VerfasserIn) , Bisdas, Sotirios (VerfasserIn) , Platten, Michael (VerfasserIn) , Glas, Martin (VerfasserIn) , Seidel, Clemens (VerfasserIn) , Herrlinger, Ulrich (VerfasserIn) , Hölzel, Michael (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 28 May 2024
In: Nature Communications
Year: 2024, Jahrgang: 15, Pages: 1-14
ISSN:2041-1723
DOI:10.1038/s41467-024-48416-9
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1038/s41467-024-48416-9
Verlag, kostenfrei, Volltext: https://www.nature.com/articles/s41467-024-48416-9
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Verfasserangaben:Frank A. Giordano, Julian P. Layer, Sonia Leonardelli, Lea L. Friker, Roberta Turiello, Dillon Corvino, Thomas Zeyen, Christina Schaub, Wolf Müller, Elena Sperk, Leonard Christopher Schmeel, Katharina Sahm, Christoph Oster, Sied Kebir, Peter Hambsch, Torsten Pietsch, Sotirios Bisdas, Michael Platten, Martin Glas, Clemens Seidel, Ulrich Herrlinger, Michael Hölzel

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520 |a The chemokine CXCL12 promotes glioblastoma (GBM) recurrence after radiotherapy (RT) by facilitating vasculogenesis. Here we report outcomes of the dose-escalation part of GLORIA (NCT04121455), a phase I/II trial combining RT and the CXCL12-neutralizing aptamer olaptesed pegol (NOX-A12; 200/400/600 mg per week) in patients with incompletely resected, newly-diagnosed GBM lacking MGMT methylation. The primary endpoint was safety, secondary endpoints included maximum tolerable dose (MTD), recommended phase II dose (RP2D), NOX-A12 plasma levels, topography of recurrence, tumor vascularization, neurologic assessment in neuro-oncology (NANO), quality of life (QOL), median progression-free survival (PFS), 6-months PFS and overall survival (OS). Treatment was safe with no dose-limiting toxicities or treatment-related deaths. The MTD has not been reached and, thus, 600 mg per week of NOX-A12 was established as RP2D for the ongoing expansion part of the trial. With increasing NOX-A12 dose levels, a corresponding increase of NOX-A12 plasma levels was observed. Of ten patients enrolled, nine showed radiographic responses, four reached partial remission. All but one patient (90%) showed at best response reduced perfusion values in terms of relative cerebral blood volume (rCBV). The median PFS was 174 (range 58-260) days, 6-month PFS was 40.0% and the median OS 389 (144-562) days. In a post-hoc exploratory analysis of tumor tissue, higher frequency of CXCL12+ endothelial and glioma cells was significantly associated with longer PFS under NOX-A12. Our data imply safety of NOX-A12 and its efficacy signal warrants further investigation. 
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