Patients with relapsed stage 4 neuroblastoma have an extremely poor long-term prognosis, making the investigation of new agents of interest. We report the outcome of the first patient treated in a phase 1 study for relapsed neuroblastoma, using the chemotherapy agent decitabine to upregulate cancer testis antigen expression, followed by a dendritic cell vaccine targeting the cancer testis antigens MAGE-A1, MAGE-A3, and NY-ESO-1. Our patient had persistent tumor in his bone marrow after completion of standard therapy for neuroblastoma, including multiagent chemotherapy, tumor resection, stem cell transplantation, radiation therapy, and anti-GD2 monoclonal antibodies. His marrow disease persisted despite chemotherapy, which was given while the vaccine was being produced. After 3 cycles of decitabine and vaccine, this patient achieved a complete remission and is now 1 year from his last treatment, with no evidence of tumor in his bone marrow or other sites. This patient was noted to have an increase in MAGE-A3–specific T cells. This is the first report combining demethylating chemotherapy to enhance tumor antigen expression followed by a cancer antigen vaccine.
They enrolled 15pts in this trial. Final collection date for outcomes is Aug 2013. Here is the trial NCT1241162.
Dacogen is also in ph3 with sapacitabine for aml. Those results will be wrapping up. Maybe we still see dacogen treating aml pts in USA?
Looking at sgi-110, it seems that ASTX will point it at the same direction. When Dacogen showed good results in Ovarian cancer, sgi-110 entered a ph2. I wonder if we see a ph2 in Pedritics with sgi-110. My guess is that we see a partnership with eisai with sgi-110. But astx holds onto the NA cards. The rest of the world can be Eisai. The side effects from dacogen are cut in a third with sgi-110. The window for this drug to hit it's target is increaded 4 fold. Makes sense to partner, specially who knows the trials better than Eisai? I see a $200M+ deal in the works. This is a win/win for astx. They get the help in ph3 trials, they keep the NA rights. Would they slap Eisai in the face by entering trials, that dacogen was in? The hiccup with dacogen is the toxicity. They remove that with sgi-110 and have the hypothlylation markers to know who the drug is benefitting.