Adenovirus-mediated p53 gene transfer in patients with advanced recurrent head and neck squamous cell carcinoma

Gary L. Clayman, Adel K. El-Naggar, Scott M. Lippman, Ying Cha Henderson, Mitchell Frederick, James A. Merritt, Louis A. Zumstein, Therese M. Timmons, Ta Jen Liu, Lawrence Ginsberg, Jack A. Roth, Waun Ki Hong, Patricia Bruso, Helmuth Goepfert

Research output: Contribution to journalArticlepeer-review

357 Scopus citations

Abstract

Purpose: Standard therapies of head and neck squamous cell carcinoma (HNSCC) often cause profound morbidity and have not significantly improved survival over the last 30 years. Preclinical studies showed that adenoviral vector delivery of the wild-type p53 gene reduced tumor growth in mouse xenograft models. Our purpose was to ascertain the safety and therapeutic potential of adenoviral (Ad)-p53 in advanced HNSCC. Patients and Methods: Patients with incurable recurrent local or regionally metastatic HNSCC received multiple intratumoral injections of Ad-p53, either with or without tumor resection. Patients were monitored for adverse events and antiadenoviral antibodies, tumors were monitored for response and p53 expression, and body fluids were analyzed for Ad-p53. Results: Tumors of 33 patients were injected with dose of up to 1 x 1011 plaque-forming units (pfu). No dose-limiting toxicity or serious adverse events were noted, p53 expression was detected in tumor biopsies despite antibody responses after Ad-p53 injections. Clinical efficacy could be evaluated in 17 patients with nonresectable tumors: two patients showed objective tumor regressions of greater than 50%, six patients showed stable disease for up to 3.5 months, and nine patients showed progressive disease. One resectable patient was considered a complete pathologic response. Ad-p53 was detected in blood and urine in a dose-dependent fashion, and in sputum. Conclusion: Patients were safely injected intratumorally with Ad-p53. Objective antitumor activity was detected in several patients. The infectious Ad-p53 in body fluids was asymptomatic, and suggests that systemic or regional treatment may be tolerable. These results suggest the further investigation of Ad-p53 as a therapeutic agent for patients with HNSCC.

Original languageEnglish (US)
Pages (from-to)2221-2232
Number of pages12
JournalJournal of Clinical Oncology
Volume16
Issue number6
DOIs
StatePublished - Jun 1998
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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