ASCO-SITC 2019—High-dose NK cell infusions show benefit in myeloid malignancies


  • Melissa Pandika
  • Univadis
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Takeaway

  • Multiple infusions of high doses of ex vivo-expanded natural killer (NK) cells administered after haploidentical stem cell transplantation (SCT) showed preliminary antitumor, antiviral activity in myeloid malignancies.   

Why this matters

  • NK cell therapy has limitations (e.g., in vivo persistence, expansion, function), which this approach may overcome.

Study design

  • Updated phase 2 findings from open-label phase 1/2 trial.
    • Phase 1: Dose escalation; NK cells starting at 1x105 to 1x108 cells/kg.
    • Phase 2: 1x108 NK mbIL-21 ex vivo-expanded NK cells/kg.
  • Funding: M.D. Anderson Cancer Center.

Key results

  • As of 3/2/2019, 25 patients treated; 24 evaluable.
    • 18 acute myeloid leukemia/myelodysplastic syndrome.
    • 7 chronic myeloid leukemia.
  • Compared with contemporaneous control of 95 patients who were not treated with NK cells.
    • Median follow-up:
      • NK cells: 23.9 months,
      • Without NK cells: 25.5 months.
    • 1-year PFS:
      • NK cells: 76.67%,
      • Without NK cells: 48.46%,
      • P=.041.
    • 1-year relapse
      • NK cells: 5.13%,
      • Without NK cells: 29.62%,
      • P=.023.
    • Lower incidence of viral reactivation with NK cell therapy, particularly BKV cystitis.

Limitations

  • Compared small cohort to nonrandomized historic control.
  • Difficult to differentiate role of NK infusions from that of graft.