The Evolution of Nadofaragene Firadenovec: A Review and the Path Forward

IF 1 4区 医学 Q4 ONCOLOGY Bladder Cancer Pub Date : 2024-05-09 DOI:10.3233/blc-230083
Alexis R. Steinmetz, Sharada Mokkapati, David McConkey, Colin P. Dinney
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引用次数: 0

Abstract

BACKGROUND:

The intravesical gene therapy nadofaragene firadenovec (rAd-IFNα/Syn3) was FDA approved in 2022 for non-muscle invasive bladder cancer (NMIBC) unresponsive to frontline treatment with BCG, and the first gene therapy developed for bladder cancer. This non-replicating recombinant adenovirus vector delivers a copy of the human interferon alpha-2b gene into urothelial and tumor cells, causing them to express this pleotropic cytokine with potent antitumor effects.

OBJECTIVE:

To provide a historical overview describing how several decades of preclinical and clinical studies investigating the role of interferon in the treatment of bladder cancer ultimately led to the development of gene therapy with nadofaragene for NMIBC.

METHODS:

We conducted a review of the literature using PubMed, Google Scholar, and ClinicalTrials.gov to summarize our knowledge of the evolution of interferon-based therapy in NMIBC.

RESULTS:

The FDA approval of this therapy represents an important landmark in urologic oncology and several decades of research dedicated to the study of interferon’s direct and indirect antitumor properties in NMIBC. The data gathered from the phase 1, 2, and 3 clinical trials continue to provide additional insights into the precise mechanisms underlying both the efficacy of and resistance to nadofaragene.

CONCLUSIONS:

Nadofaragene leverages the cytotoxic, anti-angiogenic, and immune-modulatory roles of interferon to effectively treat NMIBC that is resistant to BCG. Ongoing studies of resistance mechanisms and prognostic biomarkers have been promising; these will ultimately improve patient selection and allow for the modulation of factors in the tumor or immune microenvironment to further increase therapeutic response.

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Nadofaragene Firadenovec 的演变:回顾与展望
摘要背景:2022年,美国食品与药物管理局(FDA)批准了膀胱内基因疗法nadofaragene firadenovec(rAd-IFNα/Syn3),用于治疗对卡介苗一线治疗无反应的非肌浸润性膀胱癌(NMIBC),这也是首个针对膀胱癌开发的基因疗法。这种不可复制的重组腺病毒载体可将人类干扰素α-2b基因拷贝送入尿路上皮细胞和肿瘤细胞,使其表达这种具有强效抗肿瘤作用的多向性细胞因子。目的:概述几十年来研究干扰素在膀胱癌治疗中作用的临床前和临床研究是如何最终导致开发出纳多法仑基因疗法来治疗非肌层浸润性膀胱癌的。方法:我们利用PubMed、Google Scholar和ClinicalTrials.gov对文献进行了综述,总结了我们对基于干扰素的NMIBC疗法演变的了解。结果:FDA批准这种疗法代表了泌尿肿瘤学的一个重要里程碑,也代表了数十年来致力于研究干扰素在NMIBC中的直接和间接抗肿瘤特性的研究。从 1、2 和 3 期临床试验中收集的数据将继续为了解纳多法拉基因的疗效和耐药性的确切机制提供更多信息。正在进行的耐药机制和预后生物标志物研究很有希望;这些研究最终将改善患者的选择,并能调节肿瘤或免疫微环境中的因素,进一步提高治疗反应。
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来源期刊
Bladder Cancer
Bladder Cancer Medicine-Urology
CiteScore
1.60
自引率
0.00%
发文量
35
期刊介绍: Bladder Cancer is an international multidisciplinary journal to facilitate progress in understanding the epidemiology/etiology, genetics, molecular correlates, pathogenesis, pharmacology, ethics, patient advocacy and survivorship, diagnosis and treatment of tumors of the bladder and upper urinary tract. The journal publishes research reports, reviews, short communications, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research in basic science, translational research and clinical medicine that expedites our fundamental understanding and improves treatment of tumors of the bladder and upper urinary tract.
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