On January 14, 2020 NantKwest Inc., (Nasdaq: NK), a clinical-stage natural killer cell-based therapeutics company, reported results from their Phase 1 trial investigating a novel, first-in-human immunotherapy consisting of NantKwest’s off-the-shelf, PD-L1 tumor-targeted NK cells (NCT04050709) (Press release, NantKwest, JAN 14, 2020, https://ir.nantkwest.com/news-releases/news-release-details/nantkwest-and-immunitybio-announce-complete-response-metastatic?field_nir_news_date_value[min]= [SID1234553179]). In addition, NantKwest and ImmunityBio, Inc., a privately held immunotherapy company, reported on a compassionate use expanded access IND combining the PD-L1-targeted NK cell with ImmunityBio’s IL-15 fusion protein (N-803) in a patient with metastatic pancreatic cancer who had relapsed after prior standard of care therapy.
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The findings on the Phase 1 safety and early signals of efficacy were reported by Patrick Soon-Shiong, M.D., Chairman and CEO of NantKwest, at the J.P. Morgan Healthcare Conference in San Francisco.
"We hypothesize that a common treatment protocol that harnesses both the natural-killer cell and the T cells could be effective in treating cancer across multiple tumor types. This has been supported by the early signals of safety and efficacy in Phase 1 and 2 studies of NantKwest’s natural killer cells in advanced cancers. We recently reported at the 2019 Society for Immunotherapy of Cancer (SITC) (Free SITC Whitepaper) conference (SITC) (Free SITC Whitepaper) complete responses in third-line Merkel cell carcinoma and fourth-line head and neck cancers when haNK CD-16 NK cells combined with Pfizer’s PD-L1 antibody, Avelumab, and with ImmunityBio’s N-803, an IL-15 superagonist were administered," said Dr. Soon-Shiong. "Most recently we reported complete responses using combination therapies which included haNK, Avelumab and N-803 in Triple Negative Breast Cancer. Durable complete responses were observed in these patients who had failed all standards of care therapy for breast cancer. The results were presented at the 2019 San Antonio Breast Cancer Symposium (SABCS) in December 2019."
"The evolution of the next generation NK in our platform was now to enable haNK cells to target tumors by expressing PD-L1 CAR (chimeric antigen receptor) on the surface of haNK NK cells. These PD-L1.taNK NK cells have the properties of targeting PD-L1 on tumors, without the need of an additional PD-L1 checkpoint, Avelumab."
The FDA authorized the first-in-human safety studies of PD-L1.t-haNK (Quilt 3.064; NCT04050709) at doses of two billion cells administered bi-weekly as outpatients. No dose limiting or treatment-related events were noted in patients treated to date in this first dosing cohort. The study is now enrolling the dose cohort of four billion cells per infusion.
PD-L1.t-haNK Combined with N-803 IL-15 Protein for Treatment of Metastatic Pancreatic Cancer
An expanded access regimen incorporating N-803 with PD-L1.t-haNK was authorized to treat a patient with metastatic pancreatic cancer who had failed standard of care, based on the safety and efficacy data of the Phase 1 trial in 11 patients with metastatic pancreatic cancer who had received haNK and N-803. After five infusions of PD-L1.t-haNK and N-803, the patient’s tumor metastasis resolved completely per CT/Pet scan and the complete response has been confirmed by a repeat CT/Pet scan. Patient continues to receive ongoing treatment.
"We are extremely pleased that the FDA granted us this expanded IND authorization to initiate this novel immunotherapy treatment enabling the cross-talk of the innate natural killer system with the adaptive T cell," said Dr. Soon-Shiong. "Achieving complete response in metastatic pancreatic cancer and durable, complete responses in metastatic TNBC patients that have failed all current standards of care is a promising finding which may further validate our approach to orchestrate both the innate and adaptive immune system," continued Soon-Shiong. "Pancreatic cancer and TNBC are highly aggressive cancers with limited treatment options. These results are important, proof-of-concept supporting our hypothesis that comprehensively activating the immune responses of the NK, T and Dendritic cells, the ‘triangle offense’, would induce immunogenic cell death leading to durable responses, even among this challenging patient population. Based on these encouraging findings, we plan to initiate clinical trials to confirm efficacy in second-line metastatic pancreatic cancer and third-line Triple Negative Breast cancer."