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2015 ; 20
(10
): 1121-2
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First-in-Human Proof-of-Concept Study: Intralesional Administration of BQ788, an
Endothelin Receptor B Antagonist, to Melanoma Skin Metastases
#MMPMID26330458
Wouters J
; Hunger RE
; Garrod T
; Dubuis B
; Hunziker T
; van den Oord JJ
; Lahav-le Coutre R
Oncologist
2015[Oct]; 20
(10
): 1121-2
PMID26330458
show ga
BACKGROUND: This first-in-human proof-of-concept study aimed to check whether
safety and preclinical results obtained by intratumoral administration of BQ788,
an endothelin receptor B (EDNRB) antagonist, can be repeated in human melanoma
patients. METHODS: Three patients received a single intralesional BQ788
application of 3 mg. After 3-7 days, the lesions were measured and removed for
analysis. The administered dose was increased to a cumulative dosage of 8 mg in
patient 4 (4 × 2.0 mg, days 0-3; lesion removed on day 4) and to 10 mg in patient
5 (3 × 3.3 mg, days 0, 3, and 10; lesion removed after 14 days). Control lesions
were simultaneously treated with phosphate-buffered saline (PBS). All samples
were processed and analyzed without knowledge of the clinical findings. RESULTS:
No statistical evaluation was possible because of the number of patients (n = 5)
and the variability in the mode of administration. No adverse events were
observed, regardless of administered dose. All observations were in accordance
with results obtained in preclinical studies. Accordingly, no difference in
degree of tumor necrosis was detected between BQ788- and PBS-treated samples. In
addition, both EDNRB and Ki67 showed decreased expression in patients 2 and 5
and, to a lesser extent, in patient 1. Similarly, decreased expression of EDNRB
mRNA in patients 2 and 5 and of BCL2A1 and/or PARP3 in patients 2, 3, and 5 was
found. Importantly, semiquantitatively scored immunohistochemistry for CD31 and
CD3 revealed more blood vessels and lymphocytes, respectively, in BQ788-treated
tumors of patients 2 and 4. Also, in all patients, we observed inverse
correlation in expression levels between EDNRB and HIF1A. Finally, in patient 5
(the only patient treated for longer than 1 week), we observed inhibition in
lesion growth, as shown by size measurement. CONCLUSION: The intralesional
applications of BQ788 were well tolerated and showed signs of directly and
indirectly reducing the viability of melanoma cells.