AdCD40L is a replication-deficient virus carrying the gene for
CD40 ligand which has previously been evaluated in patients with urothelial
cancer and
malignant melanoma. Herein, we present the results of repeated intratumoral
injections of AdCD40L in seven patients with metastatic solid
cancer. One patient who developed urothelial
cancer derived from a renal transplant was treated with repeated
injections of AdCD40L alone. The remaining patients suffered from
cholangiocarcinoma, kidney, breast, rectal, or
ovarian cancer and received AdCD40L repeatedly (4x) in combination with
cyclophosphamide. The treatment was safe and generally well-tolerated. Two patients had clinical benefit of the treatment and one of them was accepted for re-treatment. Circulating proinflammatory
cytokines were commonly increased
after treatment, but save for TNFα, significances were not reached which could be due to the low number of patients. Similar to earlier findings in AdCD40L-treated
melanoma patients,
IL8 plasma levels were high in the present study. In conclusion, gene therapy by repeated intratumoral AdCD40L
injections alone, or in combination with
cyclophosphamide, is feasible and safe in patients with solid
cancers. The potential of intratumoral
CD40L gene transfer as treatment of
cancer was illustrated by the clinical improvement in two out of seven patients.