METHOD FOR ADMINISTERING ONCOLYTIC VIRUS TO TUMOR TISSUE, AND DEVICE FOR ADMINISTRATION

Abstract

Provided is a method of administering a virus to tumor tissues using an endoscope.

A method of administering a virus to tumor tissues using an endoscope, which is characterized in that it comprises inserting an endoscopic puncture needle filled with a virus-containing solution into tumor tissues and injecting the virus into the tumor tissues.

Claims

1-20. (canceled)

21. A method of administering a virus to tumor tissues using an endoscope, which is characterized in that it comprises inserting an endoscopic puncture needle filled with a virus-containing solution into tumor tissues and injecting the virus into the tumor tissues.

22. A method for treating a tumor using an endoscope, which is characterized in that it comprises inserting an endoscopic puncture needle filled with a virus-containing solution into tumor tissues and injecting the virus into the tumor tissues.

23. The method according to claim 21, wherein the tumor is at least one selected from the group consisting of stomach cancer, gastroesophageal junction cancer, esophageal cancer, duodenal cancer, pancreatic cancer, colon cancer, head and neck cancer, anal cancer, rectal cancer, small intestine cancer, lung cancer, and liver cancer.

24. The method according to claim 21, wherein the virus is administered to at least 5 sites in the tumor tissues.

25. The method according to claim 21, wherein the virus is administered in an amount of at least 0.1 mL to 1 site in the tumor tissues.

26. The method according to claim 21, wherein the virus is administered over at least 5 seconds to 1 site in the tumor tissues.

27. The method according to claim 21, wherein the virus is administered to the peripheral base of the tumor and/or the marginal region of the tumor tissues.

28. The method according to claim 21, wherein the virus is additionally administered to the same lesion one or more times.

29. The method according to claim 21, wherein the virus is an oncolytic virus.

30. The method according to claim 21, wherein the virus is an adenovirus.

31. A device for administering a virus to tumor tissues or for treating a tumor, using an endoscope, wherein the device includes an endoscope and an endoscopic puncture needle filled with a virus-containing solution.

32. The device according to claim 31, wherein the tumor is at least one selected from the group consisting of stomach cancer, gastroesophageal junction cancer, esophageal cancer, duodenal cancer, pancreatic cancer, colon cancer, head and neck cancer, anal cancer, rectal cancer, small intestine cancer, lung cancer, and liver cancer.

33. The method according to claim 22, wherein the tumor is at least one selected from the group consisting of stomach cancer, gastroesophageal junction cancer, esophageal cancer, duodenal cancer, pancreatic cancer, colon cancer, head and neck cancer, anal cancer, rectal cancer, small intestine cancer, lung cancer, and liver cancer.

34. The method according to claim 22, wherein the virus is administered to at least 5 sites in the tumor tissues.

35. The method according to claim 22, wherein the virus is administered in an amount of at least 0.1 mL to 1 site in the tumor tissues.

36. The method according to claim 22, wherein the virus is administered over at least 5 seconds to 1 site in the tumor tissues.

37. The method according to claim 22, wherein the virus is administered to the peripheral base of the tumor and/or the marginal region of the tumor tissues.

38. The method according to claim 22, wherein the virus is additionally administered to the same lesion one or more times.

39. The method according to claim 22, wherein the virus is an oncolytic virus.

40. The method according to claim 22, wherein the virus is an adenovirus.

Description

BRIEF DESCRIPTION OF DRAWINGS

[0009] FIG. 1 is a view showing a method of filling an endoscopic puncture needle with a drug solution.

[0010] FIG. 2 is a view showing the sites of cancer tissues, to which OBP-301 is administered.

[0011] FIG. 3 is a view showing the sites of cancer tissues, to which OBP-301 is administered.

[0012] FIG. 4 is a view showing a method of administering OBP-301 to cancer tissues.

[0013] FIG. 5 is a view showing a method of administering OBP-301 to cancer tissues.

[0014] FIG. 6 is a view showing a case process when a patient with esophageal cancer was treated with OBP-301.

[0015] FIG. 7 is a view showing a case process when a patient with esophageal cancer was treated with OBP-301.

[0016] FIG. 8 is a view showing a case process when a patient with esophageal cancer was treated with OBP-301.

[0017] FIG. 9 is a view showing a case process when a patient with esophageal cancer was treated with OBP-301.

DESCRIPTION OF EMBODIMENTS

[0018] The present invention relates to a method of endoscopically administering a virus to tumor tissues. In the present invention, the virus includes a proliferative virus and a non-proliferative virus. The proliferative virus includes an oncolytic virus. In one embodiment of the present invention, the virus includes adenovirus, herpesvirus, vesicular stomatitis virus, reovirus, vaccinia virus, and measles virus. Among these viruses, adenovirus, herpesvirus, and vesicular stomatitis virus are preferable, and adenovirus is particularly preferable. In the present invention, an adenovirus containing an hTERT promoter in the genome thereof is preferable.

[0019] In a preferred embodiment of the present invention, the oncolytic virus includes a recombinant oncolytic virus. The recombinant oncolytic virus of the present invention (for example, OBP-301) means a virus, in which a polynucleotide comprising a human telomerase promoter (hTERT promoter), an E1A gene, an IRES sequence and an E1B gene in this order is incorporated into the genome thereof. The type of the virus used in the present invention is not particularly limited, and from the viewpoint of safety, adenovirus is preferable. Among such adenoviruses, adenovirus type 5 is particularly preferable because of its easy handlability. The recombinant oncolytic adenovirus can be obtained by the method described in WO2004/005511. Otherwise, OBP-301 as a recombinant oncolytic adenovirus can be acquired as “Telomelysin” (registered trademark) from Oncolys BioPharma Inc. Moreover, OBP-702, in which a polynucleotide comprising an Egr-1 promoter and a p53 gene in this order is incorporated into the E3 region of OBP-301, can also be preferably used. OBP-702 can be acquired from Oncolys BioPharma Inc.

[0020] The term “cancer” is used herein to mean a malignant tumor understood in the present technical field. For example, cancer has a property by which it proliferates, without being controlled, in tissues that are likely to spread to the remote sites of the body (i.e., to metastasize). Examples of such malignant tumor (cancer) to be administered with a virus may include, not only stomach cancer and gastroesophageal junction cancer, but may also include esophageal cancer, duodenal cancer, pancreatic cancer, colon cancer, head and neck cancer, anal cancer, rectal cancer, small intestine cancer, lung cancer, and liver cancer. The head and neck cancer includes laryngeal cancer and pharyngeal cancer. Among these cancers, stomach cancer, gastroesophageal junction cancer, duodenal cancer, small intestine cancer, colon cancer, anal cancer, and rectal cancer are desirable.

[0021] The oncolytic virus of the present invention (for example, OBP-301) can be directly administered to cancer tissues via an endoscope every two weeks. For example, in a radiation therapy period for 6 weeks, OBP-301 can be endoscopically directly administered into cancer tissues a total of three times, namely, on Day 1, Day 18, and Day 32. Hereafter, the case of using OBP-301 as an oncolytic virus will be described for explanatory convenience, but a person skilled in the art could readily apply other viruses as well.

1. Preparation of OBP-301 for Use in Injection

[0022] During the transportation and storage of OBP-301, the temperature is maintained at −60° C. or lower.

[0023] At a stage in which OBP-301 is ready to be administered, a box is removed from a refrigerator, and a vial is then removed from the box. Subsequently, a cryopreserved OBP-301 solution (also referred to as an “IP solution”) is thawed at room temperature. The time required for thawing the IP solution is approximately 10 minutes. After completion of the thawing, the IP solution is stable for 4 hours. If necessary, the IP solution can be preserved in ice before injection. The IP solution is filled in a single vial, so that 2 mL of the IP solution having a concentration of 1×10.sup.12 VP/mL can be collected from the vial. Accordingly, a required amount of the IP solution is prepared, depending on the size of a lesion and the void volume to be filled with the IP solution.

2. Device for Administering IP Solution into Tumor Tissues

[0024] FIG. 1 is a view showing vials and syringes at a preparation stage for administration of the IP solution into tumor tissues.

[0025] In FIG. 1A, one to three vial(s) 101 (two vials are shown in the figure), a 1-mL syringe 102, and a 2.5-mL syringe 103 are prepared. The syringe 102 is a syringe for injecting the IP solution into tumor tissues, whereas the syringe 103 is a syringe for filling the IP solution into a tube connected with an endoscopic puncture needle (not shown in the figure).

[0026] In the present invention, in addition to the one to three vial(s) 101 comprising OBP-301, a set of endoscopic puncture needles, for example, Carr-Locke injection needles (sheath diameter: 2.5 mm, length: 230 cm, needle protrusion: 5 mm, and 25 gauge), or TOP endoscopic puncture needles for esophagus (length: 1600 mm, needle protrusion: 4 mm, and 23 gauge) are prepared. Thereafter, using the syringe 103, the IP solution is removed from the vial 101. The endoscope to be used can be selected, as appropriate, depending on the type of cancer. For example, a gastrointestinal endoscope, an airway endoscope, an ultrasonic endoscope, etc. can be adopted.

[0027] The IP solution is filled into an endoscopic puncture needle, specifically, into an endoscope tube 104 connected with the endoscopic puncture needle, immediately before the administration thereof. In the present invention, for explanatory convenience, not only an endoscopic puncture needle itself, but also an endoscopic puncture needle 403 connected with the endoscope tube 104 (see FIG. 4), are collectively referred to as, simply, an “endoscopic puncture needle.” The 2.5-mL syringe 103 containing the IP solution is attached to the end of the endoscopic puncture needle used, and then, the IP solution is slowly pushed out, so that the IP solution is filled into the endoscope tube 104 as a whole (FIG. 1B). During this operation, attention is paid not to leak the IP solution from the tip of the puncture needle. After completion of the filling, the endoscope tube 104 filled with the IP solution is gently placed on a treatment table, while not pushing the syringe. Thereby, preparation of the IP solution to be administered is completed. When the IP solution is administered into tumor tissues, the syringe 103 is removed in order to administer the IP solution contained in the endoscope tube 104 into the tumor tissues, and the syringe 102 filled with the IP solution is then attached to the tube, and thereafter, the IP solution contained in the syringe 102 is pushed out of the end thereof (FIG. 1C). Thereby, the IP solution filled in the endoscope tube 104 can be administered at a maximum dose of 1 mL (for example, 0.2 ml×5 times of administrations). The IP solution to be administered into tumor tissues is filled in the tube. A solution used to push the IP solution into the tumor tissues is not limited to the IP solution, and for example, a normal saline or the like can be used. However, from the viewpoint of reducing the risk of diluting the IP solution to be administered into tumor tissues with such a normal saline, the IP solution is preferably used also as a solution used to push the IP solution into the tumor tissues.

3. Method of Administering IP Solution into Tumor Tissues and Method for Treating Tumor

[0028] Next, the method of administering the IP solution into tumor tissues will be described. In the present description, type 2 esophageal cancer is exemplified and explained. First, the cancer region as a whole is observed, and administration sites are then determined.

[0029] FIG. 2 is a view showing the positions of tumor tissues 201 of esophagus 10, into which the IP solution is to be administered. In order that the IP solution can cover the entire region, the IP solution can be administered to at least 5 administration sites (for example, 5 to 10 sites) in the administration region, depending on the size of the tumor. In FIG. 2, the administration sites are indicated with the filled circles.

[0030] Upon administration of the IP solution into tumor tissues, iodine staining is not carried out in order to prevent inactivation of the IP solution. In addition, the lesion of the tumor may be observed as necessary, and administration sites may be then determined using image enhancement imaging (FIG. 3). FIG. 3 shows that the image of an administration region 301 was enhanced by the image enhancement imaging in an esophagus 10 having tumor tissues 201.

[0031] FIG. 4 is a view showing a state in which the IP solution is injected into tumor tissues 201 from an endoscopic puncture needle 403. In FIG. 4, an endoscope 401 is allowed to reach the tumor tissues 201 of the esophagus 10. After confirmation of a lesion, the endoscopic puncture needle 403 connected with an endoscope tube 402 is inserted into the lesion from a forceps channel, and the IP solution used as a drug solution is then injected, so that the IP solution can be spread over the entire tumor, successively from the tumor margin on the tail side to the tumor margin on the mouth side. This operation is carried out to prevent the phenomenon in which the administration sites become invisible due to bleeding occurring upon the administration. The IP solution is preferably administered to sites in which cancer cells actively divide, and thus, the IP solution is preferably injected into the peripheral base of the tumor or the marginal portion of the tumor. Moreover, administration of the IP solution to sites in which necrosis may occur is preferably avoided.

[0032] The IP solution is administered with good balance to at least 5 lesion sites (administration sites) at a predetermined dose per site. When the IP solution is injected into the lesions, a 1-mL syringe is used. While a person in charge of injection operations confirms the syringe scale, the person slowly injects the IP solution over approximately 5 seconds per site. In the present invention, the amount of the IP solution is preferably 0.1 mL or more, more preferably 0.15 mL or more, and particularly preferably 0.2 mL or more. The administration time is not limited, and administration is carried out preferably for 5 seconds or more per site, and more preferably for 5 seconds per site. According to the repeated administrations on Day 18 and Day 32, it may become impossible to identify the cancer due to reduction of the cancer. In this case, administration is carried out on the same administration sites as those on Day 1.

[0033] Next, an administration method applied in the case of esophagostenosis or superficial cancer of esophagus will be described.

[0034] FIG. 5 is a view showing that an esophagus 10 had esophagostenosis due to tumor tissues 201. When a normal endoscope hardly passes through the esophagus due to such esophagostenosis (FIG. 5A), a transnasal endoscope is used as necessary, and in principle, 0.2 mL of the IP solution is administered to 5 or more sites. In the case of superficial cancer of esophagus or small elevated cancer, an endoscope 401, an endoscope tube 402, and an endoscopic puncture needle 403 are placed as horizontal as possible, and intratumoral administration is then carried out (FIGS. 5B and C). Furthermore, submucosal injection of a normal saline for upraising cancer is preferably not carried out because the drug is diluted with the normal saline in some cases.

[0035] As mentioned above, cancer can be treated by administering a virus to a patient according to the above-described method. Therefore, the present invention provides a method for treating cancer using an endoscope.

EXAMPLES

[0036] Hereinafter, the present invention will be more specifically described in the following example. However, the following example is not intended to limit the scope of the present invention.

Example 1

1. Method

[0037] Patients with esophageal cancer, to whom standard treatments (surgical resection and chemotherapy) were hardly applied, were used as subjects, and an administration test of OBP-301 (Telomelysin) was carried out.

[0038] The backgrounds of the patients are shown in Table 1 below.

TABLE-US-00001 TABLE 1 Cohort ID Age TMN or Stage Histological Type Cohort 1 001 82 T1bN0M0 Squamous cell (Stage IA) carcinoma 002 84 T3N1M0 Adenocarcinoma (Stage IIIA) 003 82 T1bN1M0 Squamous cell (Stage IIB) carcinoma Cohort 2 004 79 T1bN0M0 Squamous cell (Stage IA) carcinoma 005 66 T3N1M0 Squamous cell (Stage IIIA) carcinoma 006 85 T2N0M0 Squamous cell (Stage IB) carcinoma

[0039] The applied dose of OBP-301 was set to be 1×10.sup.11VP/mL for Cohort 1, and 1×10.sup.12VP/mL for Cohort 2. In each cohort, on Day 1, Telomelysin was administered, at a dose of 0.2 ml to a single lesion of thoracic esophagus, to 5 sites (a total of 1 ml), using an endoscope under local anesthesia. Thereafter, intratumoral additional administration of Telomelysin was carried out on Day 18 and on Day 32. It is to be noted that, in the present example, from Day 4, radiation exposure was carried out at a dose of 2.0 Gy/day, 5 times a week (10 Gy/week), for 6 weeks (total radiation dose: 60 Gy).

[0040] The treatment period was set to be 6 weeks, and evaluation was carried out with regard to the following evaluation items.

(1) Primary Evaluation Items:

[0041] Occurrence rate of dose-limiting toxicity (DLT) [0042] Occurrence rate of harmful phenomenon

(2) Secondary Evaluation Items:

[0043] Effect of reducing tumor in therapeutic target lesion from initiation of treatment until 18th week (topical treatment effect) [0044] Effect of reducing tumor from initiation of treatment until 18th week (systemic treatment effect, Recist evaluation)

Results

[0045] The progress of the case with ID number of 002 (Cohort 1) is shown in FIG. 6 (photographs of esophageal portion) and FIG. 7 (CT images). On 71 day after initiation of the treatment, the patient achieved a complete response (CR), and even on Day 127 after initiation of the treatment, the CR continued (FIG. 6). In addition, 1 year after the treatment, lymph node metastasis disappeared, and the CR still continued (FIG. 7).

[0046] The progress of the case with ID number of 003 (Cohort 1) is shown in FIG. 8 (photographs of esophageal portion) and FIG. 9 (CT images). Also, in this case, CR was confirmed on 71 day after initiation of the treatment (FIG. 8), and even on Day 127 after initiation of the treatment, the CR continued (FIG. 8). In addition, 3 months after the treatment, lymph node metastasis was reduced (FIG. 9).

DESCRIPTION OF SYMBOLS

[0047] 10: Esophagus [0048] 101: Vial, 102: 1-mL Syringe, 103: 2.5-mL Syringe, 104: Tube [0049] 201: Tumor tissues [0050] 301: Administration region [0051] 401: Endoscope, 402: Endoscope tube, 403: Endoscopic puncture needle