INO-5150 is an investigational immunotherapy for the treatment of prostate cancer, being developed by Inovio Pharmaceuticals. It is currently in clinical testing in patients.

How INO-5150 works

It is an immunotherapy, or therapy that works by directing the body’s immune system to target and kill the cancer cells. The immune system can recognize and destroy abnormal cells, such as cancer cells, through a specific type of white blood cell (or lymphocyte) called cytotoxic T lymphocytes (CTL) or cytotoxic T-cells.

CTLs recognize cancer cells based on a substance called an antigen that is present on their surface. This recognition process triggers the production of more CTLs.

It is one of Inovio’s “SynCon immunotherapies.” These therapies use a piece of DNA that contains the genes for prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA). These genes give instructions the cell needs to be able to make the antigen.

To work, INO-5150 needs to be able to enter the cells in the body. This is achieved through an injection combined with electroporation treatment (a pulse of electricity that can keep the cell membrane open long enough for the DNA to enter).

Once in the cell, INO-5150 triggers the production of PSA and PSMA. The immune system can recognize cells infected with INO-5150 and destroy them, taking up the two prostate-specific antigens and generating new CTLs that will target cells producing PSA and PSMA. These two antigens are typically produced in large amounts by prostate cancer cells. The intended result is the body attacking the cancer cells and reducing the tumor.

INO-5150 in clinical trials

INO-5150 began being tested in prostate cancer patients in 2015. This followed promising preclinical results in a study using monkeys, which demonstrated a strong immune response after injection with INO-5150.

A Phase 1 clinical trial (NCT02514213) is nearing a conclusion. Its aim is to assess whether INO-5150 is safe and well-tolerated, whether a successful immune reaction can be triggered in people with prostate cancer, and changes in the levels of PSA. The patients are being administered 2 mg or 8.5 mg of INO-5150, followed by an electroporation treatment. The trial is also assessing whether combining INO-5150 with INO-9012 (a treatment which boosts the immune response by stimulating CTL production) has a significant effect on the treatment.

An estimated 60 patients were given four injections of INO-5150 and monitored for 72 weeks. Study results are expected in the second half of 2017.

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