Study summary · research use only
Thymosin alpha 1: from bench to bedside
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
This review traces thymosin alpha 1 (Talpha1) research from animal models to clinical trials. It reports that combinations of Talpha1 with interferon or IL-2 plus chemotherapy were studied in mouse and rat tumor models (Lewis lung carcinoma, Friend erythroleukemia, B16 melanoma, and colorectal cancer liver metastasis), which the authors say provided the basis for human trials. Early trials in advanced non-small cell lung cancer and melanoma combined Talpha1 with low-dose IFN-alpha after chemotherapy, and Talpha1 with IFN-alpha was used in chronic hepatitis B and C patients including interferon-nonresponders. The authors describe biological activities such as activation of dendritic cells via Toll-like receptor signaling and increased antigen expression. They note two ongoing trials: a phase II in advanced melanoma and a phase III in interferon-resistant hepatitis C.
Abstract
After the initial dramatic effects, observed in a Lewis lung carcinoma animal model, using a combination of thymosin alpha 1 (Talpha1) and interferon (IFN) after cyclophosphamide, a number of other preclinical models in mice (Friend erythroleukemia and B16 melanoma) and in rats (DHD/K12 colorectal cancer liver metastasis) have confirmed the efficacy of the combination therapy with Talpha1 and either IFN or IL-2 plus chemotherapy. These results provided the scientific foundation for the first clinical trials using Talpha1 in combination with BRMs and/or chemotherapy. Pivotal trials in advanced non-small cell lung cancer (NSCLC) and melanoma with Talpha1 and IFN-alpha low doses after cis-platinum or dacarbazine produced the first evidence of the high potentiality of this approach in the treatment of human cancer. The combination of Talpha1 and IFN-alpha was also used in patients affected by chronic B and C hepatitis including IFN-nonresponders and infected by precore mutants or genotype 1b. Further studies demonstrated additional biological activities clarifying the mechanism of action of Talpha1, partially explaining the synergism with IFN. It has been shown the capacity of activating infected dendritic cells through Toll-like receptor signaling, thus influencing the inflammation balance, and of increasing the expression of tumor, viral, and major histocompatibility complex (MHC) I antigens. Dose-response studies suggested the possibility of improving the efficacy of this molecule reducing the overall toxic. Based on these information two clinical trials are ongoing: a large phase II on advanced melanoma patients treated with Talpha1 at different doses after dacarbazine and a phase III one, on IFN-resistant hepatitis C virus (HCV) patients treated with a triple combination (IFN, ribavirin, and Talpha1).
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