Ajani J A, Kelsen D P, Haller D, Hargraves K, Healey D
Department of Gastrointestinal Oncology and Digestive Diseases, University of Texas M.D. Anderson Cancer Center, Houston, USA.
Cancer J. 2000 Mar-Apr;6(2):78-81.
High levels (> 200,000 molecules per carcinoma cell) of the LewisY antigen are expressed on the surface of most (> 75%) gastric carcinomas. The BMS-182248-01 is a chimeric variant of anti-LewisY monoclonal antibody that is conjugated with doxorubicin. In a phase I study, BMS-182248-01 resulted in a partial response in a patient with gastric carcinoma. We, therefore, conducted a multi-institutional phase II study of BMS-182248-01 in patients with advanced gastric carcinoma.
Only patients with evidence of LewisY antigen by immunohistochemical method on their gastric carcinoma were treated. Patients with unresectable gastric adenocarcinoma were eligible. Patients had to have adequate liver, renal, and marrow functions. Written consent was obtained from all patients. All patients were hospitalized. BMS-182248-01 was administered at the starting dose of 700 mg/m2 i.v. over 24 hours on day 1 every 3 weeks.
Fifteen patients were enrolled. There were 10 men and 5 women. The median age at enrollment was 56 years, with ages ranging from 34 to 80 years. No objective responses were observed. Five patients had disease stabilization. The remaining 10 patients progressed on study. Rapidly reversible gastrointestinal toxicity, primarily nausea and emesis, was predominant. There was no neutropenia, thrombocytopenia, or cardiomyopathy.
Although BMS-182248-01 represents a novel approach of monoclonal antibody conjugated with an active chemotherapy agent, delivered intracellularly, it was ineffective in patients with gastric carcinoma whose tumors carried LewisY antigen.
大多数(>75%)胃癌细胞表面表达高水平(>200,000个分子/癌细胞)的LewisY抗原。BMS-182248-01是一种与阿霉素偶联的抗LewisY单克隆抗体的嵌合变体。在一项I期研究中,BMS-182248-01使一名胃癌患者产生了部分缓解。因此,我们开展了一项针对晚期胃癌患者的BMS-182248-01多机构II期研究。
仅治疗通过免疫组织化学方法在其胃癌中检测到LewisY抗原的患者。不可切除的胃腺癌患者符合条件。患者必须具备足够的肝、肾和骨髓功能。所有患者均获得书面知情同意。所有患者均住院治疗。BMS-182248-01的起始剂量为700mg/m²,于第1天静脉输注24小时,每3周一次。
入组15例患者。其中男性10例,女性5例。入组时的中位年龄为56岁,年龄范围为34至80岁。未观察到客观缓解。5例患者病情稳定。其余10例患者在研究过程中病情进展。主要为快速可逆的胃肠道毒性,以恶心和呕吐为主。未出现中性粒细胞减少、血小板减少或心肌病。
尽管BMS-182248-01代表了一种将单克隆抗体与活性化疗药物偶联并在细胞内递送的新方法,但对于肿瘤携带LewisY抗原的胃癌患者无效。