Scott A M, Lee F T, Hopkins W, Cebon J S, Wheatley J M, Liu Z, Smyth F E, Murone C, Sturrock S, MacGregor D, Hanai N, Inoue K, Yamasaki M, Brechbiel M W, Davis I D, Murphy R, Hannah A, Lim-Joon M, Chan T, Chong G, Ritter G, Hoffman E W, Burgess A W, Old L J
Ludwig Institute for Cancer Research, Melbourne Tumour Biology Branch, and Department of Nuclear Medicine and Centre for Positron Emission Tomography, Surgery, and Anatomical Pathology, Melbourne, Australia.
J Clin Oncol. 2001 Oct 1;19(19):3976-87. doi: 10.1200/JCO.2001.19.19.3976.
KM871 is a chimeric monoclonal antibody against the ganglioside antigen GD3, which is highly expressed on melanoma cells. We conducted an open-label, dose escalation phase I trial of KM871 in patients with metastatic melanoma.
Seventeen patients were entered onto one of five dose levels (1, 5, 10, 20, and 40 mg/m2). Patients received three infusions of KM871 at 2-week intervals, with the first infusion of KM871 trace-labeled with indium-111 (111In) to enable assessment of biodistribution in vivo. Biopsies of metastatic melanoma sites were performed on days 7 to 10.
Fifteen of 17 patients completed a cycle of three infusions of KM871. No dose-limiting toxicity was observed during the trial; the maximum-tolerated dose was therefore not reached. Three patients (at the 1-, 5-, and 40-mg/m2 dose levels) developed pain and/or erythema at tumor sites consistent with an inflammatory response. No normal tissue uptake of 111In-KM871 was observed, and tumor uptake of 111In-KM871 was observed in all lesions greater than 1.5 cm (tumor biopsy 111KM871 uptake results: range, 0.001% to 0.026% injected dose/g). The ratio of maximum tumor to normal tissue was 15:1. Pharmacokinetic analysis revealed a 111In-KM871 terminal half-life of 7.68 +/- 2.94 days. One patient had a clinical partial response that lasted 11 months. There was no serologic evidence of human antichimeric antibody in any patient, including one patient who received 16 infusions over a 12-month period.
This study is the first to demonstrate the biodistribution and specific targeting of an anti-GD3 antibody to metastatic melanoma in patients. The long half-life and lack of immunogenicity of KM871 makes this antibody an attractive potential therapy for patients with metastatic melanoma.
KM871是一种针对神经节苷脂抗原GD3的嵌合单克隆抗体,GD3在黑色素瘤细胞上高度表达。我们对转移性黑色素瘤患者进行了一项开放标签、剂量递增的I期KM871试验。
17名患者被纳入五个剂量水平(1、5、10、20和40mg/m²)之一。患者每2周接受3次KM871输注,首次输注的KM871用铟-111(¹¹¹In)进行微量标记,以便评估体内生物分布。在第7至10天对转移性黑色素瘤部位进行活检。
17名患者中有15名完成了3次KM871输注的一个周期。试验期间未观察到剂量限制性毒性;因此未达到最大耐受剂量。3名患者(在1、5和40mg/m²剂量水平)在肿瘤部位出现与炎症反应一致的疼痛和/或红斑。未观察到¹¹¹In-KM871对正常组织的摄取,在所有大于1.5cm的病变中均观察到¹¹¹In-KM871对肿瘤的摄取(肿瘤活检¹¹¹KM871摄取结果:范围为注射剂量/克的0.001%至0.026%)。最大肿瘤与正常组织的比率为15:1。药代动力学分析显示¹¹¹In-KM871的终末半衰期为7.68±2.94天。1名患者出现持续11个月的临床部分缓解。在任何患者中均无人类抗嵌合抗体的血清学证据,包括1名在12个月内接受16次输注的患者。
本研究首次证明了抗GD3抗体在患者转移性黑色素瘤中的生物分布和特异性靶向作用。KM871的长半衰期和缺乏免疫原性使其成为转移性黑色素瘤患者有吸引力的潜在治疗方法。