Leonard John P, Coleman Morton, Ketas Jamie C, Chadburn Amy, Furman Richard, Schuster Michael W, Feldman Eric J, Ashe Michelle, Schuster Stephen J, Wegener William A, Hansen Hans J, Ziccardi Heather, Eschenberg Michael, Gayko Urte, Fields Scott Z, Cesano Alessandra, Goldenberg David M
Division of Hematology and Oncology, Center for Lymphoma and Myeloma, Weill Medical College of Cornell University and New York Presbyterian Hospital, New York, New York 10021, USA.
Clin Cancer Res. 2004 Aug 15;10(16):5327-34. doi: 10.1158/1078-0432.CCR-04-0294.
We conducted a single-center, dose-escalation study evaluating the safety, pharmacokinetics, and efficacy of epratuzumab, an anti-CD22 humanized monoclonal antibody, in patients with aggressive non-Hodgkin's lymphoma.
Epratuzumab was administered once weekly for 4 weeks at 120-1000-mg/m2 doses to 56 patients [most (n = 35) with diffuse large B-cell lymphoma].
Patients were heavily pretreated (median, 4 prior therapies), 25% received prior high-dose chemotherapy with stem cell transplant, and 84% had bulky disease (> or =5 cm). Epratuzumab was well tolerated, with no dose-limiting toxicity. Most (95%) infusions were completed within 1 h. The mean serum half-life was 23.9 days. Across all dose levels and histologies, objective responses (ORs) were observed in five patients (10%; 95% confidence interval, 3-21%), including three complete responses. In patients with diffuse large B-cell lymphoma, 15% had ORs. Overall, 11 (20%) patients experienced some tumor mass reduction. Median duration of OR was 26.3 weeks, and median time to progression for responders was 35 weeks. Two responses are ongoing at > or =34 months, including one rituximab-refractory patient.
These data demonstrate that epratuzumab has a good safety profile and exerts antitumor activity in aggressive non-Hodgkin's lymphoma at doses of > or =240 mg/m2, thus warranting further evaluation in this clinical setting.
我们开展了一项单中心剂量递增研究,评估抗CD22人源化单克隆抗体依帕珠单抗治疗侵袭性非霍奇金淋巴瘤患者的安全性、药代动力学和疗效。
56例患者(多数患者,n = 35,为弥漫性大B细胞淋巴瘤)接受依帕珠单抗治疗,剂量为120 - 1000mg/m²,每周给药1次,共4周。
患者大多接受过多种治疗(中位数为4种既往治疗),25%的患者接受过含干细胞移植的既往大剂量化疗,84%的患者有大包块病变(≥5cm)。依帕珠单抗耐受性良好,无剂量限制性毒性。大多数(95%)输注在1小时内完成。平均血清半衰期为23.9天。在所有剂量水平和组织学类型中,5例患者(10%;95%置信区间,3 - 21%)出现客观缓解(OR),包括3例完全缓解。弥漫性大B细胞淋巴瘤患者中,15%出现OR。总体而言,11例(20%)患者出现一定程度的肿瘤体积缩小。OR的中位持续时间为26.3周,缓解者的中位疾病进展时间为35周。2例缓解持续≥34个月,其中1例为利妥昔单抗难治性患者。
这些数据表明,依帕珠单抗具有良好的安全性,在≥240mg/m²剂量下对侵袭性非霍奇金淋巴瘤具有抗肿瘤活性,因此有必要在该临床环境中进一步评估。