Goel S, Bauer R J, Desai K, Bulgaru A, Iqbal T, Strachan B-K, Kim G, Kaubisch A, Vanhove G F, Goldberg G, Mani S
Albert Einstein Cancer Center, New York, NY, USA.
Ann Oncol. 2007 Oct;18(10):1704-7. doi: 10.1093/annonc/mdm280. Epub 2007 Aug 9.
ING-1 is a high-affinity, human engineeredtrade mark monoclonal antibody that recognizes a 40 kilodalton epithelial cell adhesion molecule (EpCAM) glycoprotein that is expressed in high levels on most adenocarcinomas and is an attractive target for immunotherapy.
ING-1 was administered subcutaneously weekly at doses between 0.1 and 2 mg/kg/week. Pharmacokinetic samples were drawn during weeks 1 and 6.
Fourteen patients with advanced refractory cancer received a median of 6 (range 1-9) doses of ING-1. At 1 mg/kg, a 62-year-old man with colon cancer developed reversible grade 3 pancreatitis after the third dose. His plasma ING-1 levels were similar to the other two patients dosed at 1 mg/kg. Two patients dosed at 0.6 mg/kg experienced stable disease at 6 weeks. Peak drug levels increased with dose and time, suggesting drug accumulation with repeated dosing. Low human anti-human antibody response was noted in three of the 13 patients assessed and was directed towards the variable region of ING-1.
Weekly ING-1 administered subcutaneously was well tolerated at 0.6 mg/kg/week and further experience at this dose is warranted to demonstrate safety. The risk of pancreatitis and the marginal anti-tumor effect may preclude further monotherapy studies; however, combination studies with chemotherapy are warranted.
ING-1是一种高亲和力的人源化商标单克隆抗体,可识别一种40千道尔顿的上皮细胞粘附分子(EpCAM)糖蛋白,该糖蛋白在大多数腺癌中高表达,是免疫治疗的一个有吸引力的靶点。
ING-1每周皮下给药,剂量为0.1至2mg/kg/周。在第1周和第6周采集药代动力学样本。
14例晚期难治性癌症患者接受了中位数为6(范围1 - 9)剂的ING-1治疗。在1mg/kg剂量时,一名62岁的结肠癌男性在第三次给药后出现可逆性3级胰腺炎。他的血浆ING-1水平与另外两名接受1mg/kg剂量的患者相似。两名接受0.6mg/kg剂量的患者在6周时病情稳定。药物峰值水平随剂量和时间增加,表明重复给药会导致药物蓄积。在13例接受评估的患者中,有3例出现低水平的人抗人抗体反应,且针对ING-1的可变区。
每周皮下注射ING-1,0.6mg/kg/周的耐受性良好,有必要在该剂量下进一步积累经验以证明安全性。胰腺炎风险和有限的抗肿瘤效果可能会排除进一步的单药治疗研究;然而,有必要开展与化疗的联合研究。