Kinders Robert J, Hollingshead Melinda, Khin Sonny, Rubinstein Larry, Tomaszewski Joseph E, Doroshow James H, Parchment Ralph E
Laboratory of Human Toxicology and Pharmacology, Applied/Developmental Research Support Directorate, Science Applications International Corporation-Frederick, Inc., National Cancer Institute-Frederick, Frederick, MD 21702, USA.
Clin Cancer Res. 2008 Nov 1;14(21):6877-85. doi: 10.1158/1078-0432.CCR-08-0214.
The National Cancer Institute has completed a first-in-human clinical pharmacodynamic trial of the targeted agent ABT-888, a poly (ADP-ribose) polymerase (PARP) inhibitor, under the auspices of the U.S. Food and Drug Administration's Exploratory Investigational New Drug Application. Performance of the study design, needle biopsy procedure, and validated pharmacodynamic assay were evaluated in human tumor xenograft models.
A validated ELISA was used to quantify PAR, a product of the PARP 1/2 enzyme activity. Sampling variability from tumor heterogeneity was determined by comparing PAR content in multiple tumors, and in different areas of the same tumor in a particular animal, collected under anesthesia by needle biopsy or resection before and after administration of nontoxic doses of ABT-888. The degree of PARP inhibition following single-dose treatment was evaluated in the time frame anticipated for biopsy in humans.
Sampling variability around the mean (approximately 50%) for untreated and vehicle-treated animals was random and due to specimen heterogeneity. PAR levels in initial and repeat tumor biopsies, separated by 1 week, were not altered by the stress induced by daily handling of the animals. A single ABT-888 dose (3 or 12.5 mg/kg) reduced intratumor PAR levels by >95%. ABT-888 (1.56-25 mg/kg) significantly decreased PAR levels at 2 h post-dosing.
The detailed methodologies developed for this study facilitated the design of a phase 0, first-in-human clinical trial of ABT-888 and could serve as a model for developing proof-of-principle clinical trials of molecularly targeted anticancer agents.
美国国立癌症研究所(National Cancer Institute)在美国食品药品监督管理局(U.S. Food and Drug Administration)的探索性研究新药申请(Exploratory Investigational New Drug Application)的支持下,完成了靶向药物ABT - 888(一种聚(ADP - 核糖)聚合酶(PARP)抑制剂)的首次人体临床药效学试验。在人肿瘤异种移植模型中评估了研究设计、针吸活检程序和经过验证的药效学检测方法的性能。
使用经过验证的酶联免疫吸附测定(ELISA)法对PAR(PARP 1/2酶活性的产物)进行定量。通过比较在给予无毒剂量的ABT - 888之前和之后,在麻醉状态下通过针吸活检或切除收集的同一动物体内多个肿瘤以及同一肿瘤不同区域的PAR含量,来确定肿瘤异质性导致的采样变异性。在预期的人体活检时间范围内评估单剂量治疗后PARP的抑制程度。
未治疗和给予赋形剂治疗的动物的平均水平(约50%)周围的采样变异性是随机的,并且是由样本异质性导致的。间隔1周进行的初次和重复肿瘤活检中的PAR水平不受动物每日处理所诱导的应激影响。单剂量的ABT - 888(3或12.5 mg/kg)可使肿瘤内PAR水平降低>95%。ABT - 888(1.56 - 25 mg/kg)在给药后2小时显著降低PAR水平。
为本研究开发详细的方法学有助于设计ABT - 888的0期首次人体临床试验,并可作为开展分子靶向抗癌药物原理验证性临床试验的模型。