Yamamoto Noboru, Yamada Yasuhide, Fujiwara Yutaka, Yamada Kazuhiko, Fujisaka Yasuhito, Shimizu Toshio, Tamura Tomohide
National Cancer Center Hospital, Tokyo, Japan.
Jpn J Clin Oncol. 2009 Apr;39(4):260-6. doi: 10.1093/jjco/hyp006. Epub 2009 Mar 4.
rhuMAb 2C4 (pertuzumab, RO4368451), a human epidermal growth factor receptor-2 (HER2) targeted antibody that binds to an epitope distinct from trastuzumab, blocks ligand-associated heterodimerization of HER2 with other HER receptor family members. This study evaluated the toxicity, pharmacokinetics and anti-tumor activities of pertuzumab in Japanese patients with solid tumors.
Patients with solid tumors refractory to standard therapy were administered pertuzumab 5, 10, 15, 20 and 25 mg/kg intravenously once every 3 weeks. Grade 3 toxicities were considered as dose limiting. The maximum tolerated dose (MTD) was a dose at which two out of six patients had Grade 3 toxicities.
Eighteen patients, aged 38-66 (median 57) years, with solid tumors were enrolled and a total of 32 cycles of pertuzumab were administered. Toxicities were generally acceptable. Grade 3 elevation of gamma-glutamyl transpeptidase was observed in one patient at 25 mg/kg and was considered to be dose limiting. MTD was not reached up to a dose level of 25 mg/kg. The serum concentration of pertuzumab declined slowly (terminal half-life is approximately 3 weeks). The AUC proportionally increased over the dose range tested. There was limited evidence of activity (stable disease 2; progressive disease 13; and not evaluable 3); however, tumor shrinkage and tumor marker decrease were observed in an ovarian cancer and a non-small-cell lung cancer patient, respectively.
Pertuzumab is well tolerated up to 25 mg/kg. Although objective tumor response was not observed, it is worth evaluating as a flat dose and in combination with other cytotoxics and molecular-targeted agents.
重组人源化单克隆抗体2C4(帕妥珠单抗,RO4368451)是一种靶向人表皮生长因子受体2(HER2)的抗体,其结合的表位与曲妥珠单抗不同,可阻断HER2与其他HER受体家族成员的配体相关异二聚化。本研究评估了帕妥珠单抗在日本实体瘤患者中的毒性、药代动力学及抗肿瘤活性。
对标准治疗难治的实体瘤患者静脉注射帕妥珠单抗,剂量为5、10、15、20和25mg/kg,每3周1次。3级毒性被视为剂量限制毒性。最大耐受剂量(MTD)是指6名患者中有2名出现3级毒性的剂量。
入组18例年龄在38 - 66岁(中位年龄57岁)的实体瘤患者,共给予32个周期的帕妥珠单抗治疗。毒性一般可接受。1例接受25mg/kg剂量的患者出现3级γ-谷氨酰转肽酶升高,被认为是剂量限制毒性。在25mg/kg剂量水平未达到MTD。帕妥珠单抗血清浓度下降缓慢(终末半衰期约3周)。在测试的剂量范围内,曲线下面积(AUC)成比例增加。有有限的活性证据(病情稳定2例;疾病进展13例;不可评估3例);然而,分别在1例卵巢癌患者和1例非小细胞肺癌患者中观察到肿瘤缩小和肿瘤标志物下降。
帕妥珠单抗在高达25mg/kg剂量时耐受性良好。虽然未观察到客观肿瘤反应,但作为固定剂量以及与其他细胞毒性药物和分子靶向药物联合使用时值得评估。