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帕尼单抗在日本晚期实体瘤患者中的安全性和药代动力学。

Safety and pharmacokinetics of panitumumab in Japanese patients with advanced solid tumors.

作者信息

Doi Toshihiko, Ohtsu Atsushi, Tahara Makoto, Tamura Tomohide, Shirao Kuniaki, Yamada Yasuhide, Otani Satoru, Yang Bing-Bing, Ohkura Masayuki, Ohtsu Tomoko

机构信息

Gastrointestinal/Oncology Division, National Cancer Center Hospital East, 6-5-1 Kashiwanoha Kashiwa, Chiba, Japan.

出版信息

Int J Clin Oncol. 2009 Aug;14(4):307-14. doi: 10.1007/s10147-008-0855-2. Epub 2009 Aug 25.

Abstract

BACKGROUND

Panitumumab is a fully human, monoclonal antibody against the epidermal growth factor receptor. Previous studies in non-Japanese patients with solid tumors showed that panitumumab exhibited nonlinear pharmacokinetics, was well tolerated (skin toxicities were the most common treatment-related adverse events), and had antitumor activity in some patients. This open-label, phase 1 study investigated panitumumab safety and pharmacokinetics in Japanese patients.

METHODS

Japanese patients with advanced solid tumors were enrolled into one of three sequential panitumumab dose cohorts (cohort 1, 2.5 mg/kg weekly; cohort 2, 6.0 mg/kg every 2 weeks; and cohort 3, 9.0 mg/kg every 3 weeks) and received panitumumab until disease progression or drug intolerability. Safety endpoints included the incidence of adverse events, changes in laboratory values, and the appearance of anti-panitumumab antibodies. Serial pharmacokinetic samples were collected after the first and third doses of panitumumab. Tumors were assessed at week 8 and every 8 weeks thereafter.

RESULTS

Eighteen patients (6 per cohort) were enrolled. No dose-limiting toxicities, investigator-reported infusion reactions, or deaths occurred. Seven patients had grade-3/4 adverse events; fatigue and anorexia were most common. The most common skin toxicities were rash and acneiform dermatitis. No neutralizing anti-panitumumab antibodies were detected. Panitumumab exhibited nonlinear pharmacokinetics, and antitumor activity was observed in 31% (4/13) of the patients with colorectal cancer.

CONCLUSION

In Japanese patients with solid tumors, panitumumab was well tolerated, demonstrated pharmacokinetic and safety profiles similar to those observed previously in non-Japanese patients, and exhibited encouraging antitumor activity in patients with colorectal cancer.

摘要

背景

帕尼单抗是一种完全人源化的抗表皮生长因子受体单克隆抗体。先前针对非日本实体瘤患者的研究表明,帕尼单抗呈现非线性药代动力学,耐受性良好(皮肤毒性是最常见的治疗相关不良事件),且在部分患者中具有抗肿瘤活性。这项开放标签的1期研究调查了帕尼单抗在日本患者中的安全性和药代动力学。

方法

患有晚期实体瘤的日本患者被纳入三个连续的帕尼单抗剂量组之一(组1,每周2.5mg/kg;组2,每2周6.0mg/kg;组3,每3周9.0mg/kg),并接受帕尼单抗治疗,直至疾病进展或出现药物不耐受。安全性终点包括不良事件的发生率、实验室检查值的变化以及抗帕尼单抗抗体的出现情况。在首次和第三次注射帕尼单抗后采集系列药代动力学样本。在第8周及此后每8周对肿瘤进行评估。

结果

共纳入18例患者(每组6例)。未发生剂量限制性毒性、研究者报告的输液反应或死亡。7例患者出现3/4级不良事件;疲劳和厌食最为常见。最常见的皮肤毒性为皮疹和痤疮样皮炎。未检测到中和性抗帕尼单抗抗体。帕尼单抗呈现非线性药代动力学,在31%(4/13)的结直肠癌患者中观察到抗肿瘤活性。

结论

在患有实体瘤的日本患者中,帕尼单抗耐受性良好,其药代动力学和安全性特征与先前在非日本患者中观察到的相似,并且在结直肠癌患者中展现出令人鼓舞的抗肿瘤活性。

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