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人鼠嵌合抗CD22单克隆抗体在中国CD22阳性非霍奇金淋巴瘤患者中的药代动力学及耐受性

Pharmacokinetics and tolerability of human mouse chimeric anti-CD22 monoclonal antibody in Chinese patients with CD22-positive non-Hodgkin lymphoma.

作者信息

Li Su, Zhang Dongsheng, Sun Jian, Li Zhinming, Deng Liting, Zou Benyan, Zhan Jing, Jiang Wenqi

机构信息

State Key Laboratory of Oncology in Southern China; Sun Yat-Sen University; Guangzhou, Guangdong, China; Department of Clinical Trial Center; Cancer Center; Sun Yat-sen University; Guangzhou, Guangdong, China.

State Key Laboratory of Oncology in Southern China; Sun Yat-Sen University; Guangzhou, Guangdong, China; Department of Medical Oncology; Cancer Center; Sun Yat-Sen University; Guangzhou, Guangdong, China.

出版信息

MAbs. 2012 Mar-Apr;4(2):256-66. doi: 10.4161/mabs.4.2.19136. Epub 2012 Mar 1.

Abstract

The safety and pharmacokinetics assessment of antibodies targeting CD22 (e.g., epratuzumab) have been established in western Caucasian populations, but there are no reports of the effects in Chinese populations. This dose-escalation study examines the safety, pharmacokinetics and biologic effects of multiple doses of anti-CD22 human-murine chimeric monoclonal antibody SM03 in 21 Chinese patients with CD22-positive non-Hodgkin lymphoma. Most of drug-related adverse events (AEs) were mild and reversible. Two patients experienced serious AEs (hemorrhage); one patient had grade 4 neutropenia; one patient had asymptomatic grade III prolongation of activated partial thromboplastin time (APTT). Major AEs included fever (71%), prolongation of APTT (42.8%), leukocytopenia (44.4%), alanine transaminase elevation (28.6%), elevated serum creatinine (23.8%) and injection site skin redness (14.3%). Circulating B cells transiently decreased without significant effects on T cells or immunoglobulin levels. Pharmacokinetic data revealed that mean maximum observed SM03 concentration and mean AUC from time zero to infinity increased in a dose-dependent manner up to 360 mg/m (2) SM03. Mean clearance was similar at doses ≤ 360 mg/m (2) and decreased significantly at dose 480 mg/m (2), supporting saturation of B-cell binding at 360 mg/m (2). Across all dose levels and histologies, one patient achieved partial response at 480 mg/m (2) dose; 14 patients had stable disease as best response and four patients progressed. Overall, SM03 was tolerated at doses ranging from 60-480 mg/m (2) and had potential efficacy in Chinese patients with follicular lymphoma.

摘要

针对CD22的抗体(如依帕珠单抗)的安全性和药代动力学评估已在西方白种人群中得到确立,但尚无关于其在中国人群中作用的报道。这项剂量递增研究考察了多剂量抗CD22人鼠嵌合单克隆抗体SM03对21例CD22阳性非霍奇金淋巴瘤中国患者的安全性、药代动力学及生物学效应。大多数与药物相关的不良事件(AE)为轻度且可逆。两名患者出现严重AE(出血);一名患者出现4级中性粒细胞减少;一名患者出现无症状的活化部分凝血活酶时间(APTT)III级延长。主要AE包括发热(71%)、APTT延长(42.8%)、白细胞减少(44.4%)、丙氨酸转氨酶升高(28.6%)、血清肌酐升高(23.8%)及注射部位皮肤发红(14.3%)。循环B细胞短暂减少,对T细胞或免疫球蛋白水平无显著影响。药代动力学数据显示,直至360mg/m² SM03,平均最大观察到的SM03浓度及从零至无穷大的平均药时曲线下面积(AUC)呈剂量依赖性增加。剂量≤360mg/m²时平均清除率相似,在480mg/m²剂量时显著降低,支持在360mg/m²时B细胞结合饱和。在所有剂量水平和组织学类型中,一名患者在480mg/m²剂量时达到部分缓解;14例患者最佳反应为病情稳定,4例患者病情进展。总体而言,SM03在60 - 480mg/m²剂量范围内耐受性良好,对中国滤泡性淋巴瘤患者具有潜在疗效。

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