University of Michigan Comprehensive Cancer Center, 1500 East Medical Center Drive, Room 7308, Ann Arbor, MI, 48109, USA.
Invest New Drugs. 2013 Jun;31(3):760-8. doi: 10.1007/s10637-012-9869-8. Epub 2012 Aug 21.
CC-chemokine ligand 2 (CCL2) promotes tumor growth by angiogenesis, macrophage infiltration and tumor invasion, and distant metastasis. Carlumab (CNTO 888) is a human IgG1κ mAb with high affinity and specificity for human CCL2. Preclinical data suggest carlumab may offer clinical benefit to cancer patients.
In a phase 2, open-label study, patients with metastatic castration-resistant prostate cancer (CRPC) previously treated with docetaxel received a 90-min infusion of 15 mg/kg carlumab q2w. The primary endpoint was response rate: change from baseline in skeletal lesions, extraskeletal lesions, and PSA values. Secondary endpoints included overall response rate (CR + PR) by RECIST, OS, PSA response, safety, pharmacodynamics, pharmacokinetics, immunogenicity.
Forty-six patients were treated with 6 median (range 1, 26) doses. One patient had SD >6 months. There were no PSA or RECIST responses. Fourteen (34 %) patients had SD ≥ 3 months. Median OS was 10.2 (95 % CI: 5.2, not estimable) months. Twelve (39 %) patients reported improved pain scores. AEs occurred in 43 (93 %) patients, including 27 (59 %) with grade ≥ 3 AEs. Common grade ≥ 3 AEs were back (11 %) and bone (9 %) pain. Twenty (43 %) patients experienced SAEs, including pneumonia, spinal cord compression, back pain. No patient developed antibodies to carlumab. Steady-state serum concentrations were achieved after 3 repeated doses and were above the 10-μg/mL target concentration. Suppression of free CCL2 serum concentrations was briefly observed following each dose but was not sustained.
Carlumab was well-tolerated but did not block the CCL2/CCR2 axis or show antitumor activity as a single agent in metastatic CRPC.
CC-趋化因子配体 2(CCL2)通过血管生成、巨噬细胞浸润和肿瘤侵袭以及远处转移促进肿瘤生长。Carlumab(CNTO 888)是一种人 IgG1κ mAb,对人 CCL2 具有高亲和力和特异性。临床前数据表明,Carlumab 可能为癌症患者带来临床获益。
在一项 2 期、开放性研究中,先前接受多西他赛治疗的转移性去势抵抗性前列腺癌(CRPC)患者接受 15mg/kg carlumab 每 2 周 90 分钟输注。主要终点是反应率:骨骼病变、骨骼外病变和 PSA 值的基线变化。次要终点包括根据 RECIST 的总反应率(CR + PR)、OS、PSA 反应、安全性、药效学、药代动力学和免疫原性。
46 例患者接受了 6 次中位数(范围 1,26)剂量的治疗。1 例患者的 SD >6 个月。无 PSA 或 RECIST 反应。14 例(34%)患者的 SD ≥3 个月。中位 OS 为 10.2(95%CI:5.2,无法估计)个月。12 例(39%)患者报告疼痛评分改善。43 例(93%)患者发生 AE,包括 27 例(59%)患者出现≥3 级 AE。常见的≥3 级 AE 为背部(11%)和骨骼(9%)疼痛。20 例(43%)患者发生 SAE,包括肺炎、脊髓压迫、背痛。无患者产生针对 carlumab 的抗体。在重复 3 次剂量后达到了稳态血清浓度,且高于 10μg/mL 的目标浓度。在每次给药后短暂观察到游离 CCL2 血清浓度的抑制,但未持续。
Carlumab 耐受良好,但作为单一药物在转移性 CRPC 中并未阻断 CCL2/CCR2 轴或显示抗肿瘤活性。