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一项在实体瘤患者中进行的人源化单克隆抗体 carlumab(CNTO 888)的首次人体、首次同类、I 期研究,该抗体针对 CC-趋化因子配体 2。

A first-in-human, first-in-class, phase I study of carlumab (CNTO 888), a human monoclonal antibody against CC-chemokine ligand 2 in patients with solid tumors.

机构信息

Drug Development Unit, Royal Marsden NHS Foundation Trust, The Institute of Cancer Research, Downs Road, Sutton, Surrey SM2 5PT, UK.

出版信息

Cancer Chemother Pharmacol. 2013 Apr;71(4):1041-50. doi: 10.1007/s00280-013-2099-8. Epub 2013 Feb 6.

Abstract

PURPOSE

The CC-chemokine ligand 2 (CCL2) is highly expressed in various malignancies and promotes carcinogenesis. Blocking CCL2 has preclinical antitumor activity. A phase 1 trial of carlumab (CNTO 888), a human anti-CCL2 IgG1κ mAb, was conducted to evaluate the safety, tolerability, pharmacokinetic-pharmacodynamic profile, and antitumor activity.

METHODS

Patients with advanced solid malignancy received escalating doses of carlumab 0.3, 1, 3, 10, or 15 mg/kg by 90-min intravenous infusion on days 1, 28, and every 2 weeks thereafter (dose escalation) or 10 or 15 mg/kg every 2 weeks (dose-expansion). Pharmacodynamic assessments were also performed.

RESULTS

Forty-four patients received 206 doses of carlumab. MTD was not established. Carlumab-related adverse events included grade 1-2 fatigue (9 %), nausea (7 %), headache (7 %), vomiting (5 %), and pruritus (5 %). The recommended phase II dose was 15 mg/kg every 2 weeks. Carlumab concentrations declined bi-exponentially with a terminal half-life of 6.6-9.6 days. Free CCL2 was transiently suppressed, while total CCL2 increased dose-dependently >1,000-fold post-treatment. A patient with ovarian cancer and a patient with prostate cancer achieved CA125 and PSA reductions of >50 % and RECIST SD for 10.5 and 5 months, respectively. Two other patients had RECIST SD for 7.2 and 15.7 months.

CONCLUSIONS

Carlumab was well tolerated with evidence of transient free CCL2 suppression and preliminary antitumor activity.

摘要

目的

趋化因子配体 2(CCL2)在各种恶性肿瘤中高度表达,并促进肿瘤发生。阻断 CCL2 具有临床前抗肿瘤活性。进行了一项 carlumab(CNTO 888)的 1 期试验,carumalab 是一种人抗 CCL2 IgG1κ mAb,旨在评估安全性、耐受性、药代动力学-药效学特征和抗肿瘤活性。

方法

患有晚期实体恶性肿瘤的患者接受 carlumab 0.3、1、3、10 或 15 mg/kg 的递增剂量,通过 90 分钟静脉输注,在第 1 天、第 28 天和此后每 2 周一次(剂量递增)或每 2 周 10 或 15 mg/kg(剂量扩展)。还进行了药效学评估。

结果

44 名患者接受了 206 剂 carlumab。未确定 MTD。与 carlumab 相关的不良事件包括 1-2 级疲劳(9%)、恶心(7%)、头痛(7%)、呕吐(5%)和瘙痒(5%)。推荐的 2 期剂量为每 2 周 15 mg/kg。Carlumab 浓度呈双指数下降,终末半衰期为 6.6-9.6 天。游离 CCL2 短暂抑制,而总 CCL2 增加>1000 倍。一名卵巢癌患者和一名前列腺癌患者的 CA125 和 PSA 减少>50%,RECIST 稳定持续 10.5 和 5 个月,另两名患者的 RECIST 稳定持续 7.2 和 15.7 个月。

结论

Carlumab 耐受性良好,有短暂游离 CCL2 抑制和初步抗肿瘤活性的证据。

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