Caulfield M J, Barna B, Murthy S, Tubbs R, Sergi J, Medendorp S, Bukowski R M
Section of Immunology, Cleveland Clinic Foundation, Ohio 44195.
J Biol Response Mod. 1990 Jun;9(3):319-28.
A phase Ia-Ib study was undertaken to treat melanoma patients with a constant dose of the anti-GD3 monoclonal antibody, R24, in combination with increasing dose levels of recombinant interferon-alpha (rHuIFN alpha-2a). Fifteen patients were treated on days 1-5 and 8-12 with a continuous 6-h i.v. infusion of R24 (8 mg/m2) and escalating i.m. doses of rHuIFN alpha-2a. Peripheral blood lymphocytes were obtained at multiple times before and during treatment and monitored for changes in lymphocyte subpopulations and changes in natural killer and antibody-dependent cellular toxicity functional activity. There were no consistent changes in most immune parameters; however, there was a decrease from pretreatment levels in the suppressor T cell (CD8+, CD11b+) subset and a dose-dependent decrease in the helper/inducer (CD4+, Leu-8+) T cell subset. The peak serum concentration of R24 was reached on day 5 of the study and was 9.4 micrograms/ml. During the second week of treatment, peak serum levels of R24 fell to less than 4 micrograms/ml. This finding was related to the development of human antimouse antibody, which would be detected as early as day 8 of the study. Binding of mouse Ig (R24) within the tumor bed was observed in 5 of 12 biopsy specimens. The maximal tolerated dose of the combination was dose level IV, in which patients received 8 mg/m2 of R24 and 50 x 10(6) units of rHuIFN alpha-2a on days 1-5 and 8-12 of treatment.
开展了一项Ia-Ib期研究,用恒定剂量的抗GD3单克隆抗体R24联合递增剂量水平的重组干扰素-α(rHuIFNα-2a)治疗黑色素瘤患者。15名患者在第1 - 5天和第8 - 12天接受治疗,持续6小时静脉输注R24(8mg/m²),并递增肌肉注射rHuIFNα-2a的剂量。在治疗前和治疗期间多次采集外周血淋巴细胞,监测淋巴细胞亚群的变化以及自然杀伤细胞和抗体依赖性细胞毒性功能活性的变化。大多数免疫参数没有一致的变化;然而,抑制性T细胞(CD8 + 、CD11b + )亚群较治疗前水平有所下降,辅助/诱导性(CD4 + 、Leu-8 + )T细胞亚群呈剂量依赖性下降。R24的血清峰值浓度在研究的第5天达到,为9.4μg/ml。在治疗的第二周,R24的血清峰值水平降至低于4μg/ml。这一发现与人类抗鼠抗体的产生有关,早在研究的第8天就能检测到。在12份活检标本中的5份中观察到肿瘤床内小鼠Ig(R24)的结合。该联合用药的最大耐受剂量为IV剂量水平,在此剂量下患者在治疗的第1 - 5天和第8 - 12天接受8mg/m²的R24和50×10⁶单位的rHuIFNα-2a。