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14.18 抗体在复发性或难治性 4 期神经母细胞瘤患者中的 CHO 细胞中产生:SIOPEN 1 期研究。

Ch14.18 antibody produced in CHO cells in relapsed or refractory Stage 4 neuroblastoma patients: a SIOPEN Phase 1 study.

机构信息

Children's Cancer Research Institute and St. Anna Children's Hospital and Department of Paediatric and Adolescent Medicine; Medical University; Vienna, Austria.

出版信息

MAbs. 2013 Sep-Oct;5(5):801-9. doi: 10.4161/mabs.25215. Epub 2013 May 31.

Abstract

PURPOSE

This study aimed to assess the safety, pharmacokinetic and activity profiles of the human-mouse chimeric monoclonal anti-disialoganglioside GD2 antibody ch14.18 produced in Chinese hamster ovary (CHO) cells (ch14.18/CHO).

METHODS

Sixteen children with recurrent/refractory neuroblastoma (median age 7.6 y) were enrolled in this Phase 1 dose-finding study. Patients received ch14.18/CHO courses of 10, 20 or 30 mg/m (2)/day as an eight-hour infusion over five consecutive days. Three courses at the same dose level were allowed unless disease progressed. Clearance and biodistribution of radiolabelled ch14.18/CHO in Balb/c and A/J mice were analyzed.

RESULTS

A total of 41 ch14.18/CHO courses were given (10 × 3 courses, 5 × 2 courses, 1 × 1 course). Side effects were similar in expectedness, frequency and magnitude to those reported for ch14.18/SP2/0. The dose level of 20 mg/m(2)/day was confirmed. Toxicity was reversible and no treatment-related deaths occurred. In children, the peak plasma concentration was 16.51 µg/ml ± 5.9 µg/ml and the half-life was 76.91 h ± 52.5 h. A partial response following ch14.18/CHO was observed in 2/7 patients with residual disease. In mice, the half-lives were 22.7 h ± 1.9h for ch14.18/CHO and 25.0 h ± 1.9 h for ch14.18/SP2/0. The biodistribution of (125)I-ch14.18/CHO in mice with neuroblastoma was identical to (125)I-ch14.18/SP2/0, indicating GD 2 targeting activity in vivo. Ch14.18 produced in CHO cells showed an unchanged toxicity profile and pharmacokinetics in neuroblastoma patients compared with ch14.18 produced in SP2/0 cells, and evidence of clinical activity was observed. In mice, analysis of pharmacokinetics and biodistribution showed comparable results between ch14.18/CHO and ch14.18/SP2/0. Based on these results, ch14.18/CHO was accepted for prospective clinical evaluation.

摘要

目的

本研究旨在评估在仓鼠卵巢(CHO)细胞中产生的人鼠嵌合单克隆抗二唾液酸神经节苷脂 GD2 抗体 ch14.18(ch14.18/CHO)的安全性、药代动力学和活性特征。

方法

16 名患有复发性/难治性神经母细胞瘤的儿童(中位年龄 7.6 岁)入组了这项 1 期剂量发现研究。患者接受了 ch14.18/CHO 治疗,剂量为 10、20 或 30mg/m2(2)/天,连续 5 天每天输注 8 小时。如果疾病进展,则允许进行 3 个相同剂量水平的疗程。分析放射性标记的 ch14.18/CHO 在 Balb/c 和 A/J 小鼠中的清除率和生物分布。

结果

共给予了 41 个 ch14.18/CHO 疗程(10×3 个疗程、5×2 个疗程、1×1 个疗程)。副作用的出现频率、严重程度与 ch14.18/SP2/0 报道的相似。20mg/m2(2)/天的剂量水平得到确认。毒性是可逆的,没有发生与治疗相关的死亡。在儿童中,峰值血浆浓度为 16.51μg/ml±5.9μg/ml,半衰期为 76.91h±52.5h。在有残留疾病的 2/7 名患者中观察到 ch14.18/CHO 后的部分缓解。在小鼠中,ch14.18/CHO 的半衰期为 22.7h±1.9h,ch14.18/SP2/0 的半衰期为 25.0h±1.9h。在神经母细胞瘤小鼠中,(125)I-ch14.18/CHO 的生物分布与(125)I-ch14.18/SP2/0 相同,表明体内存在 GD2 靶向活性。与 ch14.18 在 SP2/0 细胞中产生的情况相比,在神经母细胞瘤患者中,在 CHO 细胞中产生的 ch14.18 表现出相同的毒性特征和药代动力学,并且观察到了临床活性的证据。在小鼠中,对药代动力学和生物分布的分析表明,ch14.18/CHO 与 ch14.18/SP2/0 之间的结果具有可比性。基于这些结果,ch14.18/CHO 被接受进行前瞻性临床评估。

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