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难治性晚期实体瘤和多发性骨髓瘤中氟他胺单药或联合厄洛替尼的 I 期研究。

Phase I ficlatuzumab monotherapy or with erlotinib for refractory advanced solid tumours and multiple myeloma.

机构信息

Clinical Research, South Texas Accelerated Research Therapeutics (START), 4383 Medical Drive, San Antonio, TX 78229, USA.

Division of Hematology and Medical Oncology, Virginia G Piper Cancer Center, 10460 North 92nd Street, Suite 101, Scottsdale, AZ 85258, USA.

出版信息

Br J Cancer. 2014 Jul 15;111(2):272-80. doi: 10.1038/bjc.2014.290. Epub 2014 Jun 5.

Abstract

BACKGROUND

Ficlatuzumab, a humanised hepatocyte growth factor (HGF) IgG1κ inhibitory monoclonal antibody, was evaluated for recommended phase II dose (RP2D), safety, pharmacokinetics (PKs), antidrug antibody (ADA), pharmacodynamics (PDs) and antitumour activity as monotherapy or combined with erlotinib.

METHODS

Patients with solid tumours received ficlatuzumab 2, 5, 10 or 20 mg kg(-1) intravenously every 2 weeks (q2w). Additional patients were treated at the RP2D erlotinib.

RESULTS

Forty-one patients enrolled at doses ⩽20 mg kg(-1). Common adverse events (AEs) included peripheral oedema, fatigue and nausea. Three patients experienced grade ⩾3 treatment-related hyperkalaemia/hypokalaemia, diarrhoea or fatigue. Best overall response (44%) was stable disease (SD); median duration was 5.5 months (0.4-18.7 months). One patient has been on therapy with SD for >4 years. Pharmacokinetics of ficlatuzumab showed low clearance (0.17-0.26 ml h(-1) kg(-1)), a half-life of 6.8-9.4 days and dose-proportional exposure. Ficlatuzumab/erlotinib had no impact on the PK of either agent. No ADAs were detected. Ficlatuzumab increased serum HGF levels.

CONCLUSIONS

Recommended phase II dose is 20 mg kg(-1) q2w for ficlatuzumab monotherapy or with erlotinib. Preliminary antitumour activity and manageable AEs were observed. Pharmacokinetics were dose-proportional and consistent with other IgG therapeutics. Ficlatuzumab was not immunogenic, and serum HGF was a potential PD marker.

摘要

背景

Ficlatuzumab 是一种人源化肝细胞生长因子(HGF)IgG1κ 抑制性单克隆抗体,用于评估推荐的 II 期剂量(RP2D)、安全性、药代动力学(PKs)、抗药物抗体(ADA)、药效学(PDs)和作为单药或与厄洛替尼联合的抗肿瘤活性。

方法

患有实体瘤的患者接受 ficlatuzumab 2、5、10 或 20mg/kg 静脉内每 2 周(q2w)一次。其他患者接受 RP2D 厄洛替尼治疗。

结果

41 名患者在剂量 ⩽20mg/kg 时入组。常见不良事件(AE)包括外周水肿、疲劳和恶心。三名患者发生 ⩾3 级与治疗相关的高钾血症/低钾血症、腹泻或疲劳。最佳总体反应(44%)为疾病稳定(SD);中位持续时间为 5.5 个月(0.4-18.7 个月)。一名患者的 SD 治疗持续时间超过 4 年。ficlatuzumab 的药代动力学显示低清除率(0.17-0.26ml/h/kg)、半衰期为 6.8-9.4 天和剂量比例暴露。ficlatuzumab/厄洛替尼对两种药物的 PK 均无影响。未检测到 ADA。ficlatuzumab 增加了血清 HGF 水平。

结论

ficlatuzumab 单药或与厄洛替尼联合的推荐 II 期剂量为 20mg/kg,q2w。观察到初步的抗肿瘤活性和可管理的 AE。药代动力学呈剂量比例且与其他 IgG 治疗药物一致。ficlatuzumab 无免疫原性,血清 HGF 是潜在的 PD 标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9704/4102944/b2a4fbf71f16/bjc2014290f1.jpg

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