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一项针对MEDI-575(一种血小板衍生生长因子受体α单克隆抗体)在晚期实体瘤成年患者中的I期剂量递增研究。

A phase I dose-escalation study of MEDI-575, a PDGFRα monoclonal antibody, in adults with advanced solid tumors.

作者信息

Becerra Carlos R, Conkling Paul, Vogelzang Nicholas, Wu Hilary, Hong Shengyan, Narwal Rajesh, Liang Meina, Tavakkoli Fatemeh, Pandya Naimish

机构信息

Sammons Cancer Center, Texas Oncology P.A., 3410 Worth St., Suite 300, Dallas, TX, 75246, USA,

出版信息

Cancer Chemother Pharmacol. 2014 Nov;74(5):917-25. doi: 10.1007/s00280-014-2567-9. Epub 2014 Aug 23.

Abstract

PURPOSE

The purpose of the study was to evaluate safety and determine the maximum tolerated dose (MTD) of MEDI-575, a fully human monoclonal antibody that selectively binds to platelet-derived growth factor receptor-α (PDGFRα), in patients with advanced solid tumors.

METHODS

This phase I multicenter, open-label, single-arm study enrolled adults in a 3 + 3 dose escalation design to receive MEDI-575 (3, 6, 9, 12, or 15 mg/kg) once weekly (QW) until toxicity or disease progression occurred. One 0.5-mg/kg dose was given before the first dose in the 3-mg/kg cohort to determine pharmacokinetics (PK) and pharmacodynamics under unsaturated conditions. After completion of dose escalation in the QW cohorts, patients were enrolled in two additional cohorts and received MEDI-575 25 or 35 mg/kg every 3 weeks (Q3W). Secondary measures included assessments of PK, immunogenicity, and antitumor activity.

RESULTS

A total of 35 patients received MEDI-575 QW (n = 23) or Q3W (n = 12). Most treatment-related adverse events were grade 1 or 2 in severity across all dose levels, with fatigue (n = 12) and nausea (n = 8) being reported most frequently. With no reports of dose-limiting toxicities (DLTs), the MTD was not reached. MEDI-575 exhibited a nonlinear PK profile and increased plasma platelet-derived growth factor-AA levels in a dose-dependent manner with limited immunogenicity. Stable disease was reported as the best tumor response in 9 of 29 evaluable patients; however, no objective responses were reported.

CONCLUSION

Administration of MEDI-575 QW or Q3W resulted in a favorable safety profile, including a lack of DLTs, but without evidence of antitumor activity in patients with refractory solid tumors.

摘要

目的

本研究旨在评估MEDI-575(一种选择性结合血小板衍生生长因子受体-α(PDGFRα)的全人单克隆抗体)在晚期实体瘤患者中的安全性,并确定其最大耐受剂量(MTD)。

方法

本I期多中心、开放标签、单臂研究采用3+3剂量递增设计,纳入成年患者,使其每周一次(QW)接受MEDI-575(3、6、9、12或15mg/kg)治疗,直至出现毒性反应或疾病进展。在3mg/kg剂量组的首剂之前给予一剂0.5mg/kg剂量,以确定非饱和条件下的药代动力学(PK)和药效学。QW剂量组完成剂量递增后,将患者纳入另外两个剂量组,每3周(Q3W)接受25或35mg/kg的MEDI-575治疗。次要指标包括PK、免疫原性和抗肿瘤活性评估。

结果

共有35例患者接受了QW(n=23)或Q3W(n=12)的MEDI-575治疗。在所有剂量水平上,大多数与治疗相关的不良事件严重程度为1级或2级,最常报告的是疲劳(n=12)和恶心(n=8)。由于未报告剂量限制毒性(DLT),未达到MTD。MEDI-575呈现非线性PK曲线,血浆血小板衍生生长因子-AA水平以剂量依赖性方式升高,免疫原性有限。在29例可评估患者中,9例报告疾病稳定为最佳肿瘤反应;然而,未报告客观缓解。

结论

QW或Q3W给药的MEDI-575安全性良好,包括无DLT,但难治性实体瘤患者未显示出抗肿瘤活性证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09bc/4209236/a24ba6789e14/280_2014_2567_Fig1_HTML.jpg

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