Uronis Hope E, Jia Jingquan, Bendell Johanna C, Howard Leigh, Ready Neal A, Lee Paula H, Starr Mark D, Dellinger Andrew, Pang Herbert, Nixon Andrew B, Hurwitz Herbert I
Duke Cancer Institute, Duke University Medical Center, Box 3052, Durham, NC, USA.
Cancer Chemother Pharmacol. 2015 Feb;75(2):343-52. doi: 10.1007/s00280-014-2647-x. Epub 2014 Dec 20.
Inhibition of tumor angiogenesis is an effective mechanism to limit tumor growth; dual inhibition may result in additional benefit. Bevacizumab is a monoclonal antibody directed against vascular endothelial growth factor (VEGF), and intetumumab is a fully humanized monoclonal antibody that blocks αv integrins when complexed with β integrins. We evaluated the safety, tolerability, and efficacy of the combination of bevacizumab plus intetumumab in patients with refractory solid tumors. We also explored the effects of these agents on plasma-based biomarkers and wound angiogenesis.
Patients with refractory solid tumors, Karnofsky performance status ≥70%, and adequate organ function were eligible. Plasma samples and wound biopsies were obtained at baseline and on-treatment.
Twelve patients were enrolled and received study drug. No tumor responses were noted. Observed toxicities included three cases of transient uveitis likely related to intetumumab and one case of reversible posterior leukoencephalopathy syndrome likely related to bevacizumab. Biomarker analysis revealed changes in soluble endoglin, soluble E-cadherin, and soluble E-selectin as well as PlGF and VEGF-D while on treatment. There was no observed impact of bevacizumab plus intetumumab on the phosphorylated or total levels of paxillin in wound tissue; however, an increase in the ratio of phospho/total paxillin levels was noted.
Bevacizumab and intetumumab can be administered safely in combination. Bevacizumab plus intetumumab treatment resulted in changes in the plasma levels of several extracellular matrix interacting proteins and angiogenic factors.
抑制肿瘤血管生成是限制肿瘤生长的一种有效机制;双重抑制可能会带来额外益处。贝伐单抗是一种针对血管内皮生长因子(VEGF)的单克隆抗体,而英妥昔单抗是一种完全人源化的单克隆抗体,与β整合素结合时可阻断αv整合素。我们评估了贝伐单抗联合英妥昔单抗治疗难治性实体瘤患者的安全性、耐受性和疗效。我们还探讨了这些药物对基于血浆的生物标志物和伤口血管生成的影响。
难治性实体瘤患者,卡诺夫斯基体能状态≥70%,且器官功能良好者符合入选标准。在基线期和治疗期间采集血浆样本和伤口活检样本。
12名患者入组并接受了研究药物治疗。未观察到肿瘤反应。观察到的毒性包括3例可能与英妥昔单抗相关的短暂性葡萄膜炎和1例可能与贝伐单抗相关的可逆性后部白质脑病综合征。生物标志物分析显示,治疗期间可溶性内皮糖蛋白、可溶性E-钙黏蛋白、可溶性E-选择素以及胎盘生长因子(PlGF)和血管内皮生长因子-D(VEGF-D)发生了变化。未观察到贝伐单抗联合英妥昔单抗对伤口组织中桩蛋白的磷酸化水平或总水平有影响;然而,磷酸化/总桩蛋白水平的比值有所增加。
贝伐单抗和英妥昔单抗联合使用可安全给药。贝伐单抗联合英妥昔单抗治疗导致几种细胞外基质相互作用蛋白和血管生成因子的血浆水平发生变化。