Memorial Sloan Kettering Cancer Center, New York, New York.
Indiana University Simon Cancer Center, Indianapolis, Indiana.
Clin Cancer Res. 2017 Apr 15;23(8):1929-1936. doi: 10.1158/1078-0432.CCR-16-1272. Epub 2016 Oct 18.
Urelumab is an agonist antibody to CD137 with potential application as an immuno-oncology therapeutic. Data were analyzed to assess safety, tolerability, and pharmacodynamic activity of urelumab, including the dose selected for ongoing development in patients with advanced solid tumors and lymphoma. A total of 346 patients with advanced cancers who had progressed after standard treatment received at least one dose of urelumab in one of three dose-escalation, monotherapy studies. Urelumab was administered at doses ranging from 0.1 to 15 mg/kg. Safety analyses included treatment-related and serious adverse events (AEs), as well as treatment-related AEs leading to discontinuation and death, with a focus on liver function test abnormalities and hepatic AEs. Urelumab doses between 1 and 15 mg/kg given every 3 weeks resulted in a higher frequency of treatment-related AEs than 0.1 or 0.3 mg/kg every 3 weeks. Dose was the single most important factor contributing to transaminitis development, which was more frequent and severe at doses ≥1 mg/kg. At the MTD of 0.1 mg/kg every 3 weeks, urelumab was relatively well tolerated, with fatigue (16%) and nausea (13%) being the most common treatment-related AEs, and was associated with immunologic and pharmacodynamic activity demonstrated by the induction of IFN-inducible genes and cytokines. Integrated evaluation of urelumab safety data showed significant transaminitis was strongly associated with doses of ≥1 mg/kg. However, urelumab 0.1 mg/kg every 3 weeks was demonstrated to be safe, with pharmacodynamic activity supporting continued clinical evaluation of this dose as monotherapy and in combination with other immuno-oncology agents. .
乌瑞鲁单抗是一种 CD137 激动型抗体,具有作为免疫肿瘤学治疗药物的应用潜力。对乌瑞鲁单抗的安全性、耐受性和药效学活性进行了数据分析,包括在晚期实体瘤和淋巴瘤患者中进行开发的选定剂量。共有 346 名接受过标准治疗后进展的晚期癌症患者在三项剂量递增单药研究中的一项中接受了至少一剂乌瑞鲁单抗。乌瑞鲁单抗的剂量范围为 0.1 至 15mg/kg。安全性分析包括与治疗相关的不良事件(AE)和严重不良事件(SAE),以及导致停药和死亡的与治疗相关的 AE,重点关注肝功能试验异常和肝脏 AE。与每 3 周 0.1 或 0.3mg/kg 相比,每 3 周 1 至 15mg/kg 的乌瑞鲁单抗剂量导致治疗相关 AE 的频率更高。剂量是导致转氨异常发展的唯一最重要因素,在≥1mg/kg 剂量时更频繁且更严重。在每 3 周 0.1mg/kg 的 MTD 时,乌瑞鲁单抗具有相对良好的耐受性,最常见的与治疗相关的 AE 是疲劳(16%)和恶心(13%),并与免疫和药效学活性相关,表现为 IFN 诱导基因和细胞因子的诱导。乌瑞鲁单抗安全性数据的综合评估表明,明显的转氨异常与≥1mg/kg 的剂量显著相关。然而,每 3 周 0.1mg/kg 的乌瑞鲁单抗被证明是安全的,药效学活性支持继续评估该剂量作为单药以及与其他免疫肿瘤学药物联合使用。
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