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埃罗妥珠单抗对多发性骨髓瘤患者QT间期及心脏安全性的影响。

Effects of elotuzumab on QT interval and cardiac safety in patients with multiple myeloma.

作者信息

Passey Chaitali, Darbenzio Raymond, Jou Ying-Ming, Lynch Mark, Gupta Manish

机构信息

Bristol-Myers Squibb, Route 206 & Province Line Road, Princeton, NJ, 08543, USA.

出版信息

Cancer Chemother Pharmacol. 2016 Dec;78(6):1237-1244. doi: 10.1007/s00280-016-3182-8. Epub 2016 Oct 28.

DOI:10.1007/s00280-016-3182-8
PMID:27796540
Abstract

PURPOSE

To assess the effect of elotuzumab on corrected QT (QTc) intervals and cardiac safety.

METHODS

Patients with high-risk smoldering multiple myeloma who had been treated with elotuzumab monotherapy (10 or 20 mg/kg) in Study CA204011 (NCT01441973) underwent electrocardiogram (ECG) examination over 8-10 weeks (treatment cycles 1-3). ECG intervals and changes relative to baseline were assessed. The key ECG endpoint was change from baseline in QT interval corrected with Fridericia's method (ΔQTcF). The relationship between elotuzumab concentration and ΔQTcF was assessed using time-matched ΔQTcF data and linear regression. Adverse events (AEs) potentially related to abnormal ECG findings were summarized.

RESULTS

There was no trend of change from baseline in QTcF, PR and QRS intervals among all 31 evaluable patients from Study CA204011, and no patient assessed had a QTcF interval >480 ms or a ΔQTcF >60 ms. Concentration-response modeling indicated that there was no significant relationship between ΔQTcF and elotuzumab serum concentration: Upper limits of 90% confidence intervals for mean change in QTcF were <10 ms over the range of observed elotuzumab concentrations. No ECG-assessed patient had an AE associated with abnormal ECG findings potentially related to proarrhythmia.

CONCLUSIONS

Study CA204011 ECG data indicate that elotuzumab treatment was not associated with QT/QTc prolongation. Concentration-response modeling demonstrated that baseline-adjusted QTcF changes did not cross thresholds for clinical or regulatory concern.

摘要

目的

评估埃罗妥珠单抗对校正QT(QTc)间期及心脏安全性的影响。

方法

在研究CA204011(NCT01441973)中接受埃罗妥珠单抗单药治疗(10或20mg/kg)的高危冒烟型多发性骨髓瘤患者,在8 - 10周(治疗周期1 - 3)内接受心电图(ECG)检查。评估ECG间期及相对于基线的变化。关键的ECG终点是采用弗里德里西亚方法校正的QT间期相对于基线的变化(ΔQTcF)。使用时间匹配的ΔQTcF数据和线性回归评估埃罗妥珠单抗浓度与ΔQTcF之间的关系。总结了可能与异常ECG结果相关的不良事件(AE)。

结果

研究CA204011的所有31例可评估患者的QTcF、PR及QRS间期均无相对于基线的变化趋势,且没有评估患者的QTcF间期>480ms或ΔQTcF>60ms。浓度 - 反应模型表明,ΔQTcF与埃罗妥珠单抗血清浓度之间无显著关系:在观察到的埃罗妥珠单抗浓度范围内,QTcF平均变化的90%置信区间上限<10ms。没有接受ECG评估的患者出现与可能与心律失常相关的异常ECG结果相关的AE。

结论

研究CA204011的ECG数据表明,埃罗妥珠单抗治疗与QT/QTc延长无关。浓度 - 反应模型表明,经基线调整的QTcF变化未超过临床或监管关注的阈值。

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