Department of Clinical Pharmacology, Division of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
Pharma Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany.
Clin Cancer Res. 2017 Sep 15;23(18):5406-5415. doi: 10.1158/1078-0432.CCR-17-0812. Epub 2017 Jun 9.
This study investigated the safety, clinical activity, and target-associated biomarkers of lumretuzumab, a humanized, glycoengineered, anti-HER3 monoclonal antibody (mAb), in combination with the EGFR-blocking agents erlotinib or cetuximab in patients with advanced HER3-positive carcinomas. The study included two parts: dose escalation and dose extension phases with lumretuzumab in combination with either cetuximab or erlotinib, respectively. In both parts, patients received lumretuzumab doses from 400 to 2,000 mg plus cetuximab or erlotinib according to standard posology, respectively. The effect of mRNA and mRNA and protein expression were investigated in a dedicated extension cohort of squamous non-small cell lung cancer (sqNSCLC) patients treated with lumretuzumab and erlotinib. Altogether, 120 patients were treated. One dose-limiting toxicity (DLT) in the cetuximab part and two DLTs in the erlotinib part were reported. The most frequent adverse events were gastrointestinal and skin toxicities, which were manageable. The objective response rate (ORR) was 6.1% in the cetuximab part and 4.2% in the erlotinib part. In the sqNSCLC extension cohort of the erlotinib part, higher tumor and mRNA levels were associated with a numerically higher disease control rate but not ORR. The toxicity profile of lumretuzumab in combination with cetuximab and erlotinib was manageable, but only modest clinical activity was observed across tumor types. In the sqNSCLC cohort, there was no evidence of meaningful clinical benefit despite enriching for tumors with higher mRNA expression levels. .
这项研究旨在探究人源化、糖基工程化抗 HER3 单克隆抗体(mAb)lumretuzumab 与 EGFR 阻断剂厄洛替尼或西妥昔单抗联合用于治疗晚期 HER3 阳性癌患者的安全性、临床疗效和与靶点相关的生物标志物。该研究包括两部分:分别联合西妥昔单抗或厄洛替尼进行 lumretuzumab 的剂量递增和剂量扩展阶段。在这两部分中,患者分别按照标准方案接受 lumretuzumab 400 至 2000mg 剂量联合西妥昔单抗或厄洛替尼治疗。对接受 lumretuzumab 和厄洛替尼治疗的鳞癌非小细胞肺癌(sqNSCLC)患者的专门扩展队列进行了 mRNA 和 mRNA 表达及蛋白表达的效果研究。共有 120 名患者接受了治疗。在西妥昔单抗部分观察到 1 例剂量限制性毒性(DLT),在厄洛替尼部分观察到 2 例 DLT。最常见的不良反应是胃肠道和皮肤毒性,这些毒性是可管理的。西妥昔单抗部分的客观缓解率(ORR)为 6.1%,厄洛替尼部分的 ORR 为 4.2%。在厄洛替尼部分的 sqNSCLC 扩展队列中,较高的肿瘤 和 mRNA 水平与疾病控制率的数值升高相关,但与 ORR 无关。lumretuzumab 联合西妥昔单抗和厄洛替尼的毒性谱是可管理的,但在不同肿瘤类型中仅观察到适度的临床疗效。在 sqNSCLC 队列中,尽管对高 mRNA 表达水平的肿瘤进行了富集,但没有证据表明有明显的临床获益。