van den Bent Martin, Gan Hui K, Lassman Andrew B, Kumthekar Priya, Merrell Ryan, Butowski Nicholas, Lwin Zarnie, Mikkelsen Tom, Nabors Louis B, Papadopoulos Kyriakos P, Penas-Prado Marta, Simes John, Wheeler Helen, Walbert Tobias, Scott Andrew M, Gomez Erica, Lee Ho-Jin, Roberts-Rapp Lisa, Xiong Hao, Bain Earle, Ansell Peter J, Holen Kyle D, Maag David, Reardon David A
Brain Tumor Center, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075 EA, Rotterdam, the Netherlands.
School of Cancer Medicine, La Trobe University, Melbourne, VIC, Australia.
Cancer Chemother Pharmacol. 2017 Dec;80(6):1209-1217. doi: 10.1007/s00280-017-3451-1. Epub 2017 Oct 26.
Patients with recurrent glioblastoma (rGBM) have a poor prognosis. Epidermal growth factor receptor (EGFR) gene amplification is present in ~ 50% of glioblastomas (GBMs). Depatuxizumab mafodotin (depatux-m), formerly ABT-414, is an antibody-drug conjugate that preferentially binds cells with EGFR amplification, is internalized and releases a potent antimicrotubule agent, monomethyl auristatin F (MMAF). Here we report the safety, pharmacokinetics, and efficacy of depatux-m monotherapy at the recommended Phase 2 dose (RPTD) in patients with EGFR-amplified, rGBM.
M12-356 (NCT01800695) is an open-label study with three escalation and expansion cohorts. Sixty-six patients with EGFR-amplified, rGBM were treated with depatux-m monotherapy at 1.25 mg/kg intravenously every 2 weeks. Adults with measurable rGBM, who were bevacizumab-naïve, with EGFR amplification were eligible.
Among 66 patients, median age was 58 years (range 35-80). All patients were previously treated with radiotherapy/temozolomide. The most common adverse events (AEs) were eye related (91%), including blurred vision (65%), dry eye (29%), keratitis, and photophobia (27% each). Grade 3/4 AEs occurred in 42% of all patients, and ocular Grade 3/4 AEs occurred in 33% of patients overall. One patient (2%) had a Grade 4 ocular AE. Ocular AEs were manageable and usually resolved once treatment with depatux-m ceased. The objective response rate was 6.8%, the 6-month progression-free survival rate was 28.8%, and the 6-month overall survival rate was 72.5%.
Depatux-m monotherapy displayed frequent but mostly Grade 1/2 ocular toxicities. A PFS6 of 28.8% was observed in this rGBM population, warranting further study.
复发性胶质母细胞瘤(rGBM)患者预后较差。约50%的胶质母细胞瘤(GBM)存在表皮生长因子受体(EGFR)基因扩增。地帕妥昔单抗马福多汀(depatux-m,原称ABT-414)是一种抗体药物偶联物,优先结合EGFR扩增的细胞,被内化并释放一种强效抗微管药物单甲基澳瑞他汀F(MMAF)。在此,我们报告地帕妥昔单抗单药治疗在推荐的2期剂量(RPTD)下对EGFR扩增的rGBM患者的安全性、药代动力学和疗效。
Ml2-356(NCT01800695)是一项开放标签研究,包括三个剂量递增和扩展队列。66例EGFR扩增的rGBM患者接受地帕妥昔单抗单药治疗,静脉注射剂量为1.25mg/kg,每2周一次。符合条件的患者为年龄≥18岁、EGFR扩增、可测量的rGBM、未接受过贝伐单抗治疗的成年人。
66例患者中,中位年龄为58岁(范围35-80岁)。所有患者既往均接受过放疗/替莫唑胺治疗。最常见的不良事件(AE)与眼睛有关(91%),包括视力模糊(65%)、干眼(29%)、角膜炎和畏光(各27%)。3/4级AE发生在42%的患者中,眼部3/4级AE总体发生在33%的患者中。1例患者(2%)发生4级眼部AE。眼部AE可控制,通常在停止地帕妥昔单抗治疗后缓解。客观缓解率为6.8%,6个月无进展生存率为28.8%,6个月总生存率为72.5%。
地帕妥昔单抗单药治疗显示出频繁但大多为1/2级的眼部毒性。在该rGBM人群中观察到无进展生存期6个月(PFS6)为28.8%,值得进一步研究。