John H. Strickler, Duke University Medical Center, Durham, NC; Colin D. Weekes, University of Colorado, Aurora, CO; John Nemunaitis, Mary Crowley Cancer Research Center, Dallas, TX; Ramesh K. Ramanathan, Virginia Piper Cancer Center at Honor Health/Translational Genomics Research Institute, Scottsdale, AZ; Rebecca S. Heist, Massachusetts General Hospital Cancer Center, Boston, MA; Daniel Morgensztern, Washington University School of Medicine, St. Louis, MO; Eric Angevin, Gustave Roussy, Villejuif, France; Todd M. Bauer, Sarah Cannon Research Institute; Todd M. Bauer, Tennessee Oncology, Nashville, TN; Huibin Yue, Daniel Afar, and Louie Naumovski, AbbVie Inc.; Apurvasena Parikh, Clinical Pharmacology and Pharmacometrics, AbbVie Inc., Redwood City; Karen Kelly, University of California Davis Comprehensive Cancer Center, Sacramento, CA; and Monica Motwani, Edward B. Reilly, AbbVie Inc., North Chicago, IL.
J Clin Oncol. 2018 Nov 20;36(33):3298-3306. doi: 10.1200/JCO.2018.78.7697. Epub 2018 Oct 4.
PURPOSE: This first-in-human study evaluated telisotuzumab vedotin (Teliso-V), formerly called ABBV-399, an antibody-drug conjugate of the anti-c-Met monoclonal antibody ABT-700 and monomethyl auristatin E. MATERIALS AND METHODS: For dose escalation, three to six patients with advanced solid tumors were enrolled in eight cohorts (0.15 to 3.3 mg/kg). The dose-expansion phase enrolled patients with non-small-cell lung cancer (NSCLC) with c-Met-overexpressing tumors (c-Met positive; immunohistochemistry membrane H-score ≥ 150). Patients received Teliso-V monotherapy intravenously on day 1 once every 3 weeks. Safety, tolerability, pharmacokinetics, and maximum tolerated dose were determined. RESULTS: Forty-eight patients were enrolled (median age, 65 years; 35.4% NSCLC; median four prior therapies). One patient each in the 3.0-mg/kg (n = 9) and 3.3-mg/kg (n = 3) cohorts experienced dose-limiting toxicities. Although the maximum tolerated dose was not formally identified, the recommended phase II dose was defined as 2.7 mg/kg on the basis of overall safety and tolerability. The most frequent treatment-emergent adverse events (any grade) were fatigue (42%), nausea (27%), constipation (27%), decreased appetite (23%), vomiting (21%), dyspnea (21%), diarrhea (19%), peripheral edema (19%), and neuropathy (17%). The most frequent Teliso-V-related grade ≥ 3 adverse events were fatigue, anemia, neutropenia, and hypoalbuminemia (4% each). Teliso-V and total antibody pharmacokinetics were approximately dose proportional, with a mean harmonic half-life of 2 to 4 days each. Prospective screening identified 35 (60%) of 58 patients with c-Met-positive NSCLC. Of 16 patients with c-Met-positive NSCLC who were treated with Teliso-V 2.4 to 3.0 mg/kg, three (18.8%; 95% CI, 4.1% to 45.7%) achieved a partial response (median response duration, 4.8 months; median progression-free survival, 5.7 months; 95% CI, 1.2 months to 15.4 months). No other patients experienced a response. CONCLUSION: Teliso-V monotherapy demonstrated favorable safety and tolerability profiles, with encouraging evidence of antitumor activity in patients with c-Met-positive NSCLC.
目的:这项首次人体研究评估了替利妥珠单抗 Vedotin(Teliso-V),前称 ABBV-399,这是一种抗 c-Met 单克隆抗体 ABT-700 和单甲基奥瑞他汀 E 的抗体药物偶联物。
材料和方法:为了进行剂量递增,八组中每组有 3 至 6 名患有晚期实体瘤的患者入组(0.15 至 3.3mg/kg)。扩展阶段招募了患有 c-Met 过表达肿瘤的非小细胞肺癌(NSCLC)患者(c-Met 阳性;免疫组化膜 H 评分≥150)。患者每 3 周静脉注射一次替利妥珠单抗 Vedotin,剂量为 1 次 2.7mg/kg。确定了安全性、耐受性、药代动力学和最大耐受剂量。
结果:共有 48 名患者入组(中位年龄 65 岁;35.4%为 NSCLC;中位既往治疗 4 次)。在 3.0mg/kg(n=9)和 3.3mg/kg(n=3)组中,各有 1 名患者出现剂量限制毒性。尽管未正式确定最大耐受剂量,但基于总体安全性和耐受性,确定了 2.7mg/kg 作为推荐的 II 期剂量。最常见的治疗相关不良事件(任何等级)为疲劳(42%)、恶心(27%)、便秘(27%)、食欲下降(23%)、呕吐(21%)、呼吸困难(21%)、腹泻(19%)、外周水肿(19%)和周围神经病变(17%)。最常见的 Teliso-V 相关≥3 级不良事件为疲劳、贫血、中性粒细胞减少和低白蛋白血症(各 4%)。Teliso-V 和总抗体的药代动力学呈近似剂量比例关系,平均调和半衰期为 2 至 4 天。前瞻性筛查确定了 58 名 c-Met 阳性 NSCLC 患者中的 35 名(60%)。在接受 2.4 至 3.0mg/kg Teliso-V 治疗的 16 名 c-Met 阳性 NSCLC 患者中,有 3 名(18.8%;95%CI,4.1%至 45.7%)获得部分缓解(中位缓解持续时间为 4.8 个月;中位无进展生存期为 5.7 个月;95%CI,1.2 个月至 15.4 个月)。没有其他患者出现缓解。
结论:替利妥珠单抗 Vedotin 单药治疗具有良好的安全性和耐受性,在 c-Met 阳性 NSCLC 患者中具有令人鼓舞的抗肿瘤活性证据。
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