Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Osaka, Japan.
Cancer Sci. 2018 Dec;109(12):3962-3970. doi: 10.1111/cas.13846.
Olaratumab, a monoclonal antibody targeting human platelet-derived growth factor receptor α, plus doxorubicin significantly improved overall survival in patients with advanced soft-tissue sarcoma (STS) in a prior phase 1b/2 randomized trial. Subsequent exposure-response analysis suggested that higher olaratumab exposures earlier might improve outcomes in patients at risk of early disease progression. This phase 1 study (3 treatment cohorts; minimum 6 patients each) investigated the safety, pharmacokinetics and antitumor activity of olaratumab plus doxorubicin in Japanese patients with STS. Patients received olaratumab 15 mg/kg on Days 1 and 8 during each 21-day cycle until disease progression. Patients in Cohort 3 received a 20 mg/kg loading dose of olaratumab in Cycle 1. Doxorubicin was administered for up to 6 cycles. Patients in Cohort 1 received doxorubicin 25 mg/m on Days 1, 2 and 3. Patients in Cohorts 2 and 3 received doxorubicin 75 mg/m on Day 1. One patient in Cohort 2 experienced a dose-limiting toxicity of Grade 3 febrile neutropenia. Most treatment-emergent adverse events were of mild and moderate severity, and were known doxorubicin toxicities. Olaratumab serum concentrations in Cohort 3 reached a steady-state exceeding the target level in Cycle 1. Partial response was confirmed in 4 patients (2 each in Cohorts 2 and 3). Olaratumab plus doxorubicin had an acceptable safety profile in patients with STS. A loading dose of olaratumab 20 mg/kg was effective for achieving minimum serum concentrations above the target trough level in Cycle 1.
奥拉单抗是一种针对人血小板衍生生长因子受体α的单克隆抗体,在一项先前的 1b/2 期随机试验中,奥拉单抗联合多柔比星显著改善了晚期软组织肉瘤(STS)患者的总生存期。随后的暴露-反应分析表明,早期更高的奥拉单抗暴露可能会改善有早期疾病进展风险的患者的结局。这项 1 期研究(3 个治疗队列;每个队列至少 6 例患者)调查了奥拉单抗联合多柔比星在日本 STS 患者中的安全性、药代动力学和抗肿瘤活性。患者在每个 21 天周期的第 1 天和第 8 天接受 15mg/kg 的奥拉单抗治疗,直至疾病进展。队列 3 的患者在第 1 周期接受 20mg/kg 的奥拉单抗负荷剂量。多柔比星最多使用 6 个周期。队列 1 的患者在第 1、2 和 3 天接受 25mg/m2的多柔比星。队列 2 和 3 的患者在第 1 天接受 75mg/m2的多柔比星。队列 2 的 1 名患者发生了 3 级发热性中性粒细胞减少症的剂量限制毒性。大多数治疗期间出现的不良事件为轻度和中度严重程度,为已知的多柔比星毒性。队列 3 中的奥拉单抗血清浓度在第 1 周期达到了稳定状态,超过了目标水平。4 例患者(队列 2 和 3 各 2 例)确认了部分缓解。奥拉单抗联合多柔比星在 STS 患者中具有可接受的安全性。在第 1 周期,奥拉单抗 20mg/kg 的负荷剂量可有效实现目标谷浓度以上的最小血清浓度。