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达雷木单抗在 B 细胞非霍奇金淋巴瘤模型中表现出体外和体内的抗肿瘤活性,并改善了对标准化疗免疫治疗方案的反应。

Daratumumab displays in vitro and in vivo anti-tumor activity in models of B-cell non-Hodgkin lymphoma and improves responses to standard chemo-immunotherapy regimens.

机构信息

Department of Hematology-Oncology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

Centro de Investigación Biomédica en Red-Oncología (CIBERONC), Barcelona, Spain.

出版信息

Haematologica. 2020 Apr;105(4):1032-1041. doi: 10.3324/haematol.2018.211904. Epub 2019 Jul 11.

Abstract

CD38 is expressed in several types of non-Hodgkin lymphoma (NHL) and constitutes a promising target for antibody-based therapy. Daratumumab (Darzalex) is a first-in-class anti-CD38 antibody approved for the treatment of relapsed/refractory (R/R) multiple myeloma (MM). It has also demonstrated clinical activity in Waldenström macroglobulinaemia and amyloidosis. Here, we have evaluated the activity and mechanism of action of daratumumab in preclinical and models of mantle cell lymphoma (MCL), follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL), as monotherapy or in combination with standard chemo-immunotherapy. , daratumumab engages Fc-mediated cytotoxicity by antibody-dependent cell cytotoxicity and antibody-dependent cell phagocytosis in all lymphoma subtypes. In the presence of human serum, complement-dependent cell cytotoxicity was marginally engaged. We demonstrated by Selective Plane Illumination Microscopy that daratumumab fully penetrated a three-dimensional (3D) lymphoma organoid and decreased organoid volume. , daratumumab completely prevents tumor outgrowth in models of MCL and FL, and shows comparable activity to rituximab in a disseminated model of blastic MCL. Moreover, daratumumab improves overall survival (OS) in a mouse model of transformed CD20 FL, where rituximab showed limited activity. Daratumumab potentiates the antitumor activity of CHOP and R-CHOP in MCL and FL xenografts. Furthermore, in a patient-derived DLBCL xenograft model, daratumumab anti-tumor activity was comparable to R-CHOP and the addition of daratumumab to either CHOP or R-CHOP led to full tumor regression. In summary, daratumumab constitutes a novel therapeutic opportunity in certain scenarios and these results warrant further clinical development.

摘要

CD38 在几种类型的非霍奇金淋巴瘤 (NHL) 中表达,是抗体为基础的治疗的一个有前途的靶点。达雷妥尤单抗(Darzalex)是一种用于治疗复发/难治性(R/R)多发性骨髓瘤(MM)的首创抗 CD38 抗体。它在华氏巨球蛋白血症和淀粉样变性中也显示出临床活性。在这里,我们评估了达雷妥尤单抗在套细胞淋巴瘤 (MCL)、滤泡性淋巴瘤 (FL) 和弥漫性大 B 细胞淋巴瘤 (DLBCL) 的临床前和模型中的活性和作用机制,无论是单独使用还是与标准化疗免疫疗法联合使用。,达雷妥尤单抗通过抗体依赖性细胞毒性和抗体依赖性细胞吞噬作用在所有淋巴瘤亚型中发挥 Fc 介导的细胞毒性作用。在存在人血清的情况下,补体依赖性细胞毒性作用略有参与。我们通过选择性平面照明显微镜证明,达雷妥尤单抗完全穿透了三维 (3D) 淋巴瘤类器官,并减少了类器官的体积。,达雷妥尤单抗完全阻止了 MCL 和 FL 模型中的肿瘤生长,并且在弥漫性 blastic MCL 的模型中显示出与利妥昔单抗相当的活性。此外,达雷妥尤单抗改善了转化性 CD20 FL 小鼠模型的总生存期 (OS),而利妥昔单抗的活性有限。达雷妥尤单抗增强了 MCL 和 FL 异种移植物中 CHOP 和 R-CHOP 的抗肿瘤活性。此外,在患者来源的 DLBCL 异种移植模型中,达雷妥尤单抗的抗肿瘤活性与 R-CHOP 相当,并且将达雷妥尤单抗添加到 CHOP 或 R-CHOP 中导致完全肿瘤消退。总之,达雷妥尤单抗在某些情况下构成了一种新的治疗机会,这些结果值得进一步的临床开发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba7/7109732/ace619e8af40/1051032.fig1.jpg

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