Bian Li, Zhang Huiqiang, Wang Tao, Zhang Shaohua, Song Haifeng, Xu Mingli, Yao Sheng, Jiang Zefei
Department of Breast Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, China.
National Engineering Research Center for Protein Drugs, Beijing Institute of Lifeomics, Beijing 102206, China.
Ann Transl Med. 2019 Sep;7(18):435. doi: 10.21037/atm.2019.09.08.
Triple negative breast cancer (TNBC), as defined by ER, PR and HER2 negative expression in tumor, has limited treatment options beyond conventional chemotherapy. JS001, a humanized IgG4 antibody for PD-1, has demonstrated acceptable safety profile and preliminary anti-tumor activity in solid tumors.
This phase I open-label study is designed to evaluate the safety, tolerability, and antitumor activity of JS001 in advanced TNBC patients who are refractory to standard systemic therapy. The study has a 3+3 dose escalation design with planned cohorts at 1, 3, and 10 mg/kg Q2W followed by a dose expansion cohort at 3 mg/kg. (Clinical Trial ID: NCT02838823).
From August 04, 2016 to October 26, 2017, 20 heavily-pretreated advanced TNBC patients were enrolled into three dose cohorts (6 in 1 mg/kg, 8 in 3 mg/kg and 6 in 10 mg/kg). As of August 30, 2018, no DLT was observed and no MTD was reached. No AEs were grade 4 or 5. The most common treatment related AEs were all grade 1/2. Treatment related grade 3 AEs (15%) included 1 hyponatremia, 1 rash and 1 bronchospasm (infusion related reaction). Among 20 evaluable subjects, the ORR was 5%. One patient in 10 mg/kg group obtained PR, who was PD-L1 strong positive (>50%) in tumor biopsy, with treatment duration of 12.8 months as of data cutoff. As of follow-up on July 15, 2019, the patient continued PR with treatment duration of 24 months and still ongoing. Six patients achieved SD, for a DCR of 35%. The median PFS of all subjects was 1.8 months (95% CI, 1.4 to 4.6). 45% subjects are PD-L1 positive (≥1% cutoff), among whom a 11.1% ORR and a 22.2% DCR were observed.
JS001 exhibited a favorable safety profile in advanced TNBC patients who are refractory to multi-line systemic therapy. JS001 also showed a moderate response in these TNBC patients who had limited treatment options.
三阴性乳腺癌(TNBC)定义为肿瘤中雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体2(HER2)均呈阴性表达,除传统化疗外,其治疗选择有限。JS001是一种针对程序性死亡受体1(PD-1)的人源化IgG4抗体,在实体瘤中已显示出可接受的安全性和初步抗肿瘤活性。
本I期开放标签研究旨在评估JS001在对标准全身治疗难治的晚期TNBC患者中的安全性、耐受性和抗肿瘤活性。该研究采用3+3剂量递增设计,计划队列分别为1、3和10mg/kg,每2周一次,随后是3mg/kg的剂量扩展队列。(临床试验标识符:NCT02838823)。
2016年8月4日至2017年10月26日,20例经过大量预处理的晚期TNBC患者被纳入三个剂量队列(1mg/kg组6例,3mg/kg组8例,10mg/kg组6例)。截至2018年8月30日,未观察到剂量限制毒性(DLT),也未达到最大耐受剂量(MTD)。无4级或5级不良事件(AE)。最常见的治疗相关AE均为1/2级。治疗相关3级AE(15%)包括1例低钠血症、1例皮疹和1例支气管痉挛(输液相关反应)。在20例可评估受试者中,客观缓解率(ORR)为5%。10mg/kg组1例患者获得部分缓解(PR),其肿瘤活检中程序性死亡配体1(PD-L1)强阳性(>50%),截至数据截止时治疗持续时间为12.8个月。截至2019年7月15日随访时,该患者持续PR,治疗持续时间为24个月且仍在进行中。6例患者疾病稳定(SD),疾病控制率(DCR)为35%。所有受试者的中位无进展生存期(PFS)为1.8个月(95%置信区间,1.4至4.6)。45%的受试者PD-L1阳性(临界值≥1%),其中观察到11.1%的ORR和22.2%的DCR。
JS001在对多线全身治疗难治的晚期TNBC患者中表现出良好的安全性。JS001在这些治疗选择有限的TNBC患者中也显示出适度的反应。