基于模型的掩蔽型抗 PD-L1 抗体 CX-072 的药物研发。

Model-Informed Drug Development of the Masked Anti-PD-L1 Antibody CX-072.

机构信息

CytomX Therapeutics, Inc, South San Francisco, California, USA.

Certara Strategic Consulting, Menlo Park, California, USA.

出版信息

Clin Pharmacol Ther. 2021 Feb;109(2):383-393. doi: 10.1002/cpt.1985. Epub 2020 Aug 31.

Abstract

CX-072 is an anti-PD-L1 (programmed death ligand 1) Probody therapeutic (Pb-Tx) designed to be preferentially activated by proteases in the tumor microenvironment and not in healthy tissue. Here, we report the model-informed drug development of CX-072. A quantitative systems pharmacology (QSP) model that captured known mechanisms of Pb-Tx activation, biodistribution, elimination, and target engagement was used to inform clinical translation. The QSP model predicted that a trough level of masked CX-072 (intact CX-072) of 13-99 nM would correspond to a targeted, 95% receptor occupancy in the tumor. The QSP model predictions appeared consistent with preliminary human single-dose pharmacokinetic (PK) data following CX-072 0.03-30.0 mg/kg as monotherapy: CX-072 circulated predominantly as intact CX-072 with minimal evidence of target-mediated drug disposition. A preliminary population PK (POPPK) analysis based upon 130 subjects receiving 0.03-30.0 mg/kg as monotherapy included a provision for a putative time-dependent and dose-dependent antidrug antibody (ADA) effect on clearance (CL) with a mixture model. Preliminary POPPK estimates for intact CX-072 time-invariant CL and volume of distribution were 0.306 L/day and 4.84 L, respectively. Exposure-response analyses did not identify statistically significant relationships with best change from baseline sum of measurements and either adverse events of grade ≥ 3 or of special interest. Simulations suggested that > 95% of patients receiving CX-072 10 mg/kg every two weeks would exceed the targeted trough level regardless of ADA, and that dose adjustment by body weight was not necessary, supporting a fixed 800 mg dose for evaluation in phase II.

摘要

CX-072 是一种抗 PD-L1(程序性死亡配体 1)Probody 治疗剂(Pb-Tx),旨在优先被肿瘤微环境中的蛋白酶激活,而不在健康组织中激活。在这里,我们报告了 CX-072 的基于模型的药物开发。一个捕获了 Pb-Tx 激活、分布、消除和靶标结合的已知机制的定量系统药理学 (QSP) 模型被用于指导临床转化。该 QSP 模型预测,在肿瘤中,13-99 nM 的 CX-072 (完整的 CX-072)的谷浓度将对应于靶向、95%的受体占有率。QSP 模型的预测似乎与 CX-072 0.03-30.0 mg/kg 单药治疗的初步人体单剂量药代动力学 (PK) 数据一致:CX-072 主要以完整的 CX-072 循环,几乎没有证据表明存在靶介导的药物处置。基于 130 名接受 0.03-30.0 mg/kg 单药治疗的受试者的初步人群 PK (POPPK) 分析包括一个假设的时间依赖性和剂量依赖性抗药物抗体 (ADA) 对清除率 (CL) 的影响的规定,采用混合模型。完整的 CX-072 时间不变的 CL 和分布容积的初步 POPPK 估计值分别为 0.306 L/天和 4.84 L。暴露-反应分析没有发现与最佳基线总和测量值的统计学显著关系,也没有发现与≥3 级不良事件或特别关注的事件有统计学显著关系。模拟表明,无论 ADA 如何,接受 CX-072 10 mg/kg 每两周一次治疗的>95%的患者将超过目标谷浓度,并且不需要根据体重调整剂量,支持在 II 期评估时使用固定的 800 mg 剂量。

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