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复发或难治性弥漫性大B细胞淋巴瘤患者中泊洛妥珠单抗的暴露安全性和暴露有效性分析。

Exposure-safety and exposure-efficacy analyses of polatuzumab vedotin in patients with relapsed or refractory diffuse large B-cell lymphoma.

作者信息

Lu Tong, Gibiansky Leonid, Li Xiaobin, Li Chunze, Shi Rong, Agarwal Priya, Hirata Jamie, Miles Dale, Chanu Pascal, Girish Sandhya, Jin Jin Yan, Lu Dan

机构信息

Genentech, Inc, South San Francisco, CA, USA.

QuantPharm LLC, North Potomac, MD, USA.

出版信息

Leuk Lymphoma. 2020 Dec;61(12):2905-2914. doi: 10.1080/10428194.2020.1795154. Epub 2020 Jul 24.

Abstract

Exposure-response relationships were investigated to assess the risk/benefit of polatuzumab vedotin (pola) + bendamustine-rituximab (pola + BR) in relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). Analyses were conducted in pivotal study GO29365 (NCT02257567; BR/pola + BR/pola + BG [BG: bendamustine-obinutuzumab]; 1.8 mg/kg pola, every 3 weeks [Q3W], six cycles), and supportive studies DCS4968g (NCT01290549) and GO27834 (NCT01691898) (pola/pola + R/pola + G; 0.1-2.4 mg/kg pola Q3W; eight-cycle landmark), separately. Exposure was characterized as simulated cycle-6 AUC and for antibody-conjugated mono-methyl auristatin E (acMMAE) and unconjugated MMAE. Supportive studies showed response rate and safety risk (grade ≥2 peripheral neuropathy; grade ≥3 anemia) increased with exposure, suggesting not to dose below 1.8 mg/kg (up to eight-cycle) for balancing safety and efficacy. Pivotal study with limited exposure range showed no exposure-safety relationship and slightly positive exposure (acMMAE)-efficacy relationship for overall survival. The exposure-response analyses and the observed risk/benefit characteristics in pivotal study supported pola (1.8 mg/kg) +BR Q3W for six cycles in R/R DLBCL patients.

摘要

研究暴露-反应关系以评估泊洛妥珠单抗(pola)+苯达莫司汀-利妥昔单抗(pola + BR)用于复发/难治性弥漫性大B细胞淋巴瘤(R/R DLBCL)的风险/获益。分别在关键研究GO29365(NCT02257567;BR/pola + BR/pola + BG [BG:苯达莫司汀-奥妥珠单抗];1.8 mg/kg pola,每3周一次[Q3W],共6个周期)以及支持性研究DCS4968g(NCT01290549)和GO27834(NCT01691898)(pola/pola + R/pola + G;0.1 - 2.4 mg/kg pola Q3W;8周期标志性分析)中进行分析。暴露以模拟的第6周期抗体偶联单甲基奥瑞他汀E(acMMAE)和未偶联MMAE的AUC进行表征。支持性研究表明,随着暴露增加,缓解率和安全风险(≥2级周围神经病变;≥3级贫血)升高,这表明为平衡安全性和疗效,剂量不应低于1.8 mg/kg(最多8个周期)。暴露范围有限的关键研究显示,对于总生存期,不存在暴露-安全性关系,而暴露(acMMAE)-疗效关系略显阳性。关键研究中的暴露-反应分析以及观察到的风险/获益特征支持在R/R DLBCL患者中使用pola(1.8 mg/kg)+BR Q3W共6个周期。

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