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I 期、首次人体试验的程序性细胞死亡受体-1(PD-1)抑制剂 JTX-4014 在晚期、难治性实体瘤成人患者中的应用。

Phase I, first-in-human trial of programmed cell death receptor-1 (PD-1) inhibitor, JTX-4014, in adult patients with advanced, refractory, solid tumors.

机构信息

South Texas Accelerated Research Therapeutics (START), 4383 Medical Drive, Suite 4021, San Antonio, TX, 78229, USA.

START Midwest, Grand Rapids, MI, USA.

出版信息

Cancer Immunol Immunother. 2021 Mar;70(3):763-772. doi: 10.1007/s00262-020-02730-5. Epub 2020 Sep 28.

Abstract

BACKGROUND

Inhibition of programmed cell death receptor protein-1 (PD-1) has proven to be a highly effective strategy for immunotherapy of cancer. Approvals of both PD-1 and PD-L1 inhibitors [PD-(L)1i] in multiple tumor types are evidence of the durable benefits they provide to patients with cancer. In this first-in-human trial, we assessed the safety and tolerability of JTX-4014, a fully human antibody targeting PD-1.

METHODS

JTX-4014 was administered to 18 patients with multiple solid tumor types who had not previously received a PD-(L)1i. The primary objectives were to evaluate the safety and tolerability of JTX-4014 and determine the maximum tolerated dose (MTD) and recommended phase II dose (RP2D). Secondary objectives included evaluation of the pharmacokinetics (PK) of JTX-4014, anti-drug antibodies (ADA) against JTX-4014, and clinical activity.

RESULTS

JTX-4014 was well tolerated and no new safety signals were identified as compared with other PD-1is. The MTD was not reached and the RP2D was selected, based on PK modelling and supportive safety data, to be 500 mg every 3 weeks or 1000 mg every 6 weeks. Clinical activity, based on RECIST v1.1 criteria, demonstrated an overall response rate of 16.7% (n = 3) with one complete and two partial responses and a disease control rate of 44.4% (n = 8). The responses occurred at different doses in patients with PD-L1 positive tumors and in tumor types that are not typically PD-1i responsive.

CONCLUSIONS

Further development of JTX-4014 is warranted as a monotherapy or in combination with other innovative cancer therapies.

TRIAL REGISTRATION NUMBER

NCT03790488, December 31 2018.

摘要

背景

程序性细胞死亡受体蛋白-1(PD-1)的抑制已被证明是癌症免疫治疗的一种非常有效的策略。在多种肿瘤类型中批准 PD-1 和 PD-L1 抑制剂(PD-(L)1i)的证据表明,它们为癌症患者提供了持久的益处。在这项首次人体试验中,我们评估了靶向 PD-1 的全人抗体 JTX-4014 的安全性和耐受性。

方法

将 JTX-4014 施用于 18 名先前未接受过 PD-(L)1i 治疗的多种实体瘤患者。主要目标是评估 JTX-4014 的安全性和耐受性,并确定最大耐受剂量(MTD)和推荐的 II 期剂量(RP2D)。次要目标包括评估 JTX-4014 的药代动力学(PK)、针对 JTX-4014 的抗体(ADA)和临床活性。

结果

与其他 PD-1is 相比,JTX-4014 耐受性良好,未发现新的安全性信号。未达到 MTD,根据 PK 建模和支持性安全性数据,RP2D 选择为每 3 周 500mg 或每 6 周 1000mg。根据 RECIST v1.1 标准,基于临床活性的总缓解率为 16.7%(n=3),有 1 例完全缓解和 2 例部分缓解,疾病控制率为 44.4%(n=8)。在 PD-L1 阳性肿瘤患者和通常对 PD-1i 无反应的肿瘤类型中,不同剂量的患者出现了反应。

结论

需要进一步开发 JTX-4014 作为单一疗法或与其他创新癌症疗法联合使用。

试验注册

NCT03790488,2018 年 12 月 31 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf31/10991634/883561092833/262_2020_2730_Fig1_HTML.jpg

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