GlaxoSmithKline, Collegeville, Pennsylvania, USA.
GlaxoSmithKline, Research Triangle Park, North Carolina, USA.
CPT Pharmacometrics Syst Pharmacol. 2021 Aug;10(8):851-863. doi: 10.1002/psp4.12660. Epub 2021 Jul 29.
Belantamab mafodotin (belamaf) is an antibody-drug conjugate (ADC) targeting B-cell maturation antigen (BCMA). Nonlinear mixed-effects models were developed to characterize the population pharmacokinetics (PopPK) of ADC, total monoclonal antibody (mAb), and cysteine-maleimidocaproyl-MMAF (cys-mcMMAF) after 0.03-4.6 mg/kg dosing every 3 weeks in heavily pretreated patients with relapsed/refractory multiple myeloma (RRMM; DREAMM-1, n = 73; DREAMM-2, n = 218). Sequential modeling methodology was used. Individual post hoc parameter estimates from the final ADC model were used to develop total mAb and cys-mcMMAF models. Formal covariate selection used a modified stepwise forward inclusion method with backward elimination. A linear, two-compartment PopPK model with a time-varying clearance (CL) described ADC PK. Initial ADC typical value for CL for a DREAMM-2 patient was 0.936 L/day with a half-life of 11.5 days, over time CL was reduced by 28% resulting in a half-life of 14.3 days. Time to 50% maximal CL change was ~ 50 days. Baseline soluble BCMA (sBCMA), immunoglobulin (IgG), albumin, and bodyweight impacted ADC CL. Cys-mcMMAF concentrations were described with a linear two-compartment model linked to ADC; input rate was governed by deconjugation/intracellular proteolytic degradation of ADC represented by an exponentially decreasing MMAF:mAb (drug antibody ratio [DAR]) after each dose. Time to 50% DAR reduction was 10.3 days. Baseline sBCMA and IgG impacted cys-mcMMAF central volume of distribution. In conclusion, ADC, total mAb, and cys-mcMMAF concentration-time profiles in RRMM were well-described by PopPK models, and exposure was most strongly impacted by disease-related characteristics.
贝兰他单抗马妥昔单抗(belantamab mafodotin,belamaf)是一种靶向 B 细胞成熟抗原(BCMA)的抗体药物偶联物(ADC)。在复发/难治性多发性骨髓瘤(RRMM;DREAMM-1,n=73;DREAMM-2,n=218)患者中,以 0.03-4.6mg/kg 每 3 周进行剂量给药,建立了群体药代动力学(PopPK)模型,以描述 ADC、总单克隆抗体(mAb)和半胱氨酸-马来酰亚胺基-丙酰基-MMAF(cys-mcMMAF)的群体药代动力学特征。采用序贯建模方法。使用最终 ADC 模型的个体事后参数估计值来开发总 mAb 和 cys-mcMMAF 模型。正式协变量选择采用带有后向消除的修正逐步向前纳入法。具有时变清除率(CL)的线性二室 PopPK 模型描述了 ADC PK。DREAMM-2 患者初始 ADC 典型 CL 值为 0.936 L/天,半衰期为 11.5 天,随着时间的推移,CL 降低了 28%,半衰期为 14.3 天。达到 50%最大 CL 变化的时间约为 50 天。基线可溶性 BCMA(sBCMA)、免疫球蛋白(IgG)、白蛋白和体重影响 ADC CL。cys-mcMMAF 浓度用与 ADC 相关的线性二室模型描述;输入速率由 ADC 每次剂量后通过去共轭/细胞内蛋白水解降解来控制,表现为指数减少的 MMAF:mAb(药物抗体比[DAR])。达到 50% DAR 减少的时间为 10.3 天。基线 sBCMA 和 IgG 影响 cys-mcMMAF 中央分布容积。结论,RRMM 中的 ADC、总 mAb 和 cys-mcMMAF 浓度-时间曲线很好地用 PopPK 模型描述,暴露受疾病相关特征的影响最大。