一项开放标签、多中心的 1/2 期研究,评估伊沙妥昔单抗联合西妥昔单抗治疗淋巴瘤患者的疗效。

A phase 1/2, open-label, multicenter study of isatuximab in combination with cemiplimab in patients with lymphoma.

机构信息

Department of Biomedical Sciences, Humanitas University and Department of Oncology and Hematology, IRCCS Humanitas Research Hospital, Milano, Italy.

IRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia "Seràgnoli" and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università di Bologna, Bologna, Italy.

出版信息

Hematol Oncol. 2023 Feb;41(1):108-119. doi: 10.1002/hon.3089. Epub 2022 Oct 31.

Abstract

Patients with relapsed or refractory lymphoma have limited treatment options, requiring newer regimens. In this Phase 1/2 study (NCT03769181), we assessed the safety, efficacy, and pharmacokinetics of isatuximab (Isa, anti-CD38 antibody) in combination with cemiplimab (Cemi, anti-programmed death-1 [PD-1] receptor antibody; Isa + Cemi) in patients with classic Hodgkin lymphoma (cHL), diffuse large B-cell lymphoma (DLBCL), and peripheral T-cell lymphoma (PTCL). In Phase 1, we characterized the safety and tolerability of Isa + Cemi with planned dose de-escalation to determine the recommended Phase 2 dose (RP2D). Six patients in each cohort were treated with a starting dose of Isa + Cemi to determine the RP2D. In Phase 2, the primary endpoints were complete response in Cohort A1 (cHL anti-PD-1/programmed death-ligand 1 [PD-L1] naïve), and objective response rate in Cohorts A2 (cHL anti-PD-1/PD-L1 progressors), B (DLBCL), and C (PTCL). An interim analysis was performed when the first 18 (Cohort A1), 12 (Cohort A2), 17 (Cohort B), and 11 (Cohort C) patients in Phase 2 had been treated and followed up for 24 weeks. Isa + Cemi demonstrated a manageable safety profile with no new safety signals. No dose-limiting toxicities were observed at the starting dose; thus, the starting dose of each drug was confirmed as the RP2D. Based on the Lugano 2014 criteria, 55.6% (Cohort A1), 33.3% (Cohort A2), 5.9% (Cohort B), and 9.1% (Cohort C) of patients achieved a complete or partial response. Pharmacokinetic analyses suggested no effect of Cemi on Isa exposure. Modest clinical efficacy was observed in patients with cHL regardless of prior anti-PD-1/PD-L1 exposure. In DLBCL or PTCL cohorts, interim efficacy analysis results did not meet prespecified criteria to continue enrollment in Phase 2 Stage 2. Isa + Cemi did not have a synergistic effect in these patient populations.

摘要

复发或难治性淋巴瘤患者的治疗选择有限,需要新的治疗方案。在这项 I/II 期研究(NCT03769181)中,我们评估了 Isatuximab(Isa,抗 CD38 抗体)联合 Cemiplimab(Cemi,抗程序性死亡受体-1 [PD-1] 抗体;Isa+Cemi)在经典霍奇金淋巴瘤(cHL)、弥漫性大 B 细胞淋巴瘤(DLBCL)和外周 T 细胞淋巴瘤(PTCL)患者中的安全性、疗效和药代动力学。在 I 期,我们评估了 Isa+Cemi 的安全性和耐受性,并计划进行剂量下调,以确定 II 期推荐剂量(RP2D)。每个队列中的 6 名患者接受起始剂量的 Isa+Cemi 治疗,以确定 RP2D。在 II 期,主要终点是队列 A1(cHL 抗 PD-1/程序性死亡配体 1 [PD-L1] 初治)的完全缓解率,以及队列 A2(cHL 抗 PD-1/PD-L1 进展)、B(DLBCL)和 C(PTCL)的客观缓解率。当 II 期的前 18 名(队列 A1)、12 名(队列 A2)、17 名(队列 B)和 11 名(队列 C)患者接受治疗并随访 24 周时,进行了中期分析。Isa+Cemi 具有可管理的安全性特征,无新的安全性信号。起始剂量未观察到剂量限制毒性;因此,每种药物的起始剂量被确认为 RP2D。根据卢加诺 2014 标准,55.6%(队列 A1)、33.3%(队列 A2)、5.9%(队列 B)和 9.1%(队列 C)的患者达到完全或部分缓解。药代动力学分析表明 Cemi 对 Isa 暴露没有影响。无论先前是否接受过抗 PD-1/PD-L1 治疗,cHL 患者均观察到适度的临床疗效。在 DLBCL 或 PTCL 队列中,中期疗效分析结果未达到继续进行 II 期 2 期入组的预设标准。在这些患者人群中,Isa+Cemi 没有协同作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/211e/10092787/d981bcb5f944/HON-41-108-g001.jpg

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