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抗 PD-L1 抗体 cosibelimab 治疗转移性皮肤鳞状细胞癌的疗效和安全性。

Efficacy and safety of cosibelimab, an anti-PD-L1 antibody, in metastatic cutaneous squamous cell carcinoma.

机构信息

Southern Medical Day Care Centre, Wollongong, New South Wales, Australia.

Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia.

出版信息

J Immunother Cancer. 2023 Oct;11(10). doi: 10.1136/jitc-2023-007637.

Abstract

BACKGROUND

Programmed cell death receptor-1 (PD-1)-blocking antibodies are approved to treat metastatic or locally advanced cutaneous squamous cell carcinoma (CSCC) cases ineligible for curative surgery or radiation. Notwithstanding, some patients experience inadequate responses or severe immune-related adverse events (AEs), indicating the need for improved therapies. Cosibelimab is a high-affinity programmed cell death-ligand 1 (PD-L1)-blocking antibody that activates innate and adaptive immunity by blocking PD-L1 interaction with PD-1 and B7-1 receptors. It is an unmodified immunoglobulin G1 subtype with a functional Fc domain capable of inducing antibody-dependent cellular cytotoxicity and complement-dependent cytotoxicity. Here, we present results of the pivotal study of patients with metastatic CSCC from an open-label, multicenter, multiregional, multicohort, phase 1 trial of cosibelimab.

METHODS

In this trial, participants with metastatic CSCC received cosibelimab 800 mg intravenously every 2 weeks. Primary endpoint was objective response rate (ORR) by independent central review using Response Evaluation Criteria in Solid Tumors, V.1.1. Secondary endpoints included duration of response (DOR) and safety.

RESULTS

Objective response was observed in 37 of 78 participants (47.4% (95% CI: 36.0% to 59.1%)), with median follow-up of 15.4 months (range: 0.4 to 40.5) as of data cut-off. Median DOR was not reached (range: 1.4+ to 34.1+ months), with response ongoing in 73.0% of participants. Common treatment-emergent AEs (≥15%) were fatigue (26.9%), rash (16.7%), and anemia (15.4%). Eighteen participants (23.1%) experienced immune-related AEs (grade 3: n=2 (2.6%); no grade 4/5). No treatment-related deaths were reported.

CONCLUSIONS

Cosibelimab demonstrated clinically meaningful ORR and DOR and was associated with a manageable safety profile.

TRIAL REGISTRATION NUMBER

NCT03212404.

摘要

背景

程序性死亡受体-1(PD-1)阻断抗体已获批用于治疗无法进行根治性手术或放疗的转移性或局部晚期皮肤鳞状细胞癌(CSCC)病例。然而,一些患者的反应不足或出现严重的免疫相关不良反应(AE),这表明需要改进治疗方法。Cosibelimab 是一种高亲和力的程序性死亡配体 1(PD-L1)阻断抗体,通过阻断 PD-L1 与 PD-1 和 B7-1 受体的相互作用,激活先天和适应性免疫。它是一种未经修饰的免疫球蛋白 G1 亚型,具有功能 Fc 结构域,能够诱导抗体依赖性细胞毒性和补体依赖性细胞毒性。在这里,我们报告了 cosibelimab 在一项开放标签、多中心、多区域、多队列、I 期临床试验中治疗转移性 CSCC 患者的关键研究结果。

方法

在这项试验中,转移性 CSCC 患者每 2 周接受 800mg 静脉注射 cosibelimab。主要终点是独立中心评估使用实体瘤反应评估标准,V.1.1 评估的客观缓解率(ORR)。次要终点包括缓解持续时间(DOR)和安全性。

结果

78 名参与者中有 37 名(47.4%(95%CI:36.0%至 59.1%))观察到客观缓解,截至数据截止时,中位随访时间为 15.4 个月(范围:0.4 至 40.5)。中位 DOR 未达到(范围:1.4+至 34.1+个月),73.0%的参与者持续缓解。常见的治疗后出现的不良事件(≥15%)是疲劳(26.9%)、皮疹(16.7%)和贫血(15.4%)。18 名参与者(23.1%)发生免疫相关不良事件(3 级:n=2(2.6%);无 4/5 级)。无治疗相关死亡报告。

结论

Cosibelimab 显示出有临床意义的 ORR 和 DOR,且安全性良好。

试验注册号

NCT03212404。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/857c/10582968/7bf222a50db7/jitc-2023-007637f01.jpg

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