Genentech, Inc., South San Francisco, California, USA.
QuantPharm LLC, North Potomac, Maryland, USA.
Clin Transl Sci. 2023 Dec;16(12):2744-2755. doi: 10.1111/cts.13669. Epub 2023 Oct 31.
This ethnic sensitivity analysis used data from the phase III POLARIX study (NCT03274492) to assess polatuzumab vedotin pharmacokinetics (PKs) in Asian versus non-Asian patients with previously untreated diffuse large B-cell lymphoma and examined the appropriateness of extrapolating global study findings to Asian patients. PK and population PK (PopPK) analyses assessed polatuzumab vedotin analyte exposures by ethnicity (Asian [n = 84] vs. non-Asian [n = 345] patients) and region (patients enrolled from Asia [n = 80] vs. outside Asia [n = 349]). In patients from Asia versus outside Asia, observed mean antibody-conjugated monomethyl auristatin E (acMMAE) concentrations were comparable (1.2% lower at cycle [C]1 postdose, 4.4% higher at C4 predose; and 6.8% lower at C4 postdose in patients from Asia). Observed mean unconjugated MMAE was lower in patients from Asia by 6.5% (C1 postdose), 20.0% (C4 predose), and 15.3% (C4 postdose). In the PopPK analysis, C6 area under the curve and peak plasma concentrations were also comparable for acMMAE (6.3% and 3.0% lower in Asian vs. non-Asian patients, respectively) and lower for unconjugated MMAE by 19.1% and 16.7%, respectively. By region, C6 mean acMMAE concentrations were similar, and C6 mean unconjugated MMAE concentrations were lower, in patients enrolled from Asia versus outside Asia, by 3.9%-7.0% and 17.3%-19.7%, respectively. In conclusion, polatuzumab vedotin PKs were similar between Asian and non-Asian patients by ethnicity and region, suggesting PKs are not sensitive to Asian ethnicity and dose adjustments are not required in Asian patients to maintain efficacy and safety.
本项人种敏感性分析使用 III 期 POLARIX 研究(NCT03274492)的数据,评估既往未经治疗的弥漫性大 B 细胞淋巴瘤患者中,与非亚洲患者相比,亚洲患者的泊洛妥珠单抗联合维布妥昔单抗的药代动力学(PK),并考察将全球研究结果外推至亚洲患者的适宜性。PK 和群体 PK(PopPK)分析按人种(亚洲[ n = 84]与非亚洲[ n = 345]患者)和地区(来自亚洲[ n = 80]与亚洲以外地区[ n = 349]的入组患者)评估泊洛妥珠单抗联合维布妥昔单抗分析物暴露情况。与亚洲以外地区患者相比,来自亚洲患者的观察到的平均抗体结合单甲基澳瑞他汀 E(acMMAE)浓度相当(剂量后第 1 周期(C)低 1.2%,第 4 周期前(C4)高 4.4%;第 4 周期后低 6.8%)。来自亚洲患者的观察到的未结合 MMAE 浓度分别低 6.5%(C1 后)、20.0%(C4 前)和 15.3%(C4 后)。在 PopPK 分析中,acMMAE 的 C6 曲线下面积和峰血浆浓度也相似(亚洲患者分别低 6.3%和 3.0%),未结合 MMAE 分别低 19.1%和 16.7%。按地区,来自亚洲和亚洲以外地区的患者的 C6 平均 acMMAE 浓度相似,而 C6 平均未结合 MMAE 浓度分别低 3.9%-7.0%和 17.3%-19.7%。总之,在人种和地区方面,亚洲和非亚洲患者的泊洛妥珠单抗联合维布妥昔单抗 PK 相似,提示 PK 不受亚洲人种影响,无需调整亚洲患者的剂量以维持疗效和安全性。