Clinical Pharmacology Department, Jiangsu Hengrui Pharmaceuticals Co., Ltd, Shanghai, China.
Oncology Clinical Research & Development, Jiangsu Hengrui Pharmaceuticals Co., Ltd., Shanghai, China.
CPT Pharmacometrics Syst Pharmacol. 2024 Jul;13(7):1238-1251. doi: 10.1002/psp4.13155. Epub 2024 May 6.
Adebrelimab, a novel anti-PD-L1 antibody, has been approved by the National Medical Products Administration of China as an intravenous infusion for use in combination with carboplatin and etoposide as first-line treatment for extensive-stage small-cell lung cancer in 2023. A two-compartment model with empirical time-varying CL for adebrelimab was established based on data from 263 patients receiving body weight-based doses from two clinical studies. Significant covariate effects of baseline body weight, albumin levels, tumor size, neutrophil counts, and presence of anti-drug antibodies were identified on CL of debrelimab, none of which were clinically significant or warranted dose adjustment. The degree of decrease in CL was higher in patients who responded to treatment with adebrelimab than in non-responders. Adebrelimab exposures (AUC, C, or C) were not identified as a statistically significant factor related to efficacy or safety endpoint in the exposure-response analysis. Distribution of simulated exposure metrics from the flat dose regimen (1200 mg q3w) was similar to the marketed weight-based dosing regimen (20 mg/kg q3w), supporting the alternative flat dose regimen in the clinic.
阿得贝利单抗是一种新型抗 PD-L1 抗体,于 2023 年被国家药品监督管理局批准为静脉输注药物,与卡铂和依托泊苷联合用于广泛期小细胞肺癌的一线治疗。本研究基于来自两项临床研究的 263 例接受基于体重剂量的患者数据,建立了阿得贝利单抗两室模型,其中 CL 采用经验性时变模型。CL 与基线体重、白蛋白水平、肿瘤大小、中性粒细胞计数和是否存在抗药物抗体等因素显著相关,均无临床意义或需要剂量调整。与非应答者相比,对阿得贝利单抗治疗有应答的患者 CL 下降幅度更高。在暴露-反应分析中,阿得贝利单抗的暴露量(AUC、C 或 C)与疗效或安全性终点均未被确定为具有统计学意义的相关因素。模拟的从固定剂量方案(1200mg q3w)分布的暴露量指标与上市的基于体重剂量方案(20mg/kg q3w)相似,支持该固定剂量方案在临床中的应用。