Kaneko Yutaka, Kabu Koki, Anazawa Yoshio
Medical Affairs, Genmab K.K.
Nihon Yakurigaku Zasshi. 2025 Jul 1;160(4):291-301. doi: 10.1254/fpj.24110. Epub 2025 Jun 13.
The treatment of recurrent or metastatic cervical cancer has entered a new era, with immune checkpoint inhibitors now being used as first-line standard of care options. Meanwhile, there is a lack of second-line and subsequent treatment options that can adapt to this changing treatment landscape, highlighting the need for the development of new treatments with novel mechanisms of action. Tisotumab vedotin (recombinant) is an antibody-drug conjugate (ADC) consisting of tisotumab, an anti-human tissue factor (TF) monoclonal antibody (IgG1κ), the microtubule inhibitor monomethyl auristatin E (MMAE), and a valine-citrulline linker. When the linker is cleaved by a protease in a tumor cell, MMAE is released to induce cell cycle arrest and apoptosis via disruption of the microtubular network. In non-clinical studies, tisotumab vedotin demonstrated concentration-dependent cytotoxic and anti-tumor activities. Tisotumab vedotin also mediated antibody-dependent cellular cytotoxicity (ADCC) and antibody-dependent cellular phagocytosis (ADCP) activities. In a global Phase III study of tisotumab vedotin as second- or third-line therapy in patients with recurrent or metastatic cervical cancer (Study SGNTV-003/innovaTV 301), the drug demonstrated higher efficacy than the investigator's choice of chemotherapy. Although some eye-related adverse events occurred as unique toxicities, the safety profile of tisotumab vedotin was generally manageable. The results of analysis in the Japanese subpopulation of the SGNTV-003 (innovaTV 301) study were consistent with those of the overall population. Based on these results, tisotumab vedotin received regulatory approval in Japan in March 2025 for the indication of "advanced or recurrent cervical cancer that has progressed after cancer chemotherapy".
复发性或转移性宫颈癌的治疗已进入一个新时代,免疫检查点抑制剂现已被用作一线标准治疗方案。与此同时,缺乏能够适应这种不断变化的治疗格局的二线及后续治疗方案,这凸显了开发具有新作用机制的新疗法的必要性。替索妥单抗(重组)是一种抗体药物偶联物(ADC),由替索妥单抗(一种抗人组织因子(TF)单克隆抗体(IgG1κ))、微管抑制剂单甲基奥瑞他汀E(MMAE)和缬氨酸-瓜氨酸连接子组成。当连接子在肿瘤细胞中被蛋白酶切割时,MMAE被释放出来,通过破坏微管网络诱导细胞周期停滞和凋亡。在非临床研究中,替索妥单抗表现出浓度依赖性的细胞毒性和抗肿瘤活性。替索妥单抗还介导抗体依赖性细胞毒性(ADCC)和抗体依赖性细胞吞噬(ADCP)活性。在一项关于替索妥单抗作为复发性或转移性宫颈癌患者二线或三线治疗的全球III期研究(研究SGNTV-003/innovaTV 301)中,该药物显示出比研究者选择的化疗更高的疗效。尽管发生了一些与眼睛相关的不良事件作为独特的毒性反应,但替索妥单抗的安全性总体上是可控的。SGNTV-003(innovaTV 301)研究日本亚组的分析结果与总体人群的结果一致。基于这些结果,替索妥单抗于2025年3月在日本获得监管批准用于“癌症化疗后进展的晚期或复发性宫颈癌”适应症。