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zolbetuximab 联合唑来膦酸和白介素-2 多剂量在晚期胃癌和胃食管结合部癌患者 1 期研究中的免疫学效应和活性

英文原题:Immunological effects and activity of multiple doses of zolbetuximab in combination with zoledronic acid and interleukin-2 in a phase 1 study in patients with advanced gastric and gastroesophageal junction cancer.

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Immunological effects and activity of multiple doses of zolbetuximab in combination with zoledronic acid and interleukin-2 in a phase 1 study in patients with advanced gastric and gastroesophageal junction cancer.

PubMed 2023/01/06(内容时间) J Cancer Res Clin Oncol Q2 · IF 3.3(JCR 2025)

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研究概要

Zolbetuximab 在经治晚期 G/GEJ 癌症患者中介导了高效的 ADCC。ZA + IL-2 联合治疗并未进一步改善这一效应。

研究思路结论见上方概要

Zolbetuximab (IMAB362) 经工程化改造以诱导抗体依赖性细胞介导的细胞毒性 (ADCC) 和补体依赖性细胞毒性。我们评估了 ADCC 活性以及免疫调节药物唑来膦酸 (ZA) 和白细胞介素-2 (IL-2) 与 zolbetuximab 联合治疗对相关免疫细胞群和 ADCC 裂解活性的影响。

这项1期、多中心、开放标签研究,探讨了在既往接受过治疗的晚期胃和胃食管结合部(G/GEJ)腺癌患者中,单独使用zolbetuximab(n = 5)或联合ZA(n = 7)或联合ZA加两种不同剂量水平的IL-2(低剂量:1百万国际单位[mIU] [n = 9];中等剂量:3 mIU [n = 7])多次给药后的免疫学效应和活性、安全性、耐受性及抗肿瘤活性。

28例既往接受过治疗的晚期CLDN18.2表达G/GEJ腺癌患者被纳入四个治疗组。zolbetuximab + ZA + IL-2治疗在给药后2天内诱导了介导ADCC的细胞群,即γ9δ2 T细胞和NK 细胞的短暂扩增和活化;这一效应在中等剂量IL-2时更为明显。两种IL-2剂量下调节性T细胞的扩增和活化均为中等程度且短暂。单用zolbetuximab即可观察到强ADCC活性。在几例接受ZA + 中等剂量IL-2治疗的患者中观察到短暂的ADCC活性,但低剂量IL-2组未观察到。在临床疗效人群中,最佳确认缓解为疾病稳定(n = 11/19;58%)。

展开英文摘要原文

Zolbetuximab (IMAB362) is engineered to induce antibody-dependent cell-mediated cytotoxicity (ADCC) and complement-dependent cytotoxicity. We evaluated ADCC activity and the impact of the immune-modulating drugs zoledronic acid (ZA) and interleukin-2 (IL-2) as co-treatment with zolbetuximab on relevant immune cell populations and ADCC lysis activity.

This phase 1, multicenter, open-label study investigated the immunological effects and activity, safety, tolerability, and antitumor activity of multiple doses of zolbetuximab alone (n = 5) or in combination with ZA (n = 7) or with ZA plus two different dose levels of IL-2 (low dose: 1 million international units [mIU] [n = 9]; intermediate dose: 3 mIU [n = 7]) in pretreated patients with advanced gastric and gastroesophageal junction (G/GEJ) adenocarcinoma.

Twenty-eight patients with previously treated advanced G/GEJ adenocarcinoma that was CLDN18.2-expressing were enrolled into four treatment arms. Treatment with zolbetuximab + ZA + IL-2 induced short-lived expansion and activation of ADCC-mediating cell populations, namely γ9δ2 T cells and natural killer cells, within 2 days after administration; this effect was more pronounced with intermediate-dose IL-2. Expansion and activation of regulatory T cells treated with either IL2 dose was moderate and short-lived. Strong ADCC activity was observed with zolbetuximab alone. Short-lived ADCC activity was observed in several patients treated with ZA + intermediate-dose IL-2, but not lower-dose IL-2. In the clinical efficacy population, the best confirmed response was stable disease (n = 11/19; 58%).

Zolbetuximab mediates proficient ADCC in patients with pretreated advanced G/GEJ cancers. Co-treatment with ZA + IL-2 did not further improve this effect. TRIAL REGISTRATION: NCT01671774.

论文信息

作者
Lordick F、Thuss-Patience P、Bitzer M、Maurus D、Sahin U、Türeci Ö
单位
Department of Oncology, Gastroenterology, Hepatology, and Pulmonology, Comprehensive Cancer Center Central Germany (CCCG), University of Leipzig Medical Center, Liebigstraße 22, 04103, Leipzig, Germany. florian.lordick@medizin.uni-leipzig.de.Germany
文献类型
多中心研究 · I 期临床试验
期刊
Journal of cancer research and clinical oncology2023 Aug
原文标识
PubMed 36607429 · DOI 10.1007/s00432-022-04459-3