研究概要
ANV419 在最高达 243 µg/kg(即 RP2D)的剂量下耐受性良好,并在重度经治的晚期实体瘤患者人群中显示出抗肿瘤活性迹象。
研究思路结论见上方概要
背景
ANV419是一种稳定的抗体-细胞因子融合蛋白,由白细胞介素-2(IL-2)与抗IL-2单克隆抗体融合而成,该抗体在空间上阻碍IL-2与其受体α亚基的结合,但对受体βγ亚基具有选择性亲和力。因此,ANV419优先刺激与肿瘤杀伤相关的CD8+效应T细胞和NK 细胞,同时最大限度地减少免疫抑制性调节性T细胞的激活。
方法
ANV419-001是一项开放标签、多中心、1期研究,旨在评估ANV419的安全性、耐受性、最大耐受剂量(MTD)和推荐的2期剂量(RP2D)。次要目标是表征药代动力学、药效学和肿瘤反应。入组对象为既往接受过≥1线全身治疗后疾病进展的晚期实体瘤成人患者。ANV419通过静脉输注给药,每2周一次,计划治疗持续时间为12个月。研究的剂量递增部分以单患者队列探索了3、6和12 µg/kg剂量,随后采用3+3设计探索24-364 µg/kg。此处报告中期结果(数据截止日期:2023年3月22日)。
结果
40例患者入组并接受了至少一剂ANV419治疗。MTD和RP2D确定为243 µg/kg。最常见的ANV419相关治疗中出现的不良事件为1级和2级发热(31例(77.5%))、寒战(23例(57.5%))、呕吐(14例(35.0%))、细胞因子释放综合征和恶心(各12例(30.0%))。所有患者均观察到因淋巴细胞再分布导致的短暂且自限性淋巴细胞减少。在RP2D队列中,各有1例患者(12.5%)报告了≥3级血小板减少症和发热。所有事件均可通过标准支持治疗进行管理。在243 µg/kg(RP2D/MTD)剂量下,估计T 1/2约为12小时。在ANV419剂量≥108 µg/kg时,64%的患者最佳缓解至少为SD(15例SD和1例确认的PR)。
展开英文摘要原文
BACKGROUND: ANV419 is a stable antibody-cytokine fusion protein consisting of interleukin-2 (IL-2) fused to an anti-IL-2 monoclonal antibody that sterically hinders binding of IL-2 to the α subunit of its receptor but has selective affinity for the receptor βγ subunits. Thus, ANV419 preferentially stimulates CD8 + effector T cells and natural killer cells which are associated with tumor killing, while minimizing the activation of immunosuppressive regulatory T cells.
METHODS: ANV419-001 is an open-label, multicenter, phase 1 study to evaluate the safety, tolerability, maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D) of ANV419. Secondary objectives were to characterize the pharmacokinetics, pharmacodynamics and tumor response. Adult patients with advanced solid tumors and disease progression after ≥1 previous line of systemic therapy were enrolled. ANV419 was administered by intravenous infusion once every 2 weeks, with a planned treatment duration of 12 months. The dose escalation part of the study explored doses 3, 6 and 12 µg/kg as single patient cohorts followed by 24-364 µg/kg in a 3+3 design. Interim results are reported here (data cut-off: March 22, 2023).
RESULTS: Forty patients were enrolled and received at least one dose of ANV419. The MTD and RP2D were determined to be 243 µg/kg. The most common ANV419-related treatment-emergent adverse events were Grade 1 and 2 fever (31 (77.5%)), chills (23 (57.5%), vomiting (14 (35.0%)), cytokine release syndrome and nausea (12 (30.0%) each). Transient and self-limiting lymphopenia due to lymphocyte redistribution was observed in all patients. In the RP2D cohort, Grade ≥3 thrombocytopenia and fever were reported by one patient (12.5%) each. All events were manageable with standard supportive care. At doses of 243 µg/kg (RP2D/MTD), the estimated T 1/2 was approximately 12 hours. At ANV419 doses ≥108 µg/kg, 64% of patients had a best response of at least SD (15 SD and 1 confirmed PR).
CONCLUSIONS: ANV419 at doses up to 243 µg/kg (the RP2D) was well tolerated and showed signs of antitumor activity in a heavily pretreated patient population with advanced solid tumors.
TRIAL REGISTRATION NUMBER: NCT04855929.
论文信息
- 作者
- Joerger M、Calvo E、Laubli H、Lopez J、Alonso G、Corral de la Fuente E、Hess D、König D
- 单位
- Department of Medical Oncology & Hematology, Cantonal Hospital, St. Gallen, Switzerland markus.joerger@kssg.ch.Switzerland
- 文献类型
- I 期临床试验 · 多中心研究 · 非美国政府资助研究
- 期刊
- Journal for immunotherapy of cancer2023 Nov 21