1
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Jiang Z, Sun W, Du R, Yang R. A review of dose escalation for FDA-approved products treating solid tumors and hematological malignancies in first-in-human trials. Clin Transl Oncol 2024; 26:2116-2125. [PMID: 38558284 DOI: 10.1007/s12094-024-03451-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/05/2024] [Indexed: 04/04/2024]
Abstract
First-in-human (FIH) dose-escalation trials on oncology should prioritize safety and emphasize efficacy. We reviewed the FIH trials of 67 anti-tumor products approved by the Food and Drug Administration between 2018 and 2023 and found that the "3 + 3" design remains the predominant dose-escalation method (66.2%). The number of patients receiving sub-therapeutic doses is positively correlated with the maximum tolerated dose (MTD) or maximum dose (MD) to starting dose ratio (P = 0.056) and the number of dose levels in trials (P < 0.001). In addition, the proportion of products with a high ratio in antibody drugs is higher than that in small molecules (P < 0.001). The MTD or MD exceeded the label dose by three or more doses in 22.03% of the products. In conclusion, optimizing the starting dose selection method, refining the way of determining doses, and finding alternative indicators to replace toxicity as the endpoints will increase the effectiveness and broaden the beneficiary scope.
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Affiliation(s)
- Zehui Jiang
- Gobroad Healthcare Group, 20 Lize Road, Beijing, 100073, China
| | - Wenxuan Sun
- Gobroad Healthcare Group, 20 Lize Road, Beijing, 100073, China
| | - Rui Du
- Gobroad Healthcare Group, 20 Lize Road, Beijing, 100073, China
| | - Rui Yang
- Gobroad Healthcare Group, 20 Lize Road, Beijing, 100073, China.
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2
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Peterlin P, Saada-Bouzid E, Moskovitz M, Pigneux A, Yuda J, Sinnollareddy M, Henner WR, Chen D, Freise KJ, Leibman RS, Avigdor A, Shimizu T. First-in-human clinical trial results with ABBV-184, a first-in-class T-cell receptor/anti-CD3 bispecific protein, in adults with previously treated AML or NSCLC. Expert Rev Anticancer Ther 2024; 24:893-904. [PMID: 38946484 DOI: 10.1080/14737140.2024.2373888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 06/14/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND ABBV-184, a novel survivin peptide-targeting T-cell receptor (TCR)/anti-CD3 bispecific protein, demonstrated preclinical T-cell activation and cytotoxicity toward HLA-A2:01-positive tumor lines. This first-in-human trial evaluated ABBV-184 monotherapy in patients with acute myeloid leukemia (AML) and non-small cell lung cancer (NSCLC). RESEARCH DESIGN AND METHODS This phase 1 multicenter, open-label, dose escalation trial (NCT04272203) enrolled adult patients with relapsed/refractory AML or NSCLC with an HLA-A2:01 restricted genotype. Patients received ABBV-184 at 0.07 ug/kg initially, with 2- to 3-fold dose increases. The primary objective was determining the ABBV-184 recommended phase 2 dose. Secondary objectives included safety, tolerability, pharmacokinetics, and immunogenicity assessments. RESULTS Fifteen patients enrolled in the dose escalation (8 AML and 7 NSCLC). ABBV-184 doses ranged from 0.07 mg/kg-0.7 µg/kg, with a half-life of approximately 13-29 hours. Transient cytokine increases were observed at all dose levels, and in patients with NSCLC, transient peripheral blood lymphocyte decreases were observed. The most frequently reported treatment-emergent adverse events (TEAEs) were anemia, diarrhea, and headache. Grade 1-2 infusion-related reaction (IRR) and cytokine release syndrome (CRS) TEAEs were reported. CONCLUSIONS ABBV-184 was well tolerated and demonstrated preliminary evidence of CD3 engagement with transient cytokine increases and peripheral lymphocyte decreases. CLINICAL TRIAL REGISTRATION NCT04272203.
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MESH Headings
- Humans
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/pathology
- Carcinoma, Non-Small-Cell Lung/drug therapy
- Carcinoma, Non-Small-Cell Lung/pathology
- Middle Aged
- Male
- Antibodies, Bispecific/administration & dosage
- Antibodies, Bispecific/adverse effects
- Antibodies, Bispecific/pharmacology
- Aged
- Female
- Lung Neoplasms/drug therapy
- Lung Neoplasms/pathology
- Lung Neoplasms/immunology
- CD3 Complex
- Adult
- Dose-Response Relationship, Drug
- Receptors, Antigen, T-Cell
- HLA-A2 Antigen
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Affiliation(s)
- Pierre Peterlin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Cote d'Azur University, Centre Anticancer Antoine Lacassagne, Nice, France
| | - Mor Moskovitz
- Division of Oncology, Thoracic Cancer Service, Haifa, Israel
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel
| | - Arnaud Pigneux
- Department of Hematology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Junichiro Yuda
- Department of Hematology and Experimental Therapeutics, National Cancer Center Hospital East, Chiba, Japan
| | | | | | | | | | | | - Abraham Avigdor
- Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Toshio Shimizu
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
- Department of Pulmonary Medicine and Medical Oncology, Wakayama Medical University Hospital, Wakayama Medical University Graduate School of Medicine, Wakayama, Japan
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3
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Matsumoto M, Polli JR, Swaminathan SK, Datta K, Kampershroer C, Fortin MC, Salian-Mehta S, Dave R, Yang Z, Arora P, Hiura M, Suzuki M, Brennan FR, Sathish J. Beyond MABEL: An Integrative Approach to First in Human Dose Selection of Immunomodulators by the Health and Environmental Sciences Institute (HESI) Immuno-Safety Technical Committee (ITC). Clin Pharmacol Ther 2024; 116:546-562. [PMID: 38847597 DOI: 10.1002/cpt.3316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/13/2024] [Indexed: 08/22/2024]
Abstract
Administration of a new drug candidate in a first-in-human (FIH) clinical trial is a particularly challenging phase in drug development and is especially true for immunomodulators, which are a diverse and complex class of drugs with a broad range of mechanisms of action and associated safety risks. Risk is generally greater for immunostimulators, in which safety concerns are associated with acute toxicity, compared to immunosuppressors, where the risks are related to chronic effects. Current methodologies for FIH dose selection for immunostimulators are focused primarily on identifying the minimum anticipated biological effect level (MABEL), which has often resulted in sub-therapeutic doses, leading to long and costly escalation phases. The Health and Environmental Sciences Institute (HESI) - Immuno-Safety Technical Committee (ITC) organized a project to address this issue through two complementary approaches: (i) an industry survey on FIH dose selection strategies and (ii) detailed case studies for immunomodulators in oncology and non-oncology indications. Key messages from the industry survey responses highlighted a preference toward more dynamic PK/PD approaches as in vitro assays are seemingly not representative of true physiological conditions for immunomodulators. These principles are highlighted in case studies. To address the above themes, we have proposed a revised decision tree, which expands on the guidance by the IQ MABEL Working Group (Leach et al. 2021). This approach facilitates a more refined recommendation of FIH dose selection for immunomodulators, allowing for a nuanced consideration of their mechanisms of action (MOAs) and the associated risk-to-benefit ratio, among other factors.
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Affiliation(s)
- Mineo Matsumoto
- Review Division, Pharmaceuticals and Medical Devices Agency (PMDA), Chiyoda-ku, Tokyo, Japan
| | - Joseph Ryan Polli
- Pharmacokinetic Sciences, Translational Medicine, Novartis Biomedical Research, Cambridge, Massachusetts, USA
| | | | - Kaushik Datta
- Nonclinical Safety, Bristol-Myers Squibb, New Brunswick, New Jersey, USA
| | | | - Marie C Fortin
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy, Rutgers University, New Jersey, USA
| | - Smita Salian-Mehta
- Nonclinical Safety and Pathobiology, Gilead Sciences, Foster City, California, USA
| | - Rutwij Dave
- Drug Metabolism and Pharmacokinetics, Gilead Sciences, Foster City, California, USA
| | - Zheng Yang
- Drug Metabolism and Pharmacokinetics, Alnylam Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Payal Arora
- Translational Research, Kyowa Kirin Pharmaceuticals, Princeton, New Jersey, USA
| | - Masanori Hiura
- Translational Research, Kyowa Kirin, Sunto-gun, Shizuoka, Japan
| | - Mizuho Suzuki
- Review Division, Pharmaceuticals and Medical Devices Agency (PMDA), Chiyoda-ku, Tokyo, Japan
| | | | - Jean Sathish
- Comparative Medicine and Drug Safety R&D, Pfizer, Pearl River, New York, USA
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4
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Lotze MT, Olejniczak SH, Skokos D. CD28 co-stimulation: novel insights and applications in cancer immunotherapy. Nat Rev Immunol 2024:10.1038/s41577-024-01061-1. [PMID: 39054343 DOI: 10.1038/s41577-024-01061-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/27/2024]
Abstract
Substantial progress in understanding T cell signalling, particularly with respect to T cell co-receptors such as the co-stimulatory receptor CD28, has been made in recent years. This knowledge has been instrumental in the development of innovative immunotherapies for patients with cancer, including immune checkpoint blockade antibodies, adoptive cell therapies, tumour-targeted immunostimulatory antibodies, and immunostimulatory small-molecule drugs that regulate T cell activation. Following the failed clinical trial of a CD28 superagonist antibody in 2006, targeted CD28 agonism has re-emerged as a technologically viable and clinically promising strategy for cancer immunotherapy. In this Review, we explore recent insights into the molecular functions and regulation of CD28. We describe how CD28 is central to the success of current cancer immunotherapies and examine how new questions arising from studies of CD28 as a clinical target have enhanced our understanding of its biological role and may guide the development of future therapeutic strategies in oncology.
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Affiliation(s)
- Michael T Lotze
- Department of Surgery, University of Pittsburgh Hillman Cancer Center, Pittsburgh, PA, USA.
- Department of Immunology, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Scott H Olejniczak
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
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5
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Zhang N, Li Y, Cui W, Yu X, Huang Y. Application of quantitative pharmacology analysis to support early clinical development of oncology drugs: dose selection. Xenobiotica 2024; 54:420-423. [PMID: 38994684 DOI: 10.1080/00498254.2024.2377577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 07/04/2024] [Indexed: 07/13/2024]
Abstract
The selection of appropriate starting dose and suitable method to predict an efficacious dose for novel oncology drug in the early clinical development stage poses significant challenges. The traditional methods of using body surface area transformation from toxicology studies to predict the first-in human (FIH) starting dose, or simply selecting the maximum tolerated dose (MTD) or maximum administered dose (MAD) as efficacious dose or recommended phase 2 dose (RP2D), are usually inadequate and risky for novel oncology drugs.Due to the regulatory efforts aimed at improving dose optimisation in oncology drug development, clinical dose selection is now shifting away from these traditional methods towards a comprehensive benefit/risk assessment-based approach. Quantitative pharmacology analysis (QPA) plays a crucial role in this new paradigm. This mini-review summarises the use of QPA in selecting the starting dose for oncology FIH studies and potential efficacious doses for expansion or phase 2 trials. QPA allows for a more rational and scientifically based approach to dose selection by integrating information across studies and development phases.In conclusion, the application of QPA in oncology drug development has the potential to significantly enhance the success rates of clinical trials and ultimately support clinical decision-making, particularly in dose selection.
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Affiliation(s)
| | - Yu Li
- Hansoh Pharmaceutical Group, Shanghai, China
| | - Wenbin Cui
- Hansoh Pharmaceutical Group, Shanghai, China
| | | | - Ying Huang
- Hansoh Pharmaceutical Group, Shanghai, China
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6
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Kulesza A, Couty C, Lemarre P, Thalhauser CJ, Cao Y. Advancing cancer drug development with mechanistic mathematical modeling: bridging the gap between theory and practice. J Pharmacokinet Pharmacodyn 2024:10.1007/s10928-024-09930-x. [PMID: 38904912 DOI: 10.1007/s10928-024-09930-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 06/07/2024] [Indexed: 06/22/2024]
Abstract
Quantitative predictive modeling of cancer growth, progression, and individual response to therapy is a rapidly growing field. Researchers from mathematical modeling, systems biology, pharmaceutical industry, and regulatory bodies, are collaboratively working on predictive models that could be applied for drug development and, ultimately, the clinical management of cancer patients. A plethora of modeling paradigms and approaches have emerged, making it challenging to compile a comprehensive review across all subdisciplines. It is therefore critical to gauge fundamental design aspects against requirements, and weigh opportunities and limitations of the different model types. In this review, we discuss three fundamental types of cancer models: space-structured models, ecological models, and immune system focused models. For each type, it is our goal to illustrate which mechanisms contribute to variability and heterogeneity in cancer growth and response, so that the appropriate architecture and complexity of a new model becomes clearer. We present the main features addressed by each of the three exemplary modeling types through a subjective collection of literature and illustrative exercises to facilitate inspiration and exchange, with a focus on providing a didactic rather than exhaustive overview. We close by imagining a future multi-scale model design to impact critical decisions in oncology drug development.
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Affiliation(s)
| | - Claire Couty
- Novadiscovery, 1 Place Giovanni Verrazzano, 69009, Lyon, France
| | - Paul Lemarre
- Novadiscovery, 1 Place Giovanni Verrazzano, 69009, Lyon, France
| | - Craig J Thalhauser
- Genmab US, Inc., 777 Scudders Mill Rd Bldg 2 4th Floor, Plainsboro, NJ, 08536, USA
| | - Yanguang Cao
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
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7
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Saber H, Thompson MD, Leighton JK. Pharmacokinetic models for first-in-human dose selection of immune-activating products in oncology. Regul Toxicol Pharmacol 2024; 149:105616. [PMID: 38561147 DOI: 10.1016/j.yrtph.2024.105616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/06/2024] [Accepted: 03/27/2024] [Indexed: 04/04/2024]
Abstract
Pharmacokinetic (PK) models are increasingly submitted to the FDA to support first-in-human (FIH) dose selection of immune-oncology products. To examine whether a simple PK modeling (SPM) using clearance for scaling was acceptable for dose estimation, FIH(SPM) doses were computed and compared to doses that were safely administered to patients. We concluded that the SPM approach is acceptable in FIH dose estimation, but the variables should be carefully selected for CD3 constructs. For CD3 constructs, use of 60 kg BWh, a clearance exponent of 0.75, and a targeted plasma concentration based on relevant and/or sensitive activity assays was an acceptable approach for FIH dose selection; use of 0.85 as the scaling factor is questionable at this time as it resulted in a FIH dose that was too close to the AHD for one product (7%). Immune activating mAbs were not sensitive to changes in the clearance exponent (0.75-0.85) or body weight (60-70 kg). For PD-1/PD-L1 mAbs, using products' in vitro EC50 in the model resulted in suboptimal FIH doses and clinical data of closely related products informed FIH dose selection. PK models submitted by sponsors were diverse in methods, assumptions, and variables, and the resulting FIH doses were not always optimal.
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Affiliation(s)
- Haleh Saber
- US Food and Drug Administration, Center for Drug Evaluation and Research, Office of Oncologic Diseases, 10903 New Hampshire Ave, Silver Spring, MD, 20903, United States.
| | - Matthew D Thompson
- US Food and Drug Administration, Center for Drug Evaluation and Research, Office of Oncologic Diseases, 10903 New Hampshire Ave, Silver Spring, MD, 20903, United States
| | - John K Leighton
- US Food and Drug Administration, Center for Drug Evaluation and Research, Office of Oncologic Diseases, 10903 New Hampshire Ave, Silver Spring, MD, 20903, United States
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8
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Kenney RT, Cini JK, Dexter S, DaFonseca M, Bingham J, Kuan I, Chawla SP, Polasek TM, Lickliter J, Ryan PJ. A phase I trial of SON-1010, a tumor-targeted, interleukin-12-linked, albumin-binding cytokine, shows favorable pharmacokinetics, pharmacodynamics, and safety in healthy volunteers. Front Immunol 2024; 15:1362775. [PMID: 38487528 PMCID: PMC10937388 DOI: 10.3389/fimmu.2024.1362775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/09/2024] [Indexed: 03/17/2024] Open
Abstract
Background The benefits of recombinant interleukin-12 (rIL-12) as a multifunctional cytokine and potential immunotherapy for cancer have been sought for decades based on its efficacy in multiple mouse models. Unexpected toxicity in the first phase 2 study required careful attention to revised dosing strategies. Despite some signs of efficacy since then, most rIL-12 clinical trials have encountered hurdles such as short terminal elimination half-life (T½), limited tumor microenvironment targeting, and substantial systemic toxicity. We developed a strategy to extend the rIL-12 T½ that depends on binding albumin in vivo to target tumor tissue, using single-chain rIL-12 linked to a fully human albumin binding (FHAB) domain (SON-1010). After initiating a dose-escalation trial in patients with cancer (SB101), a randomized, double-blind, placebo-controlled, single-ascending dose (SAD) phase 1 trial in healthy volunteers (SB102) was conducted. Methods SB102 (NCT05408572) focused on safety, tolerability, pharmacokinetic (PK), and pharmacodynamic (PD) endpoints. SON-1010 at 50-300 ng/kg or placebo administered subcutaneously on day 1 was studied at a ratio of 6:2, starting with two sentinels; participants were followed through day 29. Safety was reviewed after day 22, before enrolling the next cohort. A non-compartmental analysis of PK was performed and correlations with the PD results were explored, along with a comparison of the SON-1010 PK profile in SB101. Results Participants receiving SON-1010 at 100 ng/kg or higher tolerated the injection but generally experienced more treatment-emergent adverse effects (TEAEs) than those receiving the lowest dose. All TEAEs were transient and no other dose relationship was noted. As expected with rIL-12, initial decreases in neutrophils and lymphocytes returned to baseline by days 9-11. PK analysis showed two-compartment elimination in SB102 with mean T½ of 104 h, compared with one-compartment elimination in SB101, which correlated with prolonged but controlled and dose-related increases in interferon-gamma (IFNγ). There was no evidence of cytokine release syndrome based on minimal participant symptoms and responses observed with other cytokines. Conclusion SON-1010, a novel presentation for rIL-12, was safe and well-tolerated in healthy volunteers up to 300 ng/kg. Its extended half-life leads to a prolonged but controlled IFNγ response, which may be important for tumor control in patients. Clinical trial registration https://clinicaltrials.gov/study/NCT05408572, identifier NCT05408572.
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Affiliation(s)
| | - John K. Cini
- Sonnet BioTherapeutics, Inc, Princeton, NJ, United States
| | - Susan Dexter
- Sonnet BioTherapeutics, Inc, Princeton, NJ, United States
| | | | | | | | - Sant P. Chawla
- Sarcoma Oncology Center, Santa Monica, CA, United States
| | - Thomas M. Polasek
- Centre for Medicine Use and Safety, Monash University, Melbourne, VIC, Australia
- InClin, Inc, San Mateo, CA, United States
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9
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Gevertz JL, Kareva I. Minimally sufficient experimental design using identifiability analysis. NPJ Syst Biol Appl 2024; 10:2. [PMID: 38184643 PMCID: PMC10771435 DOI: 10.1038/s41540-023-00325-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/12/2023] [Indexed: 01/08/2024] Open
Abstract
Mathematical models are increasingly being developed and calibrated in tandem with data collection, empowering scientists to intervene in real time based on quantitative model predictions. Well-designed experiments can help augment the predictive power of a mathematical model but the question of when to collect data to maximize its utility for a model is non-trivial. Here we define data as model-informative if it results in a unique parametrization, assessed through the lens of practical identifiability. The framework we propose identifies an optimal experimental design (how much data to collect and when to collect it) that ensures parameter identifiability (permitting confidence in model predictions), while minimizing experimental time and costs. We demonstrate the power of the method by applying it to a modified version of a classic site-of-action pharmacokinetic/pharmacodynamic model that describes distribution of a drug into the tumor microenvironment (TME), where its efficacy is dependent on the level of target occupancy in the TME. In this context, we identify a minimal set of time points when data needs to be collected that robustly ensures practical identifiability of model parameters. The proposed methodology can be applied broadly to any mathematical model, allowing for the identification of a minimally sufficient experimental design that collects the most informative data.
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Affiliation(s)
- Jana L Gevertz
- Department of Mathematics and Statistics, The College of New Jersey, Ewing, NJ, USA.
| | - Irina Kareva
- Quantitative Pharmacology Department, EMD Serono, Merck KGaA, Billerica, MA, USA
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10
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Stresser DM, Kopec AK, Hewitt P, Hardwick RN, Van Vleet TR, Mahalingaiah PKS, O'Connell D, Jenkins GJ, David R, Graham J, Lee D, Ekert J, Fullerton A, Villenave R, Bajaj P, Gosset JR, Ralston SL, Guha M, Amador-Arjona A, Khan K, Agarwal S, Hasselgren C, Wang X, Adams K, Kaushik G, Raczynski A, Homan KA. Towards in vitro models for reducing or replacing the use of animals in drug testing. Nat Biomed Eng 2023:10.1038/s41551-023-01154-7. [PMID: 38151640 DOI: 10.1038/s41551-023-01154-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Affiliation(s)
- David M Stresser
- Quantitative, Translational & ADME Sciences, AbbVie, North Chicago, IL, USA.
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ), .
- IQ Microphysiological Systems Affiliate (IQ-), .
| | - Anna K Kopec
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Drug Safety Research & Development, Pfizer, Inc., Groton, CT, USA
| | - Philip Hewitt
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Chemical and Preclinical Safety, Merck KGaA, Darmstadt, Germany
| | - Rhiannon N Hardwick
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Discovery Toxicology, Pharmaceutical Candidate Optimization, Bristol Myers Squibb, San Diego, CA, USA
| | - Terry R Van Vleet
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Investigative Toxicology and Pathology, AbbVie, North Chicago, IL, USA
| | - Prathap Kumar S Mahalingaiah
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Investigative Toxicology and Pathology, AbbVie, North Chicago, IL, USA
| | - Denice O'Connell
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- Global Animal Welfare, AbbVie, North Chicago, IL, USA
- IQ 3Rs (Replacement, Reduction, Refinement) Translational and Predictive Sciences Leadership Group
| | - Gary J Jenkins
- Quantitative, Translational & ADME Sciences, AbbVie, North Chicago, IL, USA
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Translational and ADME Sciences Leadership Group (TALG)
| | - Rhiannon David
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Clinical Pharmacology & Safety Sciences, AstraZeneca, Cambridge, UK
| | - Jessica Graham
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- Product Quality & Occupational Toxicology, Genentech, Inc., South San Francisco, CA, USA
- IQ DruSafe
- Safety Assessment, Genentech, Inc., South San Francisco, CA, USA
| | - Donna Lee
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ 3Rs (Replacement, Reduction, Refinement) Translational and Predictive Sciences Leadership Group
- Safety Assessment, Genentech, Inc., South San Francisco, CA, USA
| | - Jason Ekert
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- UCB Pharma, Cambridge, MA, USA
| | - Aaron Fullerton
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Investigative Toxicology, Genentech, Inc., South San Francisco, CA, USA
| | - Remi Villenave
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Piyush Bajaj
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Global Investigative Toxicology, Preclinical Safety, Sanofi, Cambridge, MA, USA
| | - James R Gosset
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Pharmacokinetics, Dynamics and Metabolism, Medicine Design, Pfizer, Inc, Cambridge, MA, USA
| | - Sherry L Ralston
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ 3Rs (Replacement, Reduction, Refinement) Translational and Predictive Sciences Leadership Group
- Preclinical Safety, AbbVie, North Chicago, IL, USA
| | - Manti Guha
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Discovery Biology, Incyte, Wilmington, DE, USA
| | - Alejandro Amador-Arjona
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Discovery Biology, Incyte, Wilmington, DE, USA
| | - Kainat Khan
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Clinical Pharmacology & Safety Sciences, AstraZeneca, Cambridge, UK
| | - Saket Agarwal
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Investigative Toxicology, Early Development, Alnylam Pharmaceuticals, Cambridge, MA, USA
| | - Catrin Hasselgren
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ DruSafe
- Predictive Toxicology, Genentech, Inc., South San Francisco, CA, USA
| | - Xiaoting Wang
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Translational Safety & Bioanalytical Sciences, Amgen Research, Amgen Inc., South San Francisco, CA, USA
| | - Khary Adams
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ 3Rs (Replacement, Reduction, Refinement) Translational and Predictive Sciences Leadership Group
- Laboratory Animal Resources, Incyte, Wilmington, DE, USA
| | - Gaurav Kaushik
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Nonclinical Drug Safety, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA
| | - Arkadiusz Raczynski
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ)
- IQ Microphysiological Systems Affiliate (IQ-)
- Preclinical Safety Assessment, Vertex Pharmaceuticals, Inc, Boston, MA, USA
| | - Kimberly A Homan
- International Consortium for Innovation and Quality in Pharmaceutical Development (IQ), .
- IQ Microphysiological Systems Affiliate (IQ-), .
- Complex in vitro Systems Group, Genentech, Inc., South San Francisco, CA, USA.
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11
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Blümel M, Liu J, de Jong I, Weiser S, Fast J, Litowski J, Shuman M, Mehta SB, Amery L, Tan DCT, Jia F, Shekhawat D, Dagallier C, Emamzadeh M, Medina A, Santos C, Gasser F, Urban C. Current Industry Best Practice on in-use Stability and Compatibility Studies for Biological Products. J Pharm Sci 2023; 112:2332-2346. [PMID: 37160227 DOI: 10.1016/j.xphs.2023.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/03/2023] [Accepted: 05/03/2023] [Indexed: 05/11/2023]
Abstract
Evaluating the in-use stability of a biological product including its compatibility with administration components allows to define handling instructions and potential hold times that retain product quality during dose preparation and administration. The intended drug product usage may involve the dilution of drug formulation into admixtures for infusion and exposure to new interfaces of administration components like intravenous (iv) bags, syringes, and tubing. In-use studies assess the potential impact on product quality by simulating drug handling throughout the defined in-use period. Considering the wide range of in-use conditions and administration components available globally, only limited guidance is available from regulators on expected in-use stability data. A working group reviewed and consolidated industry approaches to assess physicochemical stability of traditional protein-based biological products during clinical development and for commercial use. The insights compiled in this review article can be leveraged across the industry and encompass topics such as representative drug product material and administration components, testing conditions, quality attributes evaluated and respective acceptance criteria, applied quality standards, and regulatory requirements. These practices may help companies in the study design, and they may inform discussions with global regulators.
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Affiliation(s)
- Markus Blümel
- Novartis Pharma AG, Biologics Analytical Development, Lichtstrasse 35, CH-4056 Basel, Switzerland.
| | - Jing Liu
- Seagen Inc., Pharmaceutical Sciences, 21717 30th Drive S.E., Building 3. Bothell, WA, 98021, USA.
| | - Isabella de Jong
- Genentech (A Member of the Roche Group), Pharmaceutical Development, 1 DNA Way, South San Francisco, CA, 94080, USA
| | - Sarah Weiser
- Pfizer; Biotherapeutics Pharmaceutical Sciences, 1 Burtt Road, Andover, MA 01810, USA
| | - Jonas Fast
- F. Hoffmann-La Roche Ltd., Pharmaceutical Development & Supplies, PTD Biologics Europe, Grenzacherstrasse 124, CH, 4070 Basel, Switzerland
| | - Jennifer Litowski
- Amgen Inc., Process Development, 360 Binney St., Cambridge, MA, 02141, USA
| | - Melissa Shuman
- GSK, Strategic External Development, Sterile Drug Product Operations, 1250 S. Collegeville Road Collegeville, PA, 19426, USA
| | - Shyam B Mehta
- Teva Branded Pharmaceutical Products, Drug Product Development and Operations, 145 Brandywine Pkwy, West Chester, PA 19380, USA
| | - Leanne Amery
- AstraZeneca, Dosage Form Design and Development, Aaron Klug Building, Granta Park, Cambridge, Cambridgeshire, CB21 6GH, UK
| | | | - Feng Jia
- Biogen, Biologics Drug Product, 225 Binney Street, Cambridge, MA, 02142, USA
| | - Dushyant Shekhawat
- Eli Lilly and Company, Bioproduct Research and Development, Indianapolis, IN, 46285, USA
| | - Camille Dagallier
- Sanofi, Biologics Drug Product Development, 1 impasse des ateliers, 94403 Vitry-Sur-Seine, France
| | - Mina Emamzadeh
- AstraZeneca, Dosage Form Design and Development, Aaron Klug Building, Granta Park, Cambridge, Cambridgeshire, CB21 6GH, UK
| | - Annette Medina
- AstraZeneca, Dosage Form Design and Development, One Medimmune Way, Gaithersburg, MD, 20878, USA
| | - Camilla Santos
- Amgen Inc., Product Quality, 40 Technology Way, West Greenwich, RI, 02817, USA
| | - Florian Gasser
- Novartis Pharma AG, Biologics Analytical Development, Biochemiestrasse 10, 6336 Langkampfen, Austria
| | - Christian Urban
- Sanofi, Biologics Drug Product Development, Industriepark Höchst, D-65926 Frankfurt am Main, Germany
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12
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Grimaldi C, Ibraghimov A, Kiessling A, Rattel B, Ji C, Fuller CL, Brennan FR, Regenass-Lechner F, Shenton J, Price KD, Piché MS, Steeves MA, Prell R, Dudal S, Kronenberg S, Freebern W, Blanset D. Current nonclinical approaches for immune assessments of immuno-oncology biotherapeutics. Drug Discov Today 2023; 28:103440. [PMID: 36375739 DOI: 10.1016/j.drudis.2022.103440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/30/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
Harnessing the immune system to kill tumors has been revolutionary and, as a result, has had an enormous benefit for patients in extending life and resulting in effective cures in some. However, activation of the immune system can come at the cost of undesirable adverse events such as cytokine release syndrome, immune-related adverse events, on-target/off-tumor toxicity, neurotoxicity and tumor lysis syndrome, which are safety risks that can be challenging to assess non-clinically. This article provides a review of the biology and mechanisms that can result in immune-mediated adverse effects and describes industry approaches using in vitro and in vivo models to aid in the nonclinical safety risk assessments for immune-oncology modalities. Challenges and limitations of knowledge and models are also discussed.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Sherri Dudal
- Roche Pharmaceutical Research and Early Development, United States
| | - Sven Kronenberg
- Roche Pharmaceutical Research and Early Development, United States
| | | | - Diann Blanset
- Boehringer Ingelheim Pharmaceuticals, Inc., United States.
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13
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Dudal S, Bissantz C, Caruso A, David-Pierson P, Driessen W, Koller E, Krippendorff BF, Lechmann M, Olivares-Morales A, Paehler A, Rynn C, Türck D, Van De Vyver A, Wang K, Winther L. Translating pharmacology models effectively to predict therapeutic benefit. Drug Discov Today 2022; 27:1604-1621. [PMID: 35304340 DOI: 10.1016/j.drudis.2022.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/03/2022] [Accepted: 03/11/2022] [Indexed: 12/26/2022]
Abstract
Many in vitro and in vivo models are used in pharmacological research to evaluate the role of targeted proteins in a disease. Understanding the translational relevance and limitation of these models for analyzing the disposition, pharmacokinetic/pharmacodynamic (PK/PD) profile, mechanism, and efficacy of a drug, is essential when selecting the most appropriate model of the disease of interest and predicting clinically efficacious doses of the investigational drug. Here, we review selected animal models used in ophthalmology, infectious diseases, oncology, autoimmune diseases, and neuroscience. Each area has specific challenges around translatability and determination of an efficacious dose: new patient-specific dosing methods could help overcome these limitations.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Ken Wang
- F. Hoffmann-La Roche Ltd, Basel, Switzerland
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14
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Kale VP, Bebenek I, Ghantous H, Kapeghian J, Singh BP, Thomas LJ. Practical Considerations in Determining Adversity and the No-Observed-Adverse-Effect-Level (NOAEL) in Nonclinical Safety Studies: Challenges, Perspectives and Case Studies. Int J Toxicol 2022; 41:143-162. [PMID: 35230174 DOI: 10.1177/10915818211073047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Determining the adverse nature of findings from nonclinical safety studies often poses a challenge for the key stakeholders responsible for interpreting the results of definitive toxicity studies in support of pharmaceutical product development. Although there are instances in which responses to treatment clearly indicate intolerability or tissue injury associated with dysfunction; in practice, more often there is uncertainty in characterizing an effect of drug treatment as adverse or not. This is due to the inherent variability in responses of biological test systems to toxicological insults, leaving the ultimate analyses of adversity to individual interpretation and subjectivity. This article is a follow-up to the workshop entitled, "Adverse or Not Adverse?: Thinking process behind adversity determination during nonclinical drug development," conducted at the 58th Annual Meeting of the Society of Toxicology, March 2019 in Baltimore, MD. In this paper, we further discuss and incorporate the perspectives of authors representing different roles, such as Study Director, Study Pathologist, Pharmacology/Toxicology Reviewer (U.S. Food and Drug Administration), and Sponsor in the determination and use of adversity. We also present a practical stepwise approach as an aid in this assessment, and further apply these principles to discuss 10 case studies with different therapeutic modalities and unique challenges.
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Affiliation(s)
| | - Ilona Bebenek
- Food and Drug Administration, Silver Spring, MD, USA
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15
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Donnenberg VS, Wagner PL, Luketich JD, Bartlett DL, Donnenberg AD. Localized Intra-Cavitary Therapy to Drive Systemic Anti-Tumor Immunity. Front Immunol 2022; 13:846235. [PMID: 35222439 PMCID: PMC8873820 DOI: 10.3389/fimmu.2022.846235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 01/20/2022] [Indexed: 11/19/2022] Open
Abstract
Metastasis to the pleural and peritoneal cavities is a common terminal pathway for a wide variety of cancers. This article explores how these unique environments both promote aggressive tumor behavior and suppresses anti-tumor immunity, and ways in which local delivery of protein therapeutics can leverage the contained nature of these spaces to a therapeutic advantage, achieving high intra-cavital concentrations while minimizing systemic toxicity.
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Affiliation(s)
- Vera S. Donnenberg
- University of Pittsburgh Medical Center (UPMC) Hillman Cancer Centers, Pittsburgh, PA, United States
- McGowan Institute for Regenerative Medicine, Pittsburgh, PA, United States
- Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Patrick L. Wagner
- Surgical Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, United States
- College of Medicine, Drexel University, Pittsburgh, PA, United States
| | - James D. Luketich
- University of Pittsburgh Medical Center (UPMC) Hillman Cancer Centers, Pittsburgh, PA, United States
- Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - David L. Bartlett
- Surgical Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, United States
- College of Medicine, Drexel University, Pittsburgh, PA, United States
| | - Albert D. Donnenberg
- University of Pittsburgh Medical Center (UPMC) Hillman Cancer Centers, Pittsburgh, PA, United States
- McGowan Institute for Regenerative Medicine, Pittsburgh, PA, United States
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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16
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Ménochet K, Yu H, Wang B, Tibbitts J, Hsu CP, Kamath AV, Richter WF, Baumann A. Non-human primates in the PKPD evaluation of biologics: Needs and options to reduce, refine, and replace. A BioSafe White Paper. MAbs 2022; 14:2145997. [PMID: 36418217 PMCID: PMC9704389 DOI: 10.1080/19420862.2022.2145997] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Monoclonal antibodies (mAbs) deliver great benefits to patients with chronic and/or severe diseases thanks to their strong specificity to the therapeutic target. As a result of this specificity, non-human primates (NHP) are often the only preclinical species in which therapeutic antibodies cross-react with the target. Here, we highlight the value and limitations that NHP studies bring to the design of safe and efficient early clinical trials. Indeed, data generated in NHPs are integrated with in vitro information to predict the concentration/effect relationship in human, and therefore the doses to be tested in first-in-human trials. The similarities and differences in the systems defining the pharmacokinetics and pharmacodynamics (PKPD) of mAbs in NHP and human define the nature and the potential of the preclinical investigations performed in NHPs. Examples have been collated where the use of NHP was either pivotal to the design of the first-in-human trial or, inversely, led to the termination of a project prior to clinical development. The potential impact of immunogenicity on the results generated in NHPs is discussed. Strategies to optimize the use of NHPs for PKPD purposes include the addition of PD endpoints in safety assessment studies and the potential re-use of NHPs after non-terminal studies or cassette dosing several therapeutic agents of interest. Efforts are also made to reduce the use of NHPs in the industry through the use of in vitro systems, alternative in vivo models, and in silico approaches. In the case of prediction of ocular PK, the body of evidence gathered over the last two decades renders the use of NHPs obsolete. Expert perspectives, advantages, and pitfalls with these alternative approaches are shared in this review.
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Affiliation(s)
- Karelle Ménochet
- Quantitative Discovery and Development, UCB, Slough, UK,CONTACT Karelle Ménochet Quantitative Discovery and Development, UCB, Slough, UK
| | - Hongbin Yu
- R&D Project Management and Development Strategies, Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, CT, USA
| | - Bonnie Wang
- Nonclinical Disposition and Bioanalysis, Bristol Myers Squibb, Inc, Princeton, NJ, USA
| | - Jay Tibbitts
- Nonclinical Development, South San Francisco, CA, USA
| | - Cheng-Pang Hsu
- Preclinical Development and Clinical Pharmacology, AskGene Pharma Inc, Camarillo, CA, USA
| | - Amrita V. Kamath
- Preclinical and Translational Pharmacokinetics and Pharmacodynamics, Genentech Inc, South San Francisco, CA, USA
| | - Wolfgang F. Richter
- Roche Pharma Research and Early Development, Roche Innovation, Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Andreas Baumann
- R&D, Bayer Pharma AG, Berlin, Germany & Non-clinical Biotech Consulting, Potsdam, Germany °(° present affiliation)
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17
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Uckun FM, Watts J, Mims AS, Patel P, Wang E, Shami PJ, Cull E, Lee C, Cogle CR, Lin TL. Risk, Characteristics and Biomarkers of Cytokine Release Syndrome in Patients with Relapsed/Refractory AML or MDS Treated with CD3xCD123 Bispecific Antibody APVO436. Cancers (Basel) 2021; 13:5287. [PMID: 34771451 PMCID: PMC8582601 DOI: 10.3390/cancers13215287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/19/2021] [Indexed: 11/16/2022] Open
Abstract
We evaluate the risk, characteristics and biomarkers of treatment-emergent cytokine release syndrome (CRS) in patients with relapsed/refractory acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) who received APVO436 during the dose-escalation phase of a Phase 1B study (ClinicalTrials.gov, identifier: NCT03647800). Of four patients who developed Grade ≥ 3 CRS, two received steroid prophylaxis. The dose level, gender, race, obesity, or baseline hematologic parameters in peripheral blood did not predict the risk of CRS. Patients with a higher leukemia burden as determined by a higher total WBC, higher percentage of blasts in bone marrow, or higher percentage of blasts in peripheral blood (by hematopathology or immunophenotyping) did not have a higher incidence of CRS. There was an age difference between patients who did versus patients who did not develop CRS (72.9 ± 1.6 years (Median 73.5 years) vs. 63.3 ± 2.3 years (Median: 65.0 years), which was borderline significant (p = 0.04). Premedication with steroids did not eliminate the risk of CRS. Cytokine profiling in patients who developed CRS after APVO436 infusion indicates that the predominant cytokine in this inflammatory cytokine response was IL-6. APVO436-associated CRS was generally manageable with tocilizumab with or without dexamethasone. Notably, the development of CRS after APVO436 therapy did not appear to be associated with a response. The prolonged stabilization of disease, partial remissions and complete remissions were achieved in both patients who experienced CRS, as well as patients who did not experience CRS after APVO436 infusions.
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Affiliation(s)
- Fatih M. Uckun
- Department of Regulatory Affairs and Clinical Research, Aptevo Therapeutics, Seattle, WA 98121, USA;
- Immuno-Oncology Program, Ares Pharmaceuticals, St. Paul, MN 55110, USA
| | - Justin Watts
- Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA;
| | - Alice S. Mims
- The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA;
| | - Prapti Patel
- Harold C. Simmons Comprehensive Cancer Center, Department of Internal Medicine, Division of Hematology-Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Eunice Wang
- Roswell Park Comprehensive Cancer Center, Department of Medicine, Buffalo, NY 14263, USA;
| | - Paul J. Shami
- Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT 84112, USA;
| | - Elizabeth Cull
- Greenville Health System, Institute for Translational Oncology Research, Greenville, SC 29605, USA;
| | - Cynthia Lee
- Department of Regulatory Affairs and Clinical Research, Aptevo Therapeutics, Seattle, WA 98121, USA;
| | - Christopher R. Cogle
- Department of Medicine, Division of Hematology & Oncology, University of Florida, Gainesville, FL 32610, USA;
| | - Tara L. Lin
- Division of Hematologic Malignancies and Cellular Therapeutics, The University of Kansas Cancer Center, Westwood, KS 66205, USA;
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18
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Uckun FM, Lin TL, Mims AS, Patel P, Lee C, Shahidzadeh A, Shami PJ, Cull E, Cogle CR, Watts J. A Clinical Phase 1B Study of the CD3xCD123 Bispecific Antibody APVO436 in Patients with Relapsed/Refractory Acute Myeloid Leukemia or Myelodysplastic Syndrome. Cancers (Basel) 2021; 13:4113. [PMID: 34439266 PMCID: PMC8394899 DOI: 10.3390/cancers13164113] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 01/06/2023] Open
Abstract
APVO436 is a recombinant T cell-engaging humanized bispecific antibody designed to redirect host T cell cytotoxicity in an MHC-independent manner to CD123-expressing blast cells from patients with hematologic malignancies and has exhibited single-agent anti-leukemia activity in murine xenograft models of acute myeloid leukemia (AML). In this first-in-human (FIH) multicenter phase 1B study, we sought to determine the safety and tolerability of APVO436 in R/R AML/myelodysplastic syndrome (MDS) patients and identify a clinically active recommended phase 2 dose (RP2D) level for its further clinical development. A total of 46 R/R AML/MDS patients who had failed 1-8 prior lines of therapy received APVO436 as weekly intravenous (IV) infusions at 10 different dose levels, ranging from a Minimum Anticipated Biological Effect Level (MABEL) of 0.3 mcg to 60 mcg. APVO436 exhibited a favorable safety profile with acceptable tolerability and manageable drug-related adverse events (AEs), and its maximum tolerated dose (MTD) was not reached at a weekly dose of 60 mcg. The most common APVO436-related AEs were infusion-related reactions (IRR) occurring in 13 (28.3%) patients and cytokine release syndrome (CRS) occurring in 10 (21.7%). The single dose RP2D level was identified as 0.2 mcg/kg. Preliminary efficacy signals were observed in both AML and MDS patients: Prolonged stable disease (SD), partial remissions (PR), and complete remissions (CR) were observed in R/R AML patients as best overall responses to APVO436 at the RP2D level. Three of six evaluable MDS patients had marrow CRs. The safety and preliminary evidence of efficacy of APVO436 in R/R AML and MDS patients warrant further investigation of its clinical impact potential.
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Affiliation(s)
- Fatih M. Uckun
- Aptevo Therapeutics, Seattle, WA 98121, USA; (C.L.); (A.S.)
- Immuno-Oncology Program, Ares Pharmaceuticals, St. Paul, MN 55110, USA
| | - Tara L. Lin
- University of Kansas Cancer Center and Medical Pavillon, University of Kansas, Westwood, KS 66205, USA;
| | - Alice S. Mims
- Wexner Medical Center, James Cancer Hospital, The Ohio State University, Columbus, OH 43210, USA;
| | - Prapti Patel
- Southwestern Medical Center, University of Texas, Dallas, TX 75390, USA;
| | - Cynthia Lee
- Aptevo Therapeutics, Seattle, WA 98121, USA; (C.L.); (A.S.)
| | | | - Paul J. Shami
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA;
| | - Elizabeth Cull
- Institute for Translational Oncology Research, Greenville Health System, Greenville, SC 29605, USA;
| | - Christopher R. Cogle
- Division of Hematology and Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA;
| | - Justin Watts
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA;
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19
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Minami H, Kiyota N, Kimbara S, Ando Y, Shimokata T, Ohtsu A, Fuse N, Kuboki Y, Shimizu T, Yamamoto N, Nishio K, Kawakami Y, Nihira SI, Sase K, Nonaka T, Takahashi H, Komori Y, Kiyohara K. Guidelines for clinical evaluation of anti-cancer drugs. Cancer Sci 2021; 112:2563-2577. [PMID: 33990993 PMCID: PMC8253284 DOI: 10.1111/cas.14967] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 12/12/2022] Open
Abstract
Clinical studies intended for regulatory approval must demonstrate the clinical benefits of the drug in a target population. Clinical development of a drug proceeds by stepwise clinical studies; after safety and pharmacokinetics are evaluated and the recommended dosage and administration are determined, efficacy and safety are evaluated in an exploratory manner, and finally clinical benefits are compared with conventional standard therapies. Guidelines for the clinical evaluation of anti‐cancer drugs in Japan were established in 1991 and amended in 2006 after molecular‐targeted drugs were introduced. Recent progress in the development of drugs acting on the immune system and cancer genomic medicine targeting rare but important molecular subtypes have altered the strategy for development of anti‐cancer drugs. It is often difficult to conduct a confirmatory randomized controlled study using overall survival as the primary endpoint in rare molecular subtypes, and the primary evaluation of the efficacy of some drugs and subsequent approval is based on the tumor response. As conducting clinical studies for rare subtypes solely within Japan is difficult, drug development needs to be conducted within a global study. However, this requires robust monitoring to detect possible ethnic differences in pharmacokinetics and drug efficacy. Development using the conditional approval system for drugs enforced in 2020 may be considered, when clinical utility is evaluated based on surrogate endpoints. Because of these changes, we have revised the guidelines for the clinical evaluation of anti‐cancer drugs in Japan. To promote global development of anti‐cancer drugs involving Japan, the guidelines have been translated into English. Recent progress in development of drugs acting on the immune system and cancer genomic medicine targeting rare but important molecular subtypes have altered the strategy for development of anti‐cancer drugs. As conducting clinical studies for rare subtypes solely within Japan is difficult, drug development needs to be conducted within a global study with monitoring possible ethnic differences. Because of these changes, we have revised the guidelines for the clinical evaluation of anti‐cancer drugs in Japan.
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Affiliation(s)
- Hironobu Minami
- Division of Medical Oncology and Hematology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.,Cancer Center, Kobe University Hospital, Kobe, Japan
| | - Naomi Kiyota
- Division of Medical Oncology and Hematology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.,Cancer Center, Kobe University Hospital, Kobe, Japan
| | - Shiro Kimbara
- Division of Medical Oncology and Hematology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Tomoya Shimokata
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Atsushi Ohtsu
- National Cancer Center Hospital East, Kashiwa, Japan
| | - Nozomu Fuse
- Clinical Research Support Office, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yasutoshi Kuboki
- Department of Experimental Therapeutics, National Cancer Center Hospital East, Kashiwa, Japan
| | - Toshio Shimizu
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuto Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yutaka Kawakami
- Department of Immunology, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Shin-Ichi Nihira
- Tokyo Biochemical Research Foundation-Comprehensive Academy for Advanced Oncology, Tokyo, Japan
| | - Kazuhiro Sase
- Clinical Pharmacology & Regulatory Science, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Takahiro Nonaka
- Division of Epidemiology, Office of Medical Informatics and Epidemiology, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Hideaki Takahashi
- Office of New Drug V, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Yukiko Komori
- Office of New Drug IV, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Koshin Kiyohara
- Office of New Drug V, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
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20
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Conner KP, Pastuskovas CV, Soto M, Thomas VA, Wagner M, Rock DA. Preclinical characterization of the ADME properties of a surrogate anti-IL-36R monoclonal antibody antagonist in mouse serum and tissues. MAbs 2021; 12:1746520. [PMID: 32310023 PMCID: PMC7188401 DOI: 10.1080/19420862.2020.1746520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The decision to pursue a monoclonal antibody (mAb) as a therapeutic for disease intervention requires the assessment of many factors, such as target-biology, including the total target burden and its accessibility at the intended site of action, as well as mAb-specific properties like binding affinity and the pharmacokinetics in serum and tissue. Interleukin-36 receptor (IL-36 R) is a member of the IL-1 family cytokine receptors and an attractive target to treat numerous epithelial-mediated inflammatory conditions, including psoriatic and rheumatoid arthritis, asthma, and chronic obstructive pulmonary disease. However, information concerning the expression profile of IL-36 R at the protein level is minimal, so the feasibility of developing a therapeutic mAb against this target is uncertain. Here, we present a characterization of the properties associated with absorption, distribution, metabolism, and excretion of a high-affinity IL-36 R-targeted surrogate rat (IgG2a) mAb antagonist in preclinical mouse models. The presence of IL-36 R in the periphery was confirmed unequivocally as the driver of non-linear pharmacokinetics in blood/serum, although a predominant site of tissue accumulation was not observed based upon the kinetics of radiotracer. Additionally, the contribution of IL-36 R-mediated catabolism of mAb in kidney was tested in a 5/6 nephrectomized mouse model where minimal effects on serum pharmacokinetics were observed, although analysis of functional mAb in urine suggests that target can influence the amount of mAb excreted. Our data highlight an interesting case of target-mediated drug disposition (TMDD) where low, yet broadly expressed levels of membrane-bound target result in a cumulative effect to drive TMDD behavior typical of a large, saturable target sink. The potential differences between our mouse model and IL-36 R target profile in humans are also presented.
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Affiliation(s)
- Kip P Conner
- Department Pharmacokinetics and Drug Metabolism, Amgen, South San Francisco, CA, USA
| | - Cinthia V Pastuskovas
- Department Pharmacokinetics and Drug Metabolism, Amgen, South San Francisco, CA, USA
| | - Marcus Soto
- Department Pharmacokinetics and Drug Metabolism, Amgen, Thousand Oaks, CA, USA
| | - Veena A Thomas
- Department Pharmacokinetics and Drug Metabolism, Amgen, South San Francisco, CA, USA
| | - Mylo Wagner
- Department Pharmacokinetics and Drug Metabolism, Amgen, Thousand Oaks, CA, USA
| | - Dan A Rock
- Department Pharmacokinetics and Drug Metabolism, Amgen, South San Francisco, CA, USA
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21
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Tang Y, Li X, Cao Y. Which factors matter the most? Revisiting and dissecting antibody therapeutic doses. Drug Discov Today 2021; 26:1980-1990. [PMID: 33895315 DOI: 10.1016/j.drudis.2021.04.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/28/2021] [Accepted: 04/16/2021] [Indexed: 01/22/2023]
Abstract
Factors such as antibody clearance and target affinity can influence antibodies' effective doses for specific indications. However, these factors vary considerably across antibody classes, precluding direct and quantitative comparisons. Here, we apply a dimensionless metric, the therapeutic exposure affinity ratio (TEAR), which normalizes the therapeutic doses by antibody bioavailability, systemic clearance and target-binding property to enable direct and quantitative comparisons of therapeutic doses. Using TEAR, we revisited and dissected the doses of up to 60 approved antibodies. We failed to detect a significant influence of target baselines, turnovers or anatomical locations on antibody therapeutic doses, challenging the traditional perceptions. We highlight the importance of antibodies' modes of action for therapeutic doses and dose selections; antibodies that work through neutralizing soluble targets show higher TEARs than those working through other mechanisms. Overall, our analysis provides insights into the factors that influence antibody doses, and the factors that are crucial for antibodies' pharmacological effects.
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Affiliation(s)
- Yu Tang
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Xiaobing Li
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Department of Pharmacy, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yanguang Cao
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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22
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Schaller TH, Snyder DJ, Spasojevic I, Gedeon PC, Sanchez-Perez L, Sampson JH. First in human dose calculation of a single-chain bispecific antibody targeting glioma using the MABEL approach. J Immunother Cancer 2021; 8:jitc-2019-000213. [PMID: 32273346 PMCID: PMC7254109 DOI: 10.1136/jitc-2019-000213] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2020] [Indexed: 12/13/2022] Open
Abstract
Background First-in-human (FIH) clinical trials require careful selection of a safe yet biologically relevant starting dose. Typically, such starting doses are selected based on toxicity studies in a pharmacologically relevant animal model. However, with the advent of target-specific and highly active immunotherapeutics, both the Food and Drug Administration and the European Medicines Agency have provided guidance that recommend determining a safe starting dose based on a minimum anticipated biological effect level (MABEL) approach. Methods We recently developed a T cell activating bispecific antibody that effectively treats orthotopic patient-derived malignant glioma and syngeneic glioblastoma in mice (hEGFRvIII:CD3 bi-scFv). hEGFRvIII:CD3 bi-scFv is comprized of two single chain antibody fragments (bi-scFvs) that bind mutant epidermal growth factor receptor variant III (EGFRvIII), a mutation frequently seen in malignant glioma, and human CD3ε on T cells, respectively. In order to establish a FIH dose, we used a MABEL approach to select a safe starting dose for hEGFRvIII:CD3 bi-scFv, based on a combination of in vitro data, in vivo animal studies, and theoretical human receptor occupancy modeling. Results Using the most conservative approach to the MABEL assessment, a dose of 57.4 ng hEGFRvIII:CD3 bi-scFv/kg body weight was selected as a safe starting dose for a FIH clinical study. Conclusions The comparison of our MABEL-based starting dose to our in vivo efficacious dose and the theoretical human receptor occupancy strongly supports that our human starting dose of 57.4 ng hEGFRvIII:CD3 bi-scFv/patient kg will be safe.
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Affiliation(s)
- Teilo H Schaller
- Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina, United States.,Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, United States.,Department of Pathology, Duke University Medical Center, Durham, North Carolina, United States
| | - David J Snyder
- Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina, United States.,Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, United States
| | - Ivan Spasojevic
- PK/PD Core Laboratory, Duke Cancer Institute, Durham, North Carolina, United States.,Department of Medicine, Duke University School of Medicine, Durham, North Carolina, United States
| | - Patrick C Gedeon
- Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina, United States.,Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, United States
| | - Luis Sanchez-Perez
- Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina, United States.,Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, United States
| | - John H Sampson
- Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina, United States .,Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, United States.,Department of Pathology, Duke University Medical Center, Durham, North Carolina, United States
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23
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Considerations on the Calculation of the Human Equivalent Dose from Toxicology Studies for Biologic Anticancer Agents. Clin Pharmacokinet 2021; 60:563-567. [PMID: 33651328 PMCID: PMC8113299 DOI: 10.1007/s40262-021-00987-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2021] [Indexed: 12/23/2022]
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24
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Germovsek E, Cheng M, Giragossian C. Allometric scaling of therapeutic monoclonal antibodies in preclinical and clinical settings. MAbs 2021; 13:1964935. [PMID: 34530672 PMCID: PMC8463036 DOI: 10.1080/19420862.2021.1964935] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/19/2021] [Accepted: 08/03/2021] [Indexed: 02/06/2023] Open
Abstract
Constant technological advancement enabled the production of therapeutic monoclonal antibodies (mAbs) and will continue to contribute to their rapid expansion. Compared to small-molecule drugs, mAbs have favorable characteristics, but also more complex pharmacokinetics (PK), e.g., target-mediated nonlinear elimination and recycling by neonatal Fc-receptor. This review briefly discusses mAb biology, similarities and differences in PK processes across species and within human, and provides a detailed overview of allometric scaling approaches for translating mAb PK from preclinical species to human and extrapolating from adults to children. The approaches described here will remain vital in mAb drug development, although more data are needed, for example, from very young patients and mAbs with nonlinear PK, to allow for more confident conclusions and contribute to further growth of this field. Improving mAb PK predictions will facilitate better planning of (pediatric) clinical studies and enable progression toward the ultimate goal of expediting drug development.
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Affiliation(s)
- Eva Germovsek
- Translational Medicine and Clinical Pharmacology, Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany
| | - Ming Cheng
- Development Biologicals, Drug Metabolism And Pharmacokinetics, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, US
| | - Craig Giragossian
- Biotherapeutics Discovery, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, US
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25
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Song L, Xue J, Zhang J, Li S, Liu D, Zhou T. Mechanistic prediction of first-in-human dose for bispecific CD3/EpCAM T-cell engager antibody M701, using an integrated PK/PD modeling method. Eur J Pharm Sci 2020; 158:105584. [PMID: 33039565 DOI: 10.1016/j.ejps.2020.105584] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/08/2020] [Accepted: 10/01/2020] [Indexed: 12/18/2022]
Abstract
AIM M701 is a bispecific CD3/EpCAM T-cell engager antibody to treat malignant ascites. This study aimed to predict in vivo exposure-cytotoxicity relationship and human pharmacokinetics (PK) characteristics of M701, as well as to design optimal starting dose and effective dose for M701 first-in-human (FIH) study. METHOD Mechanistic in vitro PK/PD model was firstly developed based on in vitro data of M701's cytotoxicity and binding affinities with targeting receptors. The cell killing effect of M701 in vitro was driven by tri-molecular synapse, which formed by binding drug to both CD3 receptor on T cells and EpCAM receptor on tumor cells. Human exposure-response (E-R) curve in ascites was estimated using the same model structure with clinical systemic model parameters. Human PK was predicted by allometrically scaling monkey PK data, which was characterized using a two compartment model. Human PK model was integrated into in vivo synapse-based cell killing model to provide human PK/PD characteristics. Integrated human PK/PD model was applied in FIH dose design. Clinical starting dose and effective dose were suggested as the simulated drug concentration in human ascites that achieved the estimated in vivo minimally anticipated biological effect level (MABEL) and pharmacologically active level. Other approaches including PK-driven and receptor occupancy calculation were also employed in this study to verify the starting dose prediction. RESULTS In vitro M701 cytotoxicity curves under 24, 48, 72 h incubations were well captured by mechanistic synapse-based cell killing model. Human E-R curve in ascites was obtained based on in vitro model structure and clinical systematic parameters. We defined 10~20% and 80% of maximum cytotoxicity effect as in vivo MABEL and pharmacologically active level. Human E-R curve indicated in vivo EC10, EC20 and EC80 were 0.56, 1.26 and 31.6 ng/mL. For human PK model, clearance (CL, CLd), distribution volumes (Vc, Vp) and absorption rate were allometrically scaled using exponent of 0.9, 1 and -0.25. Predicted clearance and volume were 0.53- and 1.19-fold of observed data. Simulated average ascites M701 concentrations (calculated as Cave_ ascites = AUCτ/τ) were 0.81 and 32.5 ng/mL under dose of 5 and 200 μg within 2-hour i.p. infusion. By integrating human E-R curve and the simulated PK profile in ascites, we suggested 5 and 200 μg within 2-hour i.p. infusion as MABEL dose and pharmacologically active dose (PAD) for M701 FIH study. PK-driven approach predicted a starting dose of 5 μg, which was comparable to that predicted via PK/PD-driven approach. CONCLUSIONS This study predicted human ascites PK and E-R curve by integrating human PK model into in vivo synapse-based cell killing model. Optimal clinical MABEL dose and PAD of bispecific T cell engager antibody M701 were suggested based on current integrated PK/PD approach.
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Affiliation(s)
- Ling Song
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery System, Department of Pharmaceutics, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China.
| | - Junsheng Xue
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery System, Department of Pharmaceutics, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China
| | - Jing Zhang
- Wuhan YZY Biopharma Co., Ltd., Wuhan, HuBei, 430075, China
| | - Si Li
- Wuhan YZY Biopharma Co., Ltd., Wuhan, HuBei, 430075, China
| | - Dongyang Liu
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing, 100191, China.
| | - Tianyan Zhou
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery System, Department of Pharmaceutics, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China.
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26
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Leach MW, Clarke DO, Dudal S, Han C, Li C, Yang Z, Brennan FR, Bailey WJ, Chen Y, Deslandes A, Loberg LI, Mayawala K, Rogge MC, Todd M, Chemuturi NV. Strategies and Recommendations for Using a Data-Driven and Risk-Based Approach in the Selection of First-in-Human Starting Dose: An International Consortium for Innovation and Quality in Pharmaceutical Development (IQ) Assessment. Clin Pharmacol Ther 2020; 109:1395-1415. [PMID: 32757299 DOI: 10.1002/cpt.2009] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/02/2020] [Indexed: 01/27/2023]
Abstract
Various approaches to first-in-human (FIH) starting dose selection for new molecular entities (NMEs) are designed to minimize risk to trial subjects. One approach uses the minimum anticipated biological effect level (MABEL), which is a conservative method intended to maximize subject safety and designed primarily for NMEs having high perceived safety risks. However, there is concern that the MABEL approach is being inappropriately used for lower risk molecules with negative impacts on drug development and time to patient access. In addition, ambiguity exists in how MABEL is defined and the methods used to determine it. The International Consortium for Innovation and Quality in Pharmaceutical Development convened a working group to understand current use of MABEL and its impact on FIH starting dose selection, and to make recommendations for FIH dose selection going forward. An industry-wide survey suggested the achieved or estimated maximum tolerated dose, efficacious dose, or recommended phase II dose was > 100-fold higher than the MABEL-based starting dose for approximately one third of NMEs, including trials in patients. A decision tree and key risk factor table were developed to provide a consistent, data driven-based, and risk-based approach for selecting FIH starting doses.
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Affiliation(s)
- Michael W Leach
- Drug Safety Research and Development, Pfizer, Inc., Cambridge, Massachusetts, USA
| | - David O Clarke
- Nonclinical Safety Assessment, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana, USA
| | - Sherri Dudal
- DMPK Project Leads and Translational M&S, Pharmaceutical Sciences, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Chao Han
- Biologics Development Sciences, Janssen Research and Development, LLC, Spring House, Pennsylvania, USA
| | - Chunze Li
- Department of Clinical Pharmacology, Genentech, Inc., South San Francisco, California, USA
| | - Zheng Yang
- Metabolism and Pharmacokinetics, Bristol-Myers Squibb Co., Princeton, New Jersey, USA
| | | | - Wendy J Bailey
- Safety Assessment and Laboratory Animal Resources, Merck & Co., Inc., West Point, Pennsylvania, USA
| | - Yingxue Chen
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Boston, Massachusetts, USA
| | - Antoine Deslandes
- Translational Medicine & Early Development, Sanofi R&D, Centre de Recherche Vitry-sur-Seine 13, Vitry-sur-Seine Cedex, France
| | - Lise I Loberg
- Preclinical Safety, AbbVie, North Chicago, Illinois, USA
| | - Kapil Mayawala
- Quantitative Pharmacology and Pharmacometrics, PPDM, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Mark C Rogge
- Quantitative and Translational Science, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA
| | - Marque Todd
- Drug Safety Research and Development, Pfizer, Inc., San Diego, California, USA
| | - Nagendra V Chemuturi
- Pharmacokinetic Sciences, Novartis Institute of BioMedical Research, Inc., Cambridge, Massachusetts, USA
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27
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Song L, Yao X, Liu Y, Zhong W, Jiang J, Liu H, Zhou H, Shi C, Zong K, Wang C, Ma C, Liu D, Hu P. Translational prediction of first-in-human pharmacokinetics and pharmacodynamics of janagliflozin, a selective SGLT2 inhibitor, using allometric scaling, dedrick and PK/PD modeling methods. Eur J Pharm Sci 2020; 147:105281. [PMID: 32126254 DOI: 10.1016/j.ejps.2020.105281] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/18/2020] [Accepted: 02/25/2020] [Indexed: 12/22/2022]
Abstract
AIM Janagliflozin is an orally selective SGLT2 inhibitor. To predict human pharmacokinetics/pharmacodynamics (PK/PD) characteristics of janagliflozin. To design optimal starting dose and effective dose for janagliflozin first-in-human (FIH) study. METHODS Animal PK/PD properties of janagliflozin were obtained from preclinical in vivo and in vitro study. Pharmacologically effective level of same class SGLT2 inhibitors were assessed through preclinical and clinical efficacy data of dapagliflozin, empagliflozin and canagliflozin. Human PK parameters and profiles of janagliflozin were predicted by various methods such as allometric scaling (AS), dedrick and PK/PD modeling analysis. Mechanistic PK/PD model was developed to describe janagliflozin-mediated impact on urinary glucose excretion (UGE). Human IC50 was scaled from rat model-estimated IC50 by correcting interspecies difference of in vitro IC50 and plasma fu of rat and human. The quantitative PK/PD prediction of janagliflozin was evaluated via observed PK/PD profiles of healthy subjects. Predicted PK/PD characteristics of janagliflozin were applied in FIH dose design. Optimal starting dose was suggested by considering preclinical PD and toxicity data of janagliflozin. Effective dose was suggested by considering pharmacologically effective level of same class drugs. RESULTS PK/PD characteristics of janagliflozin in preclinical species were summarized. Pharmacologically effective level for SGLT2 inhibitors was defined as 25~30% ΔUGE (ΔUGE=--(PG*GFR)within24h) based on efficacy data of three same class drugs. Human predicted CL, Vss and F were 1.04 L/h, 77.5 L and 0.80. Predicted AUC and Cmax of janagliflozin of 10 and 50 mg were within 0.47~2.08 fold of observed values. Predicted human UGE0-24 h and UGE0-144 h of 10 and 50 mg dose range were within 0.66~1.41 fold of observed values. Optimal starting dose and pharmacologically active dose (PAD) were suggested as 10 mg and 50 mg. Dose range for FIH study was designed as 10-450 mg. CONCLUSIONS This study predicted human PK/PD characteristics of janagliflozin based on preclinical data and provide optimal dose design for janagliflozin FIH study based on pharmacologically effective level of same class drugs.
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Affiliation(s)
- Ling Song
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing, 100032, China; Department of Pharmaceutics, School of Pharmaceutical Sciences, Peking University, Beijing,100191, China.
| | - Xueting Yao
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing, 100032, China
| | - Yang Liu
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing, 100032, China
| | - Wen Zhong
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing, 100032, China
| | - Ji Jiang
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing, 100032, China
| | - Hongzhong Liu
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing, 100032, China
| | - Huimin Zhou
- XuanZhu Pharma Co., Ltd., Jinan, Shandong, 250101, China
| | - Chongtie Shi
- XuanZhu Pharma Co., Ltd., Jinan, Shandong, 250101, China
| | - Kaiqi Zong
- XuanZhu Pharma Co., Ltd., Jinan, Shandong, 250101, China
| | - Chong Wang
- XuanZhu Pharma Co., Ltd., Jinan, Shandong, 250101, China
| | - Chuanxiang Ma
- XuanZhu Pharma Co., Ltd., Jinan, Shandong, 250101, China
| | - Dongyang Liu
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing, 100032, China; Drug Clinical Trial Center, Peking University Third Hospital, Beijing 100191, China.
| | - Pei Hu
- Clinical Pharmacology Research Center, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing, 100032, China.
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Espié P, He Y, Koo P, Sickert D, Dupuy C, Chokoté E, Schuler R, Mergentaler H, Ristov J, Milojevic J, Verles A, Groenewegen A, Auger A, Avrameas A, Rotte M, Colin L, Tomek CS, Hernandez-Illas M, Rush JS, Gergely P. First-in-human clinical trial to assess pharmacokinetics, pharmacodynamics, safety, and tolerability of iscalimab, an anti-CD40 monoclonal antibody. Am J Transplant 2020; 20:463-473. [PMID: 31647605 DOI: 10.1111/ajt.15661] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/25/2019] [Accepted: 10/09/2019] [Indexed: 01/25/2023]
Abstract
Iscalimab is a fully human, CD40 pathway blocking, nondepleting monoclonal antibody being developed as an immunosuppressive agent. We describe a first-in-human, randomized, double-blind, placebo-controlled study investigating the safety, tolerability, pharmacokinetics, and pharmacodynamics of iscalimab in healthy subjects and rheumatoid arthritis patients. Healthy subjects (n = 56) received single doses of intravenous iscalimab (0.03, 0.1, 0.3, 1, or 3 mg/kg), or subcutaneous iscalimab (3 mg/kg), or placebo. Rheumatoid arthritis patients (n = 20) received single doses of intravenous iscalimab (10 or 30 mg/kg) or placebo. Iscalimab exhibited target-mediated drug disposition resulting in dose-dependent and nonlinear pharmacokinetics. Complete (≥90%) CD40 receptor occupancy on whole blood B cells was observed at plasma concentrations >0.3-0.4 µg/mL. In subjects receiving 3 mg/kg iscalimab, antibody responses to keyhole limpet hemocyanin were transiently suppressed. CD40 occupancy by iscalimab prevented ex vivo human rCD154-induced expression of CD69 on B cells in whole blood. All doses were generally safe and well tolerated, with no clinically relevant changes in any safety parameters, including no evidence of thromboembolic events. Iscalimab appears to be a promising blocker of the CD40-CD154 costimulatory pathway with potential use in transplantation and other autoimmune diseases.
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Affiliation(s)
- Pascal Espié
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - YanLing He
- Novartis Institutes for BioMedical Research, Inc., Cambridge, Massachusetts, USA
| | - Phillip Koo
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Denise Sickert
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Cyrielle Dupuy
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Edwige Chokoté
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Roland Schuler
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Jacinda Ristov
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Julie Milojevic
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Aurelie Verles
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Anita Auger
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Michael Rotte
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Laurence Colin
- Novartis Institutes for BioMedical Research, Inc., Cambridge, Massachusetts, USA
| | | | | | - James S Rush
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Peter Gergely
- Novartis Institutes for BioMedical Research, Basel, Switzerland
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A pre-clinical quantitative model predicts the pharmacokinetics/pharmacodynamics of an anti-BDCA2 monoclonal antibody in humans. J Pharmacokinet Pharmacodyn 2018; 45:817-827. [DOI: 10.1007/s10928-018-9609-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 10/20/2018] [Indexed: 12/12/2022]
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30
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Liu L. Pharmacokinetics of monoclonal antibodies and Fc-fusion proteins. Protein Cell 2018; 9:15-32. [PMID: 28421387 PMCID: PMC5777971 DOI: 10.1007/s13238-017-0408-4] [Citation(s) in RCA: 199] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/23/2017] [Indexed: 12/11/2022] Open
Abstract
There are many factors that can influence the pharmacokinetics (PK) of a mAb or Fc-fusion molecule with the primary determinant being FcRn-mediated recycling. Through Fab or Fc engineering, IgG-FcRn interaction can be used to generate a variety of therapeutic antibodies with significantly enhanced half-life or ability to remove unwanted antigen from circulation. Glycosylation of a mAb or Fc-fusion protein can have a significant impact on the PK of these molecules. mAb charge can be important and variants with pI values of 1-2 unit difference are likely to impact PK with lower pI values being favorable for a longer half-life. Most mAbs display target mediated drug disposition (TMDD), which can have significant consequences on the study designs of preclinical and clinical studies. The PK of mAb can also be influenced by anti-drug antibody (ADA) response and off-target binding, which require careful consideration during the discovery stage. mAbs are primarily absorbed through the lymphatics via convection and can be conveniently administered by the subcutaneous (sc) route in large doses/volumes with co-formulation of hyaluronidase. The human PK of a mAb can be reasonably estimated using cynomolgus monkey data and allometric scaling methods.
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Affiliation(s)
- Liming Liu
- Department of Pharmacokinetics, Pharmacodynamics and Drug Metabolism, MRL, West Point, PA, 19486, USA.
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Abstract
CEA TCB is a novel T-cell-bispecific (TCB) antibody targeting the carcinoembryonic antigen (CEA) expressed on tumor cells and the CD3 epsilon chain (CD3e) present on T cells, which is currently in Phase 1 clinical trials (NCT02324257) for the treatment of CEA-positive solid tumors. Because the human CEA (hCEA) binder of CEA TCB does not cross-react with cynomolgus monkey and CEA is absent in rodents, alternative nonclinical safety evaluation approaches were considered. These included the development of a cynomolgus monkey cross-reactive homologous (surrogate) antibody (cyCEA TCB) for its evaluation in cynomolgus monkey and the development of double-transgenic mice, expressing hCEA and human CD3e (hCEA/hCD3e Tg), as a potential alternative species for nonclinical safety studies. However, a battery of nonclinical in vitro/ex vivo experiments demonstrated that neither of the previous approaches provided a suitable and pharmacologically relevant model to assess the safety of CEA TCB. Therefore, an alternative approach, a minimum anticipated biological effect level (MABEL), based on an in vitro tumor lysis assay was used to determine the starting dose for the first-in-human study. Using the most conservative approach to the MABEL assessment, a dose of 52 μg was selected as a safe starting dose for clinical study.
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Shi S, Hashemi V, Wang SC, Yang J, Yang M(M, Semple A, Narasimhan C, Antochshuk V. Overcoming Challenges With Intravenous Administration of an Investigational Protein Therapeutic. J Pharm Sci 2017; 106:3465-3473. [DOI: 10.1016/j.xphs.2017.07.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/10/2017] [Accepted: 07/25/2017] [Indexed: 12/25/2022]
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Liu Z, Delavan B, Roberts R, Tong W. Lessons Learned from Two Decades of Anticancer Drugs. Trends Pharmacol Sci 2017; 38:852-872. [DOI: 10.1016/j.tips.2017.06.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/09/2017] [Accepted: 06/19/2017] [Indexed: 02/08/2023]
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Alpers DH, Young GP, Tran CD, Mortimer EK, Gopalsamy GL, Krebs NF, Manary MJ, Ramakrishna BS, Binder HJ, Brown IL, Miller LV. Drug-development concepts as guides for optimizing clinical trials of supplemental zinc for populations at risk of deficiency or diarrhea. Nutr Rev 2017; 75:147-162. [PMID: 28399577 DOI: 10.1093/nutrit/nuw065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Studies on the efficacy of zinc supplementation for treatment or prevention of diarrhea have shown an inconsistent effect in populations at risk for zinc deficiency. Unlike drugs, which have no preexisting presence in the body, endogenous zinc must be assessed pharmacokinetically by isotope tracer studies. Although such methods have produced much data, very few studies have estimated the dose and the timing of dosing of zinc supplementation. This review examines drug kinetics used to establish the best dose, the timing of such doses, and the mechanism of action through pharmacodynamic markers and applies them, where possible, to zinc supplements. The findings reveal that little is known, especially in children at highest risk of zinc deficiency. Key data missing to inform proper dosing, whether for treatment of disease or for preventive nutrient supplementation, are noted. Addressing these uncertainties could improve study design, leading to future studies of zinc supplements that might be of greater benefit.
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Affiliation(s)
- David H Alpers
- School of Medicine, Washington University, St Louis, Missouri, USA
| | - Graeme P Young
- School of Medicine, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Cuong D Tran
- CSIRO Health and Biosecurity, Adelaide, South Australia, Australia.,School of Medicine, Faculty of Health Sciences, The University of Adelaide, South Australia, Australia
| | - Elissa K Mortimer
- School of Medicine, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Geetha L Gopalsamy
- School of Medicine, Flinders University of South Australia, Adelaide, South Australia, Australia.,CSIRO Health and Biosecurity, Adelaide, South Australia, Australia
| | - Nancy F Krebs
- Section of Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Mark J Manary
- School of Medicine, Washington University, St Louis, Missouri, USA
| | | | - Henry J Binder
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Ian L Brown
- School of Medicine, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Leland V Miller
- Section of Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Denver, Colorado, USA
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Wang B, Wu CY, Jin D, Vicini P, Roskos L. Model-Based Discovery and Development of Biopharmaceuticals: A Case Study of Mavrilimumab. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2017; 7:5-15. [PMID: 28836356 PMCID: PMC5784736 DOI: 10.1002/psp4.12245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 07/06/2017] [Accepted: 08/01/2017] [Indexed: 01/08/2023]
Abstract
Drug development is a lengthy, costly process with low probability of success. Biopharmaceuticals are highly specific molecules, with efficacy and safety closely tied to target biology and pharmacology. The “learning−predicting−confirming” continuum by translational and clinical modeling and simulation (M&S) was implemented at every decision point for mavrilimumab, a human monoclonal antibody in development for rheumatoid arthritis (RA). This tutorial uses mavrilimumab as an example to demonstrate rational discovery, preclinical development, clinical study design, and dose selection of biotherapeutics by M&S.
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Affiliation(s)
- Bing Wang
- MedImmune, Mountain View, California, USA
| | | | - Denise Jin
- MedImmune, Mountain View, California, USA
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36
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In vitro assays supporting the safety assessment of immunomodulatory monoclonal antibodies. Toxicol In Vitro 2017; 45:296-308. [PMID: 28263892 DOI: 10.1016/j.tiv.2017.02.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/08/2017] [Accepted: 02/28/2017] [Indexed: 01/11/2023]
Abstract
Many monoclonal antibodies (mAbs) licensed for human use or in clinical development for cancer and autoimmune disease directly interact with the immune system. These immunomodulatory mAbs have an inherent risk of adverse immune-mediated drug reactions, including infusion reactions, cytokine storms, immunosuppression and autoimmunity. A thorough understanding of the potential for immunotoxicity of a mAb is required to support administration to humans. This review will highlight the key role of in vitro assays in defining the immunopharmacology, immunotoxicity and immunogenicity of mAbs. A wide range of in vitro tests with multiple formats of different complexity can be utilized to characterize i) the antibody-binding domains of the mAb, such as on-target binding and downstream pharmacological effects (e.g. immunosuppression, immune activation, cytokine release) in both humans and animal species used for toxicology studies and off-target binding; ii) Fc-dependent effects such as Fc-mediated cellular activation (e.g. of leukocytes, platelets) and cytokine release, complement activation; and iii) product-related factors (sequence, physical-chemical properties and impurities) that can impact both pharmacological activity and immunogenicity potential of a mAb. These assays can be crucial to the selection of mAbs with an optimum balance of safety and efficacy, in defining whether a mAb is a high risk molecule, and together with animal data, can inform human safe starting doses and escalation schemes.
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Abstract
Monoclonal antibodies (MAbs) have become a substantial part of many pharmaceutical company portfolios. However, the development process of MAbs for clinical use is quite different than for small-molecule drugs. MAb development programs require careful interdisciplinary evaluations to ensure the pharmacology of both the MAb and the target antigen are well-understood. Selection of appropriate preclinical species must be carefully considered and the potential development of anti-drug antibodies (ADA) during these early studies can limit the value and complicate the performance and possible duration of preclinical studies. In human studies, many of the typical pharmacology studies such as renal or hepatic impairment evaluations may not be needed but the pharmacokinetics and pharmacodynamics of these agents is complex, often necessitating more comprehensive evaluation of clinical data and more complex bioanalytical assays than might be used for small molecules. This paper outlines concerns and strategies for development of MAbs from the early in vitro assessments needed through preclinical and clinical development. This review focuses on how to develop, submit, and comply with regulatory requirements for MAb therapeutics.
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Lapchak PA, Zhang JH. The High Cost of Stroke and Stroke Cytoprotection Research. Transl Stroke Res 2016; 8:307-317. [PMID: 28039575 DOI: 10.1007/s12975-016-0518-y] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 12/18/2016] [Accepted: 12/21/2016] [Indexed: 10/20/2022]
Abstract
Acute ischemic stroke is inadequately treated in the USA and worldwide due to a lengthy history of neuroprotective drug failures in clinical trials. The majority of victims must endure life-long disabilities that not only affect their livelihood, but also have an enormous societal economic impact. The rapid development of a neuroprotective or cytoprotective compound would allow future stroke victims to receive a treatment to reduce disabilities and further promote recovery of function. This opinion article reviews in detail the enormous costs associated with developing a small molecule to treat stroke, as well as providing a timely overview of the cell-death time-course and relationship to the ischemic cascade. Distinct temporal patterns of cell-death of neurovascular unit components provide opportunities to intervene and optimize new cytoprotective strategies. However, adequate research funding is mandatory to allow stroke researchers to develop and test their novel therapeutic approach to treat stroke victims.
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Affiliation(s)
- Paul A Lapchak
- Director of Translational Research, Department of Neurology & Neurosurgery, Advanced Health Sciences Pavilion, Suite 8305, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Los Angeles, CA, 90048, USA.
| | - John H Zhang
- Director, Center for Neuroscience Research, Loma Linda University School of Medicine, 11175 Campus St, Loma Linda, CA, 92350, USA
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Suh HY, Peck CC, Yu KS, Lee H. Determination of the starting dose in the first-in-human clinical trials with monoclonal antibodies: a systematic review of papers published between 1990 and 2013. DRUG DESIGN DEVELOPMENT AND THERAPY 2016; 10:4005-4016. [PMID: 27994442 PMCID: PMC5153257 DOI: 10.2147/dddt.s121520] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
A systematic review was performed to evaluate how the maximum recommended starting dose (MRSD) was determined in first-in-human (FIH) studies with monoclonal antibodies (mAbs). Factors associated with the choice of each MRSD determination method were also identified. PubMed was searched for FIH studies with mAbs published in English between January 1, 1990 and December 31, 2013, and the following information was extracted: MRSD determination method, publication year, therapeutic area, antibody type, safety factor, safety assessment results after the first dose, and number of dose escalation steps. Seventy-nine FIH studies with mAbs were identified, 49 of which clearly reported the MRSD determination method. The no observed adverse effects level (NOAEL)-based approach was the most frequently used method, whereas the model-based approach was the least commonly used method (34.7% vs 16.3%). The minimal anticipated biological effect level (MABEL)- or minimum effective dose (MED)-based approach was used more frequently in 2011–2013 than in 1990–2007 (31.6% vs 6.3%, P=0.036), reflecting a slow, but steady acceptance of the European Medicines Agency’s guidance on mitigating risks for FIH clinical trials (2007). The median safety factor was much lower for the MABEL- or MED-based approach than for the other MRSD determination methods (10 vs 32.2–53). The number of dose escalation steps was not significantly different among the different MRSD determination methods. The MABEL-based approach appears to be safer and as efficient as the other MRSD determination methods for achieving the objectives of FIH studies with mAbs faster.
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Affiliation(s)
- Hoon Young Suh
- Department of Clinical Pharmacology and Therapeutics, College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Carl C Peck
- Department of Bioengineering and Therapeutic Sciences, School of Pharmacy, University of California, San Francisco, CA, USA
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Howard Lee
- Department of Clinical Pharmacology and Therapeutics, College of Medicine, Seoul National University Hospital, Seoul, Korea; Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
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Koonrungsesomboon N, Laothavorn J, Karbwang J. Ethical considerations and challenges in first-in-human research. Transl Res 2016; 177:6-18. [PMID: 27337526 DOI: 10.1016/j.trsl.2016.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 05/26/2016] [Accepted: 05/31/2016] [Indexed: 11/16/2022]
Abstract
First-in-human (FIH) research is a translational process to move a new potential therapy from bench to bedside. Major ethical challenges of an FIH trial arise because of the indeterminate nature of the risks involved and the controversial risk-benefit justification. Severe adverse events and death of subjects who participated in FIH research in the past have led to an increased attention on ethical considerations in the design and conduct of such research. Furthermore, novel therapies in the current decade, such as molecular-targeted, gene transfer, and pluripotent stem cells therapies, have led to numerous emerging ethical challenges or different ethical assessment and justification frameworks for FIH research. This article presents, discusses, and interlinks ethical considerations and challenges in FIH research through a review of related ethical principles and their application to each ethical issue with given examples. Possible solutions to address each ethical challenge are presented. The scope of this article focuses on 4 major ethical issues in FIH research: risk-benefit assessment and justification for the conduct of research, selection of a suitable target population, informed consent, and conflict of interest.
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Affiliation(s)
- Nut Koonrungsesomboon
- Department of Clinical Product Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Leading Program, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Junjira Laothavorn
- Chulabhon International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Juntra Karbwang
- Department of Clinical Product Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
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Baumann A, Fischmann S, Blaich G, Friedrich M. Leverage nonclinical development of bispecifics by translational science. DRUG DISCOVERY TODAY. TECHNOLOGIES 2016; 21-22:95-102. [PMID: 27978993 DOI: 10.1016/j.ddtec.2016.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/09/2016] [Accepted: 08/11/2016] [Indexed: 06/06/2023]
Abstract
Bispecific antibody constructs (Bispecifics, bsAbs) may have greater functionality compared to established monoclonal antibodies because they bind to 2 different targets or, potentially, to 2 epitopes on the same target (dual targeting). This may result in enhanced binding avidity with preferential binding to cells that express both targets or binding to targets on different cells. However, development of these next-generation biologics, including new formats, creates unique challenges due to their increased complexity. Here we review aspects of bsAbs preclinical development programs that may increase the success rates of bsAbs in clinical development.
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Affiliation(s)
| | | | - Guenter Blaich
- AbbVie Germany GmbH & Co. KG, Knollstrasse, 67061 Ludwigshafen, Germany
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Reichard JF, Maier MA, Naumann BD, Pecquet AM, Pfister T, Sandhu R, Sargent EV, Streeter AJ, Weideman PA. Toxicokinetic and toxicodynamic considerations when deriving health-based exposure limits for pharmaceuticals. Regul Toxicol Pharmacol 2016; 79 Suppl 1:S67-78. [DOI: 10.1016/j.yrtph.2016.05.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 05/19/2016] [Indexed: 12/11/2022]
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Liu M, Li Z, Yang J, Jiang Y, Chen Z, Ali Z, He N, Wang Z. Cell-specific biomarkers and targeted biopharmaceuticals for breast cancer treatment. Cell Prolif 2016; 49:409-20. [PMID: 27312135 PMCID: PMC6496337 DOI: 10.1111/cpr.12266] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 05/04/2016] [Indexed: 12/13/2022] Open
Abstract
Breast cancer is the second leading cause of cancer death among women, and its related treatment has been attracting significant attention over the past decades. Among the various treatments, targeted therapy has shown great promise as a precision treatment, by binding to cancer cell-specific biomarkers. So far, great achievements have been made in targeted therapy of breast cancer. In this review, we first discuss cell-specific biomarkers, which are not only useful for classification of breast cancer subtyping but also can be utilized as goals for targeted therapy. Then, the innovative and generic-targeted biopharmaceuticals for breast cancer, including monoclonal antibodies, non-antibody proteins and small molecule drugs, are reviewed. Finally, we provide our outlook on future developments of biopharmaceuticals, and provide solutions to problems in this field.
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Affiliation(s)
- Mei Liu
- School of Biological Science and Medical EngineeringSoutheast UniversityNanjingChina
| | - Zhiyang Li
- School of Biological Science and Medical EngineeringSoutheast UniversityNanjingChina
- Department of Laboratory MedicineNanjing Drum Tower Hospital Clinical CollegeNanjing UniversityNanjingChina
| | - Jingjing Yang
- School of Chemistry and Chemical EngineeringSoutheast UniversityNanjingChina
| | - Yanyun Jiang
- School of Chemistry and Chemical EngineeringSoutheast UniversityNanjingChina
| | - Zhongsi Chen
- School of Biological Science and Medical EngineeringSoutheast UniversityNanjingChina
| | - Zeeshan Ali
- School of Chemistry and Chemical EngineeringSoutheast UniversityNanjingChina
| | - Nongyue He
- School of Biological Science and Medical EngineeringSoutheast UniversityNanjingChina
| | - Zhifei Wang
- School of Chemistry and Chemical EngineeringSoutheast UniversityNanjingChina
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Chen X, Haddish-Berhane N, Moore P, Clark T, Yang Y, Li H, Xuan D, Barton HA, Betts AM, Barletta F. Mechanistic Projection of First-in-Human Dose for Bispecific Immunomodulatory P-Cadherin LP-DART: An Integrated PK/PD Modeling Approach. Clin Pharmacol Ther 2016; 100:232-41. [DOI: 10.1002/cpt.393] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/05/2016] [Accepted: 05/06/2016] [Indexed: 12/19/2022]
Affiliation(s)
- X Chen
- Pharmacokinetics, Dynamics and Metabolism; Pfizer; Cambridge Massachusetts USA
| | - N Haddish-Berhane
- Pharmacokinetics, Dynamics and Metabolism; Pfizer; Groton Connecticut USA
- Current Address: Clinical Pharmacology and Pharmacometrics; Quantitative Sciences Janssen Pharmaceuticals, Spring House, Pennsylvania USA
| | - P Moore
- MacroGenics; Rockville; Maryland USA
| | - T Clark
- Pharmacokinetics, Dynamics and Metabolism; Pfizer; Groton Connecticut USA
| | - Y Yang
- MacroGenics; Rockville; Maryland USA
| | - H Li
- MacroGenics; Rockville; Maryland USA
| | - D Xuan
- Clinical Pharmacology; Pfizer; San Diego California USA
| | - HA Barton
- Pharmacokinetics, Dynamics and Metabolism; Pfizer; Groton Connecticut USA
| | - AM Betts
- Pharmacokinetics, Dynamics and Metabolism; Pfizer; Groton Connecticut USA
| | - F Barletta
- Pharmacokinetics, Dynamics and Metabolism; Pfizer; Pearl River New York USA
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45
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Sussman RG, Naumann BD, Pfister T, Sehner C, Seaman C, Weideman PA. A harmonization effort for acceptable daily exposure derivation - Considerations for application of adjustment factors. Regul Toxicol Pharmacol 2016; 79 Suppl 1:S57-66. [PMID: 27221789 DOI: 10.1016/j.yrtph.2016.05.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 05/19/2016] [Indexed: 11/25/2022]
Abstract
Acceptable daily exposures (ADEs) are established to determine the quantity of one drug substance that can contaminate another drug product without causing harm to the patient. An important part in setting an ADE for a drug substance, after identification of the unwanted critical effect(s) of the compound (see Bercu et al., 2016, this issue), is the determination of an appropriate overall margin of safety that is need to be maintained below the dose causing a certain critical effect (i.e., the point of departure or PoD). The overall margin of safety used to protect the general patient population from critical effects is derived as the product (i.e., composite adjustment factor) of various individual factors that account for variability and uncertainty in extrapolating from the PoD to an ADE. These factors address the considerations of interindividual variability, interspecies extrapolation, LOAEL-to-NOAEL extrapolation, exposure duration adjustment, effect severity, and database completeness. The factors are considered individually, but are not necessarily independent and their interdependence should be identified, with subsequent adjustment to the composite factor, as appropriate. It is important to identify all sources of variability and uncertainty pertinent to the derivation of the ADE and ensure each is considered in the assessment, at least by one of the adjustment factors. This manuscript highlights the basis for and selection of factors that address variability and uncertainty as used in the guidance documents on setting ADEs or other related health-based limits.
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Filkova M, Cope A, Mant T, Galloway J. Is there a role of synovial biopsy in drug development? BMC Musculoskelet Disord 2016; 17:172. [PMID: 27094362 PMCID: PMC4837502 DOI: 10.1186/s12891-016-1028-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 04/09/2016] [Indexed: 12/27/2022] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease which causes significant pain, joint deformity, functional disability. The pathological hallmark of RA is inflammation of the synovium characterized by involvement of inflammatory and resident stromal cells, soluble mediators and signalling pathways leading to irreversible joint destruction. The treatment goal in RA has evolved over the last decade towards a target of disease remission that is achieved in less than a third of patients in clinical trials. The lack of therapeutic response to current treatments is suggestive of alternative drivers of RA pathogenesis that might serve as promising therapeutic targets. There are data to justify the use of synovial tissue in early drug development. Synovial tissue represents an appropriate compartment to be studied in patients with inflammatory arthritis and provides information that is distinct from peripheral blood. Modern techniques have made the procedure much more accessible and ultrasound guided biopsies represent a safe and acceptable option. Advances in analytic technologies allowing transcriptomic level of analysis can provide unique inside to target organ/tissue following the exposure to investigational medicinal product. However, there are still caveats with regard to both the choice of technique and analytical methods. Therefore the significance of synovial biopsy remains to be determined in future clinical trials. The aim of the current debate is to explore the potential for accessing and evaluating synovial tissue in early drug development, to summarize lessons we have learned from clinical trials and to discuss the challenges that have arisen so far.
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Affiliation(s)
- Maria Filkova
- Academic Department of Rheumatology, Weston Education Centre, King's College London, Cutcombe Road, SE5 9RJ, London, UK
| | - Andrew Cope
- Academic Department of Rheumatology, Weston Education Centre, King's College London, Cutcombe Road, SE5 9RJ, London, UK
| | - Tim Mant
- Quintiles Drug Research Unit at Guy's Hospital, London, UK
| | - James Galloway
- Academic Department of Rheumatology, Weston Education Centre, King's College London, Cutcombe Road, SE5 9RJ, London, UK.
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Sahota T, Danhof M, Della Pasqua O. Pharmacology-based toxicity assessment: towards quantitative risk prediction in humans. Mutagenesis 2016; 31:359-74. [PMID: 26970519 DOI: 10.1093/mutage/gev081] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Despite ongoing efforts to better understand the mechanisms underlying safety and toxicity, ~30% of the attrition in drug discovery and development is still due to safety concerns. Changes in current practice regarding the assessment of safety and toxicity are required to reduce late stage attrition and enable effective development of novel medicines. This review focuses on the implications of empirical evidence generation for the evaluation of safety and toxicity during drug development. A shift in paradigm is needed to (i) ensure that pharmacological concepts are incorporated into the evaluation of safety and toxicity; (ii) facilitate the integration of historical evidence and thereby the translation of findings across species as well as between in vitro and in vivo experiments and (iii) promote the use of experimental protocols tailored to address specific safety and toxicity questions. Based on historical examples, we highlight the challenges for the early characterisation of the safety profile of a new molecule and discuss how model-based methodologies can be applied for the design and analysis of experimental protocols. Issues relative to the scientific rationale are categorised and presented as a hierarchical tree describing the decision-making process. Focus is given to four different areas, namely, optimisation, translation, analytical construct and decision criteria. From a methodological perspective, the relevance of quantitative methods for estimation and extrapolation of risk from toxicology and safety pharmacology experimental protocols, such as points of departure and potency, is discussed in light of advancements in population and Bayesian modelling techniques (e.g. non-linear mixed effects modelling). Their use in the evaluation of pharmacokinetics (PK) and pharmacokinetic-pharmacodynamic relationships (PKPD) has enabled great insight into the dose rationale for medicines in humans, both in terms of efficacy and adverse events. Comparable benefits can be anticipated for the assessment of safety and toxicity profile of novel molecules.
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Affiliation(s)
- Tarjinder Sahota
- Division of Pharmacology, Leiden Academic Centre for Drug Research, University of Leiden, Leiden, The Netherlands
| | - Meindert Danhof
- Division of Pharmacology, Leiden Academic Centre for Drug Research, University of Leiden, Leiden, The Netherlands
| | - Oscar Della Pasqua
- Division of Pharmacology, Leiden Academic Centre for Drug Research, University of Leiden, Leiden, The Netherlands, Clinical Pharmacology, Modelling and Simulation, GlaxoSmithKline, Stockley Park West, Uxbridge, UK, Clinical Pharmacology and Therapeutics, University College London, London, UK
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Ricci MS, Frazier M, Moore J, Cromwell M, Galush WJ, Patel AR, Adler M, Altenburger U, Grauschopf U, Goldbach P, Fast JL, Krämer I, Mahler HC. In-use physicochemical and microbiological stability of biological parenteral products. Am J Health Syst Pharm 2015; 72:396-407. [PMID: 25694415 DOI: 10.2146/ajhp140098] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Margaret Speed Ricci
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd
| | - Michelle Frazier
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd
| | - Jamie Moore
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd
| | - Mary Cromwell
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd
| | - William J Galush
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd
| | - Ankit R Patel
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd
| | - Michael Adler
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd
| | - Ulrike Altenburger
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd
| | - Ulla Grauschopf
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd
| | - Pierre Goldbach
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd
| | - Jonas L Fast
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd
| | - Irene Krämer
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd
| | - Hanns-Christian Mahler
- Margaret Speed Ricci, Ph.D., is Director of Process Development, Drug Product Development, Genentech, South San Francisco, CA. Michelle Frazier, M.S., is Director, Regulatory Affairs, Amgen, Thousand Oaks, CA. Jamie Moore, Ph.D., is Director, Early-Stage Pharmaceutical Development; Mary Cromwell, Ph.D., is Director, Late-Stage Pharmaceutical Development; William J. Galush, Ph.D., is Scientist, Late-Stage Pharmaceutical Development; and Ankit R. Patel, Ph.D., is Scientist, Early-Stage Pharmaceutical Development, Pharmaceutical Development, Pharma Technical Development Biologics U.S., Genentech, South San Francisco, CA. Michael Adler, Ph.D., is Head, Late-Stage Pharmaceutical and Processing Development; Ulrike Altenburger, Ph.D., is Head, Early-Stage Pharmaceutical Development and GLP Tox Supplies; Ulla Grauschopf, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; Pierre Goldbach, Ph.D., is Senior Group Leader, Late-Stage Pharmaceutical and Processing Development; and Jonas L. Fast, Ph.D., is Group Leader, Early-Stage Pharmaceutical Development and GLP Tox Supplies, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd., Basel, Switzerland. Irene Krämer, Ph.D., is Director, Pharmacy Department, Medical Center of Johannes Gutenberg-University Hospital, Mainz, Germany, and Professor of Clinical Pharmacy, Pharmacy School of Johannes Gutenberg-University, Mainz. Hanns-Christian Mahler, Ph.D., is Head, Pharmaceutical Development and Supplies, Pharma Technical Development Biologics EU, F. Hoffmann-LaRoche Ltd.
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Yang Z, Wang H, Salcedo TW, Suchard SJ, Xie JH, Schneeweis LA, Fleener CA, Calore JD, Shi R, Zhang SXY, Rodrigues AD, Car BD, Marathe PH, Nadler SG. Integrated Pharmacokinetic/Pharmacodynamic Analysis for Determining the Minimal Anticipated Biological Effect Level of a Novel Anti-CD28 Receptor Antagonist BMS-931699. J Pharmacol Exp Ther 2015; 355:506-15. [PMID: 26442523 DOI: 10.1124/jpet.115.227249] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 10/06/2015] [Indexed: 02/05/2023] Open
Abstract
BMS-931699 (lulizumab pegol), a domain antibody (dAb) conjugated with 40-kDa branched polyethylene glycol, is a human anti-CD28 receptor antagonist under development for the treatment of inflammatory and autoimmune diseases. In the present work, the minimal anticipated biologic effect level (MABEL) was determined for BMS-931699 by integrating all the available preclinical data. The relevance of the in vitro mixed lymphocyte reaction (MLR) assay to a whole blood CD28 receptor occupancy (RO) assessment, as well as the relationship between the CD28 RO and the inhibition of T-cell-dependent antibody response to keyhole limpet hemocyanin in vivo, was demonstrated through an integrated pharmacokinetic/pharmacodynamic analysis using anti-hCD28 dAb-001 (differing from BMS-931699 by two additional amino acids at the N-terminus) and a mouse surrogate. Based on this analysis, the EC10 value (0.32 nM) from the human MLR assay and the human plasma volume (0.04 l/kg) were employed to calculate the MABEL (0.01 mg) of BMS-931699 in humans, with a CD28 RO predicted to be ≤10%. The estimated MABEL dose was threefold higher than the value derived from the binding constant and twofold less than the MABEL converted from animal efficacy studies based on the body surface area. Furthermore, it was 2900-fold lower than the human equivalent dose derived from the no observed adverse effect level in monkeys (15 mg/kg/week for 5 doses, intravenous dosing) with a 10-fold safety factor applied. Therefore, the MABEL dose represented a sound approach to mitigate any potential risk in targeting CD28 and was successfully used as the first-in-human starting dose for BMS-931699.
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Affiliation(s)
- Zheng Yang
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - Haiqing Wang
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - Theodora W Salcedo
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - Suzanne J Suchard
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - Jenny H Xie
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - Lumelle A Schneeweis
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - Catherine A Fleener
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - James D Calore
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - Rong Shi
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - Sean X Y Zhang
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - A David Rodrigues
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - Bruce D Car
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - Punit H Marathe
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
| | - Steven G Nadler
- Department of Metabolism and Pharmacokinetics, Pharmaceutical Candidate Optimization (Z.Y., H.W, A.D.R., B.D.C., and P.H.M.), Department of Exploratory Clinical and Translational Research (C.A.F., R.S., S.X.Y.Z.), Department of Protein Structures and Sciences (L.A.S.), Department of Immunology Discovery (S.J.S., J.H.X., and S.G.N.), Department of Bioanalytical Sciences (J.D.C.), Bristol-Myers Squibb Research and Development, Princeton, New Jersey; and Department of Drug Safety Evaluation (T.W.S.), Bristol-Myers Squibb Research and Development, New Brunswick, New Jersey
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Zhang Y, Doshi S, Zhu M. Pharmacokinetics and pharmacodynamics of rilotumumab: a decade of experience in preclinical and clinical cancer research. Br J Clin Pharmacol 2015; 80:957-64. [PMID: 25912961 DOI: 10.1111/bcp.12663] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 04/06/2015] [Accepted: 04/20/2015] [Indexed: 12/11/2022] Open
Abstract
Rilotumumab is a fully human monoclonal antibody against hepatocyte growth factor, the only known ligand of the MET receptor. Over the last decade, rilotumumab has been extensively tested in preclinical studies and in clinical studies in a variety of cancer types. In this review, we examine the pharmacokinetic and pharmacodynamic data that have been collected in the rilotumumab programme to date, and discuss retrospectively how the knowledge acquired in this programme can be applied to a number of key issues in oncology drug development, including: (i) using preclinical data to inform first-in-human study design; (ii) the role of biomarkers in the identification of a target patient population; (iii) the potential for drug interactions between therapeutic proteins and other anticancer agents; and (iv) pharmacokinetic and pharmacodynamic considerations in phase 3 study design.
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Affiliation(s)
- Y Zhang
- Department of Clinical Pharmacology, Modeling, and Simulation, Amgen Inc, One Amgen Center Drive, Thousand Oaks, CA, 91320, USA
| | - S Doshi
- Department of Clinical Pharmacology, Modeling, and Simulation, Amgen Inc, One Amgen Center Drive, Thousand Oaks, CA, 91320, USA
| | - M Zhu
- Department of Clinical Pharmacology, Modeling, and Simulation, Amgen Inc, One Amgen Center Drive, Thousand Oaks, CA, 91320, USA
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