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Xu B, Li S, Kang B, Fan S, He Z, Zhou J. CD25-targeted antibody-drug conjugate camidanlumab tesirine for relapsed or refractory classical Hodgkin lymphoma. Invest New Drugs 2022; 40:1333-1341. [PMID: 36074313 DOI: 10.1007/s10637-022-01300-z] [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: 06/20/2022] [Accepted: 08/30/2022] [Indexed: 10/14/2022]
Abstract
Classic Hodgkin lymphoma (cHL) accounts for more than 90% of HL in developed countries. Although the current combined modality therapy make it have a high cure rate, the prognosis for heavily pretreated patients with relapsed or refractory (R/R) cHL remains poor. A novel antibody-drug conjugate (ADC), named camidanlumab tesirine (ADCT-301, Cami), is currently being evaluated for its efficacy and safety in R/R cHL. The primary objective of this review is to examine the current pharmacological properties of camidanlumab tesirine as well as its clinical antitumor activity and safety. Camidanlumab tesirine comprises a human IgG1 anti-CD25 monoclonal antibody HuMax®-TAC, conjugated to a pyrrolobenzodiazepine dimer toxin. Once it bound to CD25-expressing cells, camidanlumab tesirine is internalized by cells and delivers SG3199, then SG3199 irreversibly binds to DNA and forms DNA interstrand crosslinks, ultimately leading to cell death. In the phase 1 study, patients with R/R cHL who received camidanlumab tesirine had an overall response rate (ORR) of 71% and a complete response rate (CRR) of 42%. Additionally, the recommended doses provided in R/R cHL were determined to be 30 and 45 μg/kg. The pivotal phase 2 trial showed significant antitumor activity of camidanlumab tesirine in heavily pretreated R/R cHL patients who failed brentuximab vedotin and programmed death-1 blockade: ORR was 70.1% and CRR was 33.3%, and the median duration of response was 13.7 months. Adverse events such as fatigue, maculopapular rash, and anemia were frequently observed following administration of camidanlumab tesirine. Moreover, camidanlumab tesirine may cause Guillain-Barré syndrome or polyradiculopathy.
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Affiliation(s)
- Bo Xu
- Pharmacy Department, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China.,Hengyang Clinical Pharmacology Research Center, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China.,Hengyang Key Laboratory of Clinical Pharmacology, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China.,School of Pharmaceutical Science, Hengyang Medical School, University of South China, 421001, Hengyang, China
| | - Shaoqian Li
- Pharmacy Department, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China.,Hengyang Clinical Pharmacology Research Center, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China.,Hengyang Key Laboratory of Clinical Pharmacology, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China
| | - Bo Kang
- Pharmacy Department, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China.,Hengyang Clinical Pharmacology Research Center, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China.,Hengyang Key Laboratory of Clinical Pharmacology, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China
| | - Shangzhi Fan
- Pharmacy Department, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China.,Hengyang Clinical Pharmacology Research Center, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China.,Hengyang Key Laboratory of Clinical Pharmacology, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China
| | - Zunbo He
- Pharmacy Department, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China.,Hengyang Clinical Pharmacology Research Center, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China.,Hengyang Key Laboratory of Clinical Pharmacology, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China
| | - Jiecan Zhou
- Pharmacy Department, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China. .,Hengyang Clinical Pharmacology Research Center, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China. .,Hengyang Key Laboratory of Clinical Pharmacology, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, 421001, Hunan, China. .,School of Pharmaceutical Science, Hengyang Medical School, University of South China, 421001, Hengyang, China.
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Lin KC, Chen TM, Yuan KSP, Wu ATH, Wu SY. Assessment of Predictive Scoring System for 90-Day Mortality Among Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma Who Have Completed Concurrent Chemoradiotherapy. JAMA Netw Open 2020; 3:e1920671. [PMID: 32215631 DOI: 10.1001/jamanetworkopen.2019.20671] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
IMPORTANCE There is currently no system to predict 90-day morality among patients with locally advanced head and neck squamous cell carcinoma (HNSCC) after the completion of concurrent chemoradiotherapy (CCRT). OBJECTIVE To validate the accuracy of a predictive scoring system for 90-day mortality among patients with locally advanced HNSCC who have completed CCRT. DESIGN, SETTING, AND PARTICIPANTS This prognostic study included 16 029 patients with HNSCC who completed CCRT between January 2006 and December 2015. Data were extracted from the Taiwan Cancer Registry Database. A risk scoring system was developed based on significant risk factors and corresponding risk coefficients. Data analysis was conducted from June 2018 to February 2019. EXPOSURES Mortality within 90 days of completion of definitive CCRT. MAIN OUTCOMES AND MEASURES The 90-day mortality rate after completion of CCRT and the accuracy of the scoring system, based on a comparison of mortality rates between training and test data sets. RESULTS Among 16 029 patients with locally advanced HNSCC, 1068 (6.66%; 1016 [95.1%] men; mean [SD] age, 55.11 [11.45] years) died before reaching the 90-day threshold, and 14 961 (93.4%; 14 080 [94.1%] men; mean [SD] age, 52.07 [9.99] years) survived. Multivariable analysis revealed that being aged 50 years or older (adjusted hazard ratio [aHR], 1.263; 95% CI, 1.104-1.445; P < .001), being aged 70 years or older (aHR, 2.183; 95% CI, 1.801-2.645; P < .001), having pneumonia (aHR, 1.946; 95% CI, 1.636-2.314; P < .001), having sepsis (aHR, 3.005; 95% CI, 2.503-3.607; P < .001), having hemiplegia (aHR, 1.430; 95% CI, 1.085-1.884; P = .01), having moderate or severe renal disease (aHR, 2.054; 95% CI, 1.643-2.568; P < .001), having leukemia (aHR, 4.541; 95% CI, 1.132-8.207; P = .03), and having non-HNSCC metastatic solid cancers (aHR, 1.457; 95% CI, 1.292-1.644; P < .001) were significant risk factors for 90-day mortality. Risk scores were categorized as very low risk (score of 0), low risk (score 1-3), moderate risk (score 4-6), and high risk (score ≥7), with 90-day mortality rates of 3.37%, 5.00% to 10.98%, 16.15% to 29.13%, and 33.93% to 37.50%, respectively. Mortality rates for patients with the same risk score in the training and test data sets were similar (score of 0, 3.27% vs 3.66%; score of 6, 27.42% vs 25.00%). CONCLUSIONS AND RELEVANCE In this prognostic study, a 90-day mortality scoring system accurately predicted 90-day mortality among patients with locally advanced HNSCC who completed CCRT.
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Affiliation(s)
- Kuan-Chou Lin
- Department of Oral and Maxillofacial Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Tsung-Ming Chen
- Department of Otorhinolaryngology, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kevin Sheng-Po Yuan
- Department of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Alexander T H Wu
- Program for Translational Medicine, Taipei Medical University, Taipei, Taiwan
| | - Szu-Yuan Wu
- Department of Food Nutrition and Health Biotechnology, Asia University College of Medical and Health Science, Taichung, Taiwan
- Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Li X, Liu L, Zhang Y, Qu Q, Yao Y, Wang T, Jiao W, Wu D. Efficacy of cytarabine, aclarubicin and granulocyte colony-stimulating factor (CAG) regimen compared to FLAG regimen for adult patients with relapsed/refractory Philadelphia chromosome-negative acute lymphoblastic leukemia. Leuk Res 2015; 39:S0145-2126(15)30366-0. [PMID: 26360548 DOI: 10.1016/j.leukres.2015.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/10/2015] [Accepted: 08/25/2015] [Indexed: 01/13/2023]
Abstract
In this study, we retrospectively assess the results in comparing the efficacies and toxicities of the three chemotherapy regimens: CAG (cytarabine, aclarubicin and granulocyte colony-stimulating factor (G-CSF), n=87), HD-CAG (increasing the dose of aclarubicin in CAG regimen, n=73), and FLAG (fludarabine, cytarabine and G-CSF, n=41) regimens in patients with relapsed/refractory Philadelphia chromosome-negative acute lymphoblastic leukemia (Ph--ALL). Our study indicated that after one therapy course, the overall response (OR, complete reimssion (CR)+partial remission (PR)) rate was higher in CAG than that in FLAG regimen (55.2% vs. 31.7%, P=0.013), while the CR (50.7% vs. 26.8%, P =0.013) and OR (64.4% vs. 31.7%, P=0.001) rates in HD-CAG regimen were both higher than that in FLAG regimen. Furthermore, the results were more pronounced in the subgroup of patients with T cell and refractory Ph--ALL. There were no significant differences in CR and OR rates between the CAG and HD-CAG regimens. Meanwhile, the adverse effects of CAG regimen were less toxic than the FLAG and HD-CAG regimens. There were no statistically significant differences in overall survival rates at two years among the three groups (FLAG: 9.8%±4.6%, CAG: 11.8%±4.5%, HD-CAG: 11.1%±4.0%; P>0.05). Our preliminary results indicated that CAG and HD-CAG regimens could be more effective and safer than FLAG regimen for relapsed/refractory Ph--ALL.
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Affiliation(s)
- Xiaoli Li
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou, Jiangsu Province 215006, PR China
| | - Limin Liu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou, Jiangsu Province 215006, PR China
| | - Yanming Zhang
- Department of Hematology, Huai'an Hospital Affiliated to Xuzhou Medical College, Huai'an Second People's Hospital, Huai'an, Jiangsu Province 223002, PR China
| | - Qi Qu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou, Jiangsu Province 215006, PR China
| | - Yao Yao
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou, Jiangsu Province 215006, PR China
| | - Tong Wang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou, Jiangsu Province 215006, PR China
| | - Wenjing Jiao
- Department of Hematology, Xian Yang Central Hospital, Xianyang, Shanxi Province 712000, PR China
| | - Depei Wu
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou, Jiangsu Province 215006, PR China.
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