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Xie R, Wang N, Peng C, Zhang S, Zhong A, Chen J. Current application of immunotherapy in melanoma. Chin Med J (Engl) 2023; 136:1174-1176. [PMID: 37075763 PMCID: PMC10278730 DOI: 10.1097/cm9.0000000000002660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Indexed: 04/21/2023] Open
Affiliation(s)
- Ruxin Xie
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ningning Wang
- Chinese Medical Journals Publishing House Co., Ltd, Beijing 100710, China
| | - Caihui Peng
- Department of Athletics and Swimming, Chengdu Sport University, Chengdu, Sichuan 610041, China
| | - Shiwei Zhang
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ai Zhong
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Junjie Chen
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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Dengler AF, Weiss R, Truong T, Irvin SC, Gadhia N, Hassanein M, Georgaros C, Taylor JA, Paccaly A, Sumner G, Andisik MD, Torri A, Partridge MA. Bioanalytical Challenges due to Prior Checkpoint Inhibitor Exposure: Interference and Mitigation in Drug Concentration and Immunogenicity Assays. AAPS JOURNAL 2021; 23:109. [PMID: 34608545 PMCID: PMC8490245 DOI: 10.1208/s12248-021-00643-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/24/2021] [Indexed: 12/18/2022]
Abstract
Monoclonal antibodies (mAbs) are a leading class of biotherapeutics. In oncology, patients often fail on early lines of biologic therapy to a specific target. Some patients may then enroll in a new clinical trial with a mAb specific for the same target. Therefore, immunoassays designed to quantify the current mAb therapy or assess immunogenicity to the drug may be susceptible to cross-reactivity or interference with residual prior biologics. The impact of two approved anti-PD-1 mAbs, pembrolizumab and nivolumab, was tested in several immunoassays for cemiplimab, another approved anti-PD-1 mAb. The methods included a target-capture drug concentration assay, a bridging anti-drug antibody (ADA) assay and a competitive ligand-binding neutralizing antibody (NAb) assay. We also tested bioanalytical strategies to mitigate cross-reactivity or interference in these assays from other anti-PD-1 biologics. Both pembrolizumab and nivolumab cross-reacted in the cemiplimab drug concentration assay. This was mitigated by addition of antibodies specific to pembrolizumab or nivolumab. ADA specific for pembrolizumab and nivolumab did not interfere in the cemiplimab ADA assay. However, pembrolizumab and nivolumab generated a false-positive response in a target-capture NAb assay. Our results demonstrate that similar exogenous pre-existing anti-PD-1 mAbs (biotherapeutics) such as pembrolizumab and nivolumab are detected and accurately quantified in the cemiplimab drug concentration assay. However, once steady state is achieved for the new therapy, prior biologics would likely not be detected. Cross-reactivity and interference in immunoassays from previous treatment with class-specific biotherapeutic(s) pose significant bioanalytical challenges, especially in immuno-oncology.
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Affiliation(s)
- Andrew F Dengler
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Rachel Weiss
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Tiffany Truong
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Susan C Irvin
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Nidhi Gadhia
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Mohamed Hassanein
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA.,Pfizer, 401 N Middletown Rd, Pearl River, New York, 10965, USA
| | - Camille Georgaros
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Jessica-Ann Taylor
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Anne Paccaly
- Regeneron Pharmaceuticals, Pharmacometrics (DSP), 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Giane Sumner
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Matthew D Andisik
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Albert Torri
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA
| | - Michael A Partridge
- Regeneron Pharmaceuticals, Bioanalytical Sciences, 777 Old Saw Mill River Rd, Tarrytown, New York, 10591, USA.
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Schilling B, Martens A, Geukes Foppen MH, Gebhardt C, Hassel JC, Rozeman EA, Gesierich A, Gutzmer R, Kähler KC, Livingstone E, Diamantopoulos PT, Gogas H, Madonna G, Ascierto PA, Goldinger SM, Mangana J, Garbe C, Schadendorf D, Blank C, Weide B. First-line therapy-stratified survival in BRAF-mutant melanoma: a retrospective multicenter analysis. Cancer Immunol Immunother 2019; 68:765-772. [PMID: 30806748 PMCID: PMC11028062 DOI: 10.1007/s00262-019-02311-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 01/31/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Inhibition of the mitogen-activated protein kinase (MAPK) pathway as well as programmed death 1 receptor (PD-1) blockade was shown to prolong overall survival (OS) in patients with advanced B-Raf proto-oncogene (BRAF)-mutant melanoma. However, due to the lack of head-to-head trials, it remains unclear if one of these therapeutic approaches should be preferred in first-line therapy. Here, we present a retrospective analysis comparing anti-PD-1 monotherapy with BRAF/MAPK/ERK kinase (MEK) combined inhibition used as first-line agents in a real-world clinical setting. PATIENTS AND METHODS Clinical data, routine blood counts and lactate dehydrogenase (LDH) levels of 301 patients with unresectable or metastatic melanoma harboring an activating mutation in BRAF (V600E/K) were included. Of these, 106 received anti-PD-1 antibodies, while 195 patients were treated with a selective BRAF inhibitor combined with an MEK inhibitor as palliative first-line therapy. Patients were sub-grouped according to previously described predictive and prognostic markers. RESULTS OS was significantly longer in patients receiving anti-PD-1 monotherapy compared to patients receiving combined MAPK inhibitors. Subsequent therapies were comparable among these groups. The difference in OS was less pronounced in patients with high LDH levels and visceral metastatic spread. CONCLUSION First-line treatment with a PD-1 blocking antibody might be associated with longer OS than first-line inhibition of the MAPK pathway in patients with advanced melanoma harboring mutant BRAF. These hypothesis-generating data need to be confirmed or rejected in prospective, randomized trials.
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Affiliation(s)
- Bastian Schilling
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | - Alexander Martens
- Department of Dermatology, University Medical Center Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Germany
| | - Marnix H Geukes Foppen
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Christoffer Gebhardt
- Department of Dermatology, University Hospital Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Dermatology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jessica C Hassel
- Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Elisa A Rozeman
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Anja Gesierich
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | - Ralf Gutzmer
- Department of Dermatology, Skin Cancer Center, Hannover Medical School, Hannover, Germany
| | - Katharina C Kähler
- Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Elisabeth Livingstone
- Department of Dermatology, West German Cancer Center, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Panagiotis T Diamantopoulos
- First Department of Internal Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Helen Gogas
- First Department of Internal Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Simone M Goldinger
- Department of Dermatology, University Hospital of Zürich, Zurich, Switzerland
| | - Johanna Mangana
- Department of Dermatology, University Hospital of Zürich, Zurich, Switzerland
| | - Claus Garbe
- Department of Dermatology, University Medical Center Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Germany
| | - Dirk Schadendorf
- Department of Dermatology, West German Cancer Center, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Christian Blank
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Benjamin Weide
- Department of Dermatology, University Medical Center Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Germany.
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