1
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Liu ZL, Chen HH, Zheng LL, Sun LP, Shi L. Angiogenic signaling pathways and anti-angiogenic therapy for cancer. Signal Transduct Target Ther 2023; 8:198. [PMID: 37169756 PMCID: PMC10175505 DOI: 10.1038/s41392-023-01460-1] [Citation(s) in RCA: 84] [Impact Index Per Article: 84.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/20/2023] [Accepted: 04/20/2023] [Indexed: 05/13/2023] Open
Abstract
Angiogenesis, the formation of new blood vessels, is a complex and dynamic process regulated by various pro- and anti-angiogenic molecules, which plays a crucial role in tumor growth, invasion, and metastasis. With the advances in molecular and cellular biology, various biomolecules such as growth factors, chemokines, and adhesion factors involved in tumor angiogenesis has gradually been elucidated. Targeted therapeutic research based on these molecules has driven anti-angiogenic treatment to become a promising strategy in anti-tumor therapy. The most widely used anti-angiogenic agents include monoclonal antibodies and tyrosine kinase inhibitors (TKIs) targeting vascular endothelial growth factor (VEGF) pathway. However, the clinical benefit of this modality has still been limited due to several defects such as adverse events, acquired drug resistance, tumor recurrence, and lack of validated biomarkers, which impel further research on mechanisms of tumor angiogenesis, the development of multiple drugs and the combination therapy to figure out how to improve the therapeutic efficacy. Here, we broadly summarize various signaling pathways in tumor angiogenesis and discuss the development and current challenges of anti-angiogenic therapy. We also propose several new promising approaches to improve anti-angiogenic efficacy and provide a perspective for the development and research of anti-angiogenic therapy.
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Affiliation(s)
- Zhen-Ling Liu
- Department of Medicinal Chemistry, Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, 210009, Nanjing, China
| | - Huan-Huan Chen
- Department of Medicinal Chemistry, Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, 210009, Nanjing, China
| | - Li-Li Zheng
- Department of Medicinal Chemistry, Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, 210009, Nanjing, China
| | - Li-Ping Sun
- Department of Medicinal Chemistry, Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, 210009, Nanjing, China.
| | - Lei Shi
- Department of Medicinal Chemistry, Jiangsu Key Laboratory of Drug Design and Optimization, China Pharmaceutical University, 210009, Nanjing, China.
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2
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Sa R, Xu Y, Pan X, Wang Y, Lin Z, Zhang X, Zhang B. A bibliometric analysis of research progress on pharmacovigilance and cancer from 2002 to 2021. Front Oncol 2023; 13:1078254. [PMID: 36761953 PMCID: PMC9905820 DOI: 10.3389/fonc.2023.1078254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/02/2023] [Indexed: 01/26/2023] Open
Abstract
The complexity of cancer itself and treatment makes pharmacovigilance critical in oncology. Despite rapid progress on pharmacovigilance and cancer research in the past two decades, there has been no bibliometric analysis in this field. Therefore, based on the Web of Science database, we used CiteSpace, VOS-viewer and R-bibliometrix to analyze and visualize publications, and described the development trend and research hot spots in this field. 502 publications were included. The development of pharmacovigilance and cancer research has continued to grow. The USA has the largest number of publications and citations, followed by France and UK. Vanderbilt University and Sorbonne University are the institutions that contribute the most papers, and 5 of the top 10 high-yield institutions are from France. Salem JE and Lebrun-Vignes B of Sorbonne University have published the most papers, and they have a strong cooperative relationship. Salem JE has the highest H index. Drug Safety has the largest number of publications in the field of pharmacovigilance and cancer, with a high impact factor (IF). In recent years, immune checkpoint inhibitors (ICIs) have been identified as a hot topic and will continue to be maintained. This paper can help researchers get familiar with the current situation and trend of pharmacovigilance and cancer research, and provide valuable reference for the selection of future research directions.
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Affiliation(s)
- Rina Sa
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China,Department of Pharmacy, Gansu Provincial Hospital, Lanzhou, Gansu, China,Center for Pharmacovigilance and Rational Use of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yi Xu
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China,Center for Pharmacovigilance and Rational Use of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xinbo Pan
- Institute of liver diseases, The Second People’s Hospital of Lanzhou, Lanzhou, China
| | - Yu Wang
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China,Center for Pharmacovigilance and Rational Use of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zhijian Lin
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China,Center for Pharmacovigilance and Rational Use of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaomeng Zhang
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China,Center for Pharmacovigilance and Rational Use of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Bing Zhang
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China,Center for Pharmacovigilance and Rational Use of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China,*Correspondence: Bing Zhang,
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3
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Joshi D, Khursheed R, Gupta S, Wadhwa D, Singh TG, Sharma S, Porwal S, Gauniyal S, Vishwas S, Goyal S, Gupta G, Eri RD, Williams KA, Dua K, Singh SK. Biosimilars in Oncology: Latest Trends and Regulatory Status. Pharmaceutics 2022; 14:pharmaceutics14122721. [PMID: 36559215 PMCID: PMC9784530 DOI: 10.3390/pharmaceutics14122721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/07/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
Biologic-based medicines are used to treat a variety of diseases and account for around one-quarter of the worldwide pharmaceutical market. The use of biologic medications among cancer patients has resulted in substantial advancements in cancer treatment and supportive care. Biosimilar medications (or biosimilars) are very similar to the reference biologic drugs, although they are not identical. As patent protection for some of the most extensively used biologics begins to expire, biosimilars have the potential to enhance access and provide lower-cost options for cancer treatment. Initially, regulatory guidelines were set up in Europe in 2003, and the first biosimilar was approved in 2006 in Europe. Many countries, including the United States of America (USA), Canada, and Japan, have adopted Europe's worldwide regulatory framework. The use of numerous biosimilars in the treatment and supportive care of cancer has been approved and, indeed, the count is set to climb in the future around the world. However, there are many challenges associated with biosimilars, such as cost, immunogenicity, lack of awareness, extrapolation of indications, and interchangeability. The purpose of this review is to provide an insight into biosimilars, which include various options available for oncology, and the associated adverse events. We compare the regulatory guidelines for biosimilars across the world, and also present the latest trends and challenges in medical oncology both now and in the future, which will assist healthcare professionals, payers, and patients in making informed decisions, increasing the acceptance of biosimilars in clinical practice, increasing accessibility, and speeding up the health and economic benefits associated with biosimilars.
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Affiliation(s)
- Deeksha Joshi
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, India
| | - Rubiya Khursheed
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, India
| | - Saurabh Gupta
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, India
| | - Diksha Wadhwa
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, India
| | | | - Sumit Sharma
- Delhi Pharmaceutical Sciences and Research University, New Delhi 110017, India
| | - Sejal Porwal
- Department of Pharmaceutical Sciences, Amity University Lucknow, Lucknow 226028, India
| | - Swati Gauniyal
- Department of Pharmacology, KLE College of Pharmacy, Hubballi 580031, India
| | - Sukriti Vishwas
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, India
| | - Sanjay Goyal
- Department of Internal Medicine, Government Medical College, Patiala 147001, India
| | - Gaurav Gupta
- School of Pharmacy, Suresh Gyan Vihar University, Mahal Road, Jagatpura 333031, India
- Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602117, India
- Uttaranchal Institute of Pharmaceutical Sciences, Uttaranchal University, Dehradun 248007, India
| | - Rajaraman D. Eri
- School of Science, STEM College, RMIT University, Melbourne, VIC 3001, Australia
- Correspondence: (R.D.E.); (S.K.S.); Tel.: +61-3-6324-5467 (R.D.E.); +91-9888720835 (S.K.S.)
| | - Kylie A. Williams
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Sachin Kumar Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, India
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW 2007, Australia
- Correspondence: (R.D.E.); (S.K.S.); Tel.: +61-3-6324-5467 (R.D.E.); +91-9888720835 (S.K.S.)
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4
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van Dijk E, van Werkhoven E, Asher R, Mooi JK, Espinoza D, van Essen HF, van Tinteren H, van Grieken NCT, Punt CJA, Tebbutt NC, Ylstra B. Predictive value of chromosome 18q11.2-q12.1 loss for benefit from bevacizumab in metastatic colorectal cancer; a post-hoc analysis of the randomized phase III-trial AGITG-MAX. Int J Cancer 2022; 151:1166-1174. [PMID: 35489024 PMCID: PMC9545440 DOI: 10.1002/ijc.34061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/07/2022] [Accepted: 04/12/2022] [Indexed: 11/24/2022]
Abstract
The VEGF‐A monoclonal antibody bevacizumab is currently recommended for first‐line treatment of all metastatic colorectal cancer (mCRC) patients. Cost‐benefit ratio and side‐effects however necessitate patient selection. A large retrospective yet nonrandomized study showed that patients with loss of chromosome 18q11.2‐q12.1 in the tumor and treated with bevacizumab have 3 months improved median progression‐free (PFS) and overall survival (OS) benefit compared to patients without this loss and/or treatment modality. Implementation for loss of chromosome 18q11.2‐q12.1 as a marker in clinical practice mandates evidence in a randomized controlled trial for bevacizumab. Of the trials with randomization of chemotherapy vs chemotherapy with bevacizumab, the AGITG‐MAX trial was the only one with tumor materials available. Chromosome 18q11.2‐q12.1 copy number status was measured for 256 AGITG‐MAX trial patients and correlated with PFS according to a predefined analysis plan with marker‐treatment interaction as the primary end‐point. Chromosome 18q11.2‐q12.1 losses were detected in 71% of patients (181/256) characteristic for mCRC. Consistent with the nonrandomized study, significant PFS benefit of bevacizumab was observed in patients with chromosome 18q11.2‐q12.1 loss (P = .009), and not in patients without 18q loss (P = .67). Although significance for marker‐treatment interaction was not reached (Pinteraction = .28), hazard ratio and 95% confidence interval of this randomized cohort (HRinteraction = 0.72; 95% CI = 0.39‐1.32) shows striking overlap with the nonrandomized study cohorts (HRinteraction = 0.41; 95% CI = 0.32‐0.8) supported by a nonsignificant Cochrane χ2 test (P = .11) for heterogeneity. We conclude that post hoc analysis of the AGITG‐MAX RCT provides supportive evidence for chromosome 18q11.2‐q12.1 as a predictive marker for bevacizumab in mCRC patients.
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Affiliation(s)
- Erik van Dijk
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Erik van Werkhoven
- Biometrics Department, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Rebecca Asher
- Department of Biostatistics, NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - Jennifer K Mooi
- Olivia Newton-John Cancer Research Institute, Heidelberg; Department of Medicine, University of Melbourne, Melbourne, Australia.,Peter MacCallum Cancer Institute, Melbourne, Australia
| | - David Espinoza
- Department of Biostatistics, NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - Hendrik F van Essen
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Harm van Tinteren
- Trial and Datacenter, Princess Máxima Center for pedeatric oncology, Utrecht, The Netherlands
| | - Nicole C T van Grieken
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
| | - Cornelis J A Punt
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands.,Department of Epidemiology, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Niall C Tebbutt
- Department of Medical Oncology, Austin Health, Heidelberg, Australia.,Department of Surgery, University of Melbourne
| | - Bauke Ylstra
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC, VU University Medical Center, Amsterdam, the Netherlands
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5
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Nahleh Z, Lyman GH, Schilsky RL, Peterson DE, Tagawa ST, Chavez-MacGregor M, Rumble RB, Gupta S. Use of Biosimilar Medications in Oncology. JCO Oncol Pract 2022; 18:177-186. [PMID: 35041524 DOI: 10.1200/op.21.00771] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The increased number and expanded utilization of biosimilars raise important considerations for their safe and appropriate use in oncology practice. This report provides an update on currently approved oncology biosimilars and identifies current knowledge gaps in the management of patients with cancer. METHODS An Expert Panel was convened to review the medical literature and to provide a practical summary of currently approved biosimilar therapeutics for cancer treatment or supportive care in the United States. RESULTS A total of 17 cancer or cancer-related biosimilar products have been approved by the US Food and Drug Administration since 2015. Despite years of clinical experience with oncology biosimilars, variance in their use persists. ASCO supports that biosimilars and reference products are considered equally efficacious for the purpose of inclusion in ASCO clinical practice guideline recommendations. CONCLUSION The use of biosimilars might provide competitive, lower-cost alternatives to biologics used in cancer care, and specific mention in ASCO guidelines and other evidence products is supported where appropriate.
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Affiliation(s)
| | - Gary H Lyman
- Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA
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6
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Zhou R, Yang J, Liu Y, Zhang Q, Lu C, Tang K, Li X, Tang W, Gao E, Wu C, Dou C, Hu W. A randomized, double-blind, parallel-group phase I study comparing the pharmacokinetics, safety, and immunogenicity of LY01008, a candidate bevacizumab biosimilar, with its reference product Avastin® in healthy Chinese male subjects. Expert Opin Biol Ther 2021; 22:263-269. [PMID: 34913787 DOI: 10.1080/14712598.2022.2019703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Bevacizumab, an inhibitor of angiogenesis, has been approved in several anti-cancer therapies. This study compared the pharmacokinetic (PK) profiles, safety, and immunogenicity of a bevacizumab biosimilar, LY01008, with those of European Union - approved bevacizumab (Avastin®) in healthy Chinese males. RESEARCH DESIGN AND METHODS In this double-blind, open-label, parallel-group study, healthy Chinese male subjects were randomized 1:1 to receive either LY01008 or Avastin® 3 mg/kg intravenously. Primary study endpoints were PK parameters such as the area under the concentration-time curve (AUC) from time zero to infinity (AUC0-∞), AUC from time zero to last quantifiable concentration (AUC0-t), and maximum serum concentration (Cmax). Secondary study endpoints included safety, tolerability, and immunogenicity. RESULTS One hundred and twelve subjects were randomized to receive LY01008 (n = 56) or Avastin® (n = 56). The 90% CIs of the GMRs of AUC0-t, AUC0-∞, and Cmax of LY01008 to Avastin® were all within the bioequivalence margin. Other PK parameters, safety, and immunogenicity profiles were comparable across the two treatment groups. CONCLUSIONS This study demonstrated equivalent PK, comparable safety, and similar immunogenicity of LY01008 to Avastin® in healthy subjects, thus paving the way for further clinical evaluation. TRIAL REGISTRATION The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT05110118).
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Affiliation(s)
- Renpeng Zhou
- Department of Clinical Pharmacology, The Second Hospital of Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Jingjing Yang
- Department of Clinical Pharmacology, The Second Hospital of Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Yueyue Liu
- Department of Clinical Pharmacology, The Second Hospital of Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Qian Zhang
- Department of Clinical Pharmacology, The Second Hospital of Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Chao Lu
- First Affiliated Hospital, Anhui University of Science & Technology, Huainan, China
| | - Ke Tang
- Research and development center, Shandong Boan Biotechnology Co., Ltd. ., Yantai, China
| | - Xiao Li
- Research and development center, Shandong Boan Biotechnology Co., Ltd. ., Yantai, China
| | - Wei Tang
- Research and development center, Shandong Boan Biotechnology Co., Ltd. ., Yantai, China
| | - Emei Gao
- Research and development center, Shandong Boan Biotechnology Co., Ltd. ., Yantai, China
| | - Can Wu
- Research and development center, Shandong Boan Biotechnology Co., Ltd. ., Yantai, China
| | - Changlin Dou
- Research and development center, Shandong Boan Biotechnology Co., Ltd. ., Yantai, China
| | - Wei Hu
- Department of Clinical Pharmacology, The Second Hospital of Anhui Medical University, Hefei, China.,Anhui Provincial Institute of Translational Medicine, Hefei, China
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7
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Gong G, Zheng Y, Kong X, Wen Z. Anti-angiogenesis Function of Ononin via Suppressing the MEK/Erk Signaling Pathway. JOURNAL OF NATURAL PRODUCTS 2021; 84:1755-1762. [PMID: 34029083 DOI: 10.1021/acs.jnatprod.1c00008] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Angiogenesis is a complicated pathological process and plays an important role in modulating tumor development. Flavonoids, sharing the basic functional group with estrogen, have been utilized as chemopreventive agents to inhibit endothelial cell angiogenesis and also suppress tumor cell proliferation. Ononin, also referred to as formononetin-7-O-β-d-glucoside, is one of the bioactive chemicals found within many functional food or plants. The anticancer functions of ononin have been reported both in vitro and in vivo. However, the anti-angiogenetic properties of ononin have not been reported. The possible efficacies of ononin against angiogenesis was verified in cultured endothelial cells. Ononin suppressed vascular endothelial growth factor (VEGF)-induced HUVEC migration, invasion. and tube formation activity after 48 h. The apoptosis rate and specific markers, i.e., Bax/Bc-2 ratio, cleaved caspase 3/9 (Cl-caspase 3/9), and cytochrome c (Cyto c), were enhanced in the ononin-treated group. On the other hand, the protein expressions levels of hypoxia-inducible factor 1α (HIF-1α), mitogen-activated protein kinase kinase (MEK)/extracellular signal-regulated kinase (ERK), and vascular endothelial growth factor receptor 2 (VEGFR2) were restricted after ononin treatment for 2 days in VEGF-pretreated endothelial cells. In summary, ononin acts as a candidate for angiogenetic-related disease prevention and treatment.
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Affiliation(s)
- Guowei Gong
- Department of Bioengineering, Zunyi Medical University, Zhuhai Campus, Zhuhai, Guangdong 519041, China
| | - Yuzhong Zheng
- School of Life Sciences and Food Engineering, Hanshan Normal University, Chaozhou, Guangdong 521041, China
| | - Xiangpeng Kong
- Institute of Pharmaceutical & Food Engineering, Chinese Medicine Master Studio of Wang shimin, Shanxi University of Chinese Medicine, Shanxi 030619, China
| | - Zhen Wen
- College of Chemistry and Environmental Engineering, Shenzhen University, Shenzhen 518060, China
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8
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Qin S, Li J, Bai Y, Shu Y, Li W, Yin X, Cheng Y, Sun G, Deng Y, Zhong H, Li Y, Qian X, Zhang L, Zhang J, Chen K, Kang W. Efficacy, Safety, and Immunogenicity of HLX04 Versus Reference Bevacizumab in Combination with XELOX or mFOLFOX6 as First-Line Treatment for Metastatic Colorectal Cancer: Results of a Randomized, Double-Blind Phase III Study. BioDrugs 2021; 35:445-458. [PMID: 34014555 PMCID: PMC8295119 DOI: 10.1007/s40259-021-00484-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 12/24/2022]
Abstract
Background HLX04 is a proposed biosimilar of bevacizumab. Objective This phase III study aimed to evaluate the efficacy, safety, and
immunogenicity of HLX04 compared with reference bevacizumab in combination with XELOX
or mFOLFOX6 as first-line treatment for recurrent/metastatic colorectal cancer
(CRC). Methods In this double-blind, parallel-group study, patients were randomized 1:1
to receive HLX04 or bevacizumab (7.5 mg/kg every 3 weeks when combined with XELOX; 5
mg/kg every 2 weeks when combined with mFOLFOX6). The primary endpoint was
progression-free survival rate at week 36 (PFSR36w) per
Response Evaluation Criteria in Solid Tumors (RECIST v1.1). Prespecified equivalence
margins of PFSR36w were set as − 11 to 15% (rate difference)
and 0.8 to 1.25 (rate ratio). Secondary endpoints included efficacy, safety,
immunogenicity, and pharmacokinetics. Results A total of 677 patients were randomized (HLX04 n = 340; bevacizumab n = 337)
between April 2018 and April 2020. PFSR36w was 46.4% (95%
confidence interval [CI] 41.1–51.8) with HLX04 and 50.7% (95% CI 45.4–56.1) with
bevacizumab. The rate difference (− 4.2%; 90% CI − 10.6 to 2.1) and rate ratio (0.92;
90% CI 0.80–1.05) both fell within the prespecified equivalence margins. No notable
differences were observed between treatment groups in any efficacy endpoints or their
subgroup analyses. Safety, immunogenicity, and pharmacokinetic profiles were
comparable between the two treatment groups. Conclusions HLX04 demonstrated equivalent efficacy with similar safety and
immunogenicity profiles to reference bevacizumab among patients with
recurrent/metastatic CRC, thus offering an alternative treatment option to
patients. Trial registration Chinadrugtrials.org.cn, CTR20171503 (18 March 2018); ClinicalTrials.gov,
NCT03511963 (30 April 2018). Supplementary Information The online version contains supplementary material available at 10.1007/s40259-021-00484-9. Colorectal cancer (CRC) is the third most common cancer worldwide. Approximately 20%
of patients with CRC have metastases at their first visit. Bevacizumab is a biologic
antibody approved in many countries for the treatment of metastatic CRC. However, high
treatment costs significantly limit patient access to bevacizumab. Therefore, HLX04, a
potential bevacizumab biosimilar, which is almost identical to bevacizumab but less
expensive and more accessible, has been developed. This randomized clinical trial was
designed to evaluate the efficacy (ability of a drug to produce the desired treatment
effects), safety, and immunogenicity (ability of a drug to induce immune response that
would affect its efficacy and safety) of HLX04 compared with the reference bevacizumab
in patients with recurrent/metastatic CRC. Efficacy of the tested drug was evaluated by
comparing the proportion of patients without disease progression or death at week 36
(PFSR36w). Safety was monitored using adverse events and other
clinical evaluations. Immunogenicity was assessed by the incidence of antidrug
antibodies. Of the 677 patients enrolled in the study, 340 received HLX04 and 337
received bevacizumab. Statistical analyses showed that HLX04 was equivalent to
bevacizumab in efficacy evaluations (the difference in PFSR36w
between the two treatment groups fell within the prespecified “equivalence margins”).
Moreover, the two treatments were similar with respect to safety and immunogenicity
evaluations. In summary, patients responded equally well to HLX04 and bevacizumab,
supporting the development of HLX04 as a proposed biosimilar to bevacizumab for patients
with recurrent/metastatic CRC.
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Affiliation(s)
- Shukui Qin
- Department of Oncology, Qinhuai Medical Area, Eastern Theater General Hospital of PLA China, Nanjing, China
| | - Jin Li
- Department of Medical Oncology, Tongji University Shanghai East Hospital, No. 1800 Yuntai Road, Pudong New Area, Shanghai, China.
| | - Yuxian Bai
- Department of Gastroenterology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yongqian Shu
- Department of Oncology, Jiangsu Province Hospital, Nanjing, China
| | - Wei Li
- Department of Oncology, The First Hospital of Jilin University, Changchun, China
| | - Xianli Yin
- Department of Gastroenterology and Urology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Ying Cheng
- Department of Internal Medicine, Jilin Cancer Hospital, Changchun, China
| | - Guoping Sun
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yanhong Deng
- Department of Medical Oncology, The Sixth Affiliated Hospital (Guangdong Gastrointestinal Hospital), Sun Yat-sen University, Guangzhou, China
| | - Haijun Zhong
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Yunfeng Li
- Department of Colorectal Surgery, Yunnan Cancer Hospital, Kunming, China
| | - Xiaoping Qian
- The Comprehensive Cancer Center of Nanjing Drum Tower Hospital, Medical School of Nanjing University, Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Liangming Zhang
- Department of Medical Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Jingdong Zhang
- Medical Oncology Department of Gastrointestinal Tumors, Liaoning Cancer Hospital and Institute, Cancer Hospital of China Medical University, Shenyang, China
| | - Kehe Chen
- Department of Chemotherapy Division II in Clinical Tumor Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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9
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Hummel M, Bosje T, Shaw A, Liu MS, Barve A, Kothekar M, Socinski MA, Waller CF. A pharmacokinetics study of proposed bevacizumab biosimilar MYL-1402O vs EU-bevacizumab and US-bevacizumab. J Cancer Res Clin Oncol 2021; 148:487-496. [PMID: 33866430 PMCID: PMC8800899 DOI: 10.1007/s00432-021-03628-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/01/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE Bevacizumab is a recombinant humanized monoclonal antibody that inhibits vascular endothelial growth factor-specific angiogenesis in some cancers. MYL-1402O is a proposed bevacizumab biosimilar. METHODS The primary objective of this single-center, randomized, double-blind, three-arm, parallel-group, phase 1 study in healthy male volunteers was to evaluate bioequivalence of MYL-1402O to EU and US-reference bevacizumab, and EU-reference bevacizumab to US-reference bevacizumab. The primary pharmacokinetic parameter was area under the serum concentration-time curve from 0 extrapolated to infinity (AUC0-∞). Pharmacokinetic parameters were analyzed using general linear models of analysis of variance. Secondary endpoints included safety and tolerability. RESULTS Of 111 enrolled subjects, 110 were included in the pharmacokinetic analysis (MYL-1402O, n = 37; EU-reference bevacizumab, n = 36; US-reference bevacizumab, n = 37). Bioequivalence was demonstrated between MYL-1402O and EU-reference bevacizumab, MYL-1402O and US-reference bevacizumab, and between EU- and US-reference bevacizumab where least squares mean ratios of AUC0-∞ were close to 1, and 90% CIs were within the equivalence range (0.80-1.25). Secondary pharmacokinetic parameters (AUC from 0 to time of last quantifiable concentration [AUC0-t], peak serum concentration [Cmax], time to Cmax, elimination rate constant, and elimination half-life) were also comparable, with 90% CIs for ratios of AUC0-t and Cmax within 80-125%. Treatment-emergent adverse events were similar across all three treatment groups and were consistent with clinical data for bevacizumab. CONCLUSION MYL-1402O was well tolerated and demonstrated pharmacokinetic and safety profiles similar to EU-reference bevacizumab and US-reference bevacizumab in healthy male volunteers. No new significant safety issues emerged (ClinicalTrials.gov, NCT02469987; ClinicalTrialsRegister.eu EudraCT, 2014-005621-12; June 12, 2015).
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Affiliation(s)
| | - Tjerk Bosje
- PRA Health Sciences, Groningen, The Netherlands
| | | | | | | | - Mudgal Kothekar
- Biocon Research Ltd (Now With Sun Pharma Advanced Research Company, Mumbai, India), Bangalore, India
| | | | - Cornelius F Waller
- Department of Haematology, Oncology and Stem Cell Transplantation, University Medical Centre Freiburg and Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
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Cheng C, Nguyen MN, Nayernama A, Jones SC, Brave M, Agrawal S, Amiri-Kordestani L, Woronow D. Arterial aneurysm and dissection with systemic vascular endothelial growth factor inhibitors: A review of cases reported to the FDA Adverse Event Reporting System and published in the literature. Vasc Med 2021; 26:526-534. [PMID: 33840328 DOI: 10.1177/1358863x211006470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The US Food and Drug Administration (FDA) has approved multiple systemic vascular endothelial growth factor (VEGF) inhibitors since 2004 to treat various malignancies. Inhibition of the VEGF signaling pathway can result in impairment of vascular wall integrity through medial degeneration and endothelial dysfunction, potentially resulting in arterial (including aortic) aneurysm/dissection. We performed a postmarketing review to evaluate arterial aneurysm/dissection as a potential safety risk for patients with cancer treated with VEGF inhibitors. We searched the FDA Adverse Event Reporting System (FAERS) database and literature for reports of arterial (including aortic) aneurysm/dissection with VEGF inhibitors currently approved by the FDA for a cancer indication. We identified 240 cases of arterial aneurysm/dissection associated with VEGF inhibitors. The median time to onset of an arterial aneurysm/dissection event from the initiation of a VEGF inhibitor was 94 days (range 1-1955 days). Notably, 22% (53/240) of cases reported fatal outcomes related to arterial aneurysm/dissection. We determined the drug-event association as probable in 15 cases that lacked relevant confounding factors for arterial aneurysm/dissection, which is supported by unremarkable computed tomography (CT) findings prior to starting VEGF inhibitor therapy, despite nondrug-associated background arterial aneurysm/dissection generally demonstrating preexisting arterial abnormalities. FAERS and literature case-level evidence suggests that VEGF inhibitors may have contributed to arterial aneurysm/dissection, as a class effect, based on short onset relative to natural history of disease and biologic plausibility. Cardiovascular and oncology healthcare professionals should be aware of this rare, but life-threatening safety risk associated with VEGF inhibitors.
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Affiliation(s)
- Connie Cheng
- Division of Pharmacovigilance, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Michelle Nadeau Nguyen
- Division of Pharmacovigilance, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Afrouz Nayernama
- Division of Pharmacovigilance, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - S Christopher Jones
- Division of Pharmacovigilance, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Michael Brave
- Division of Oncology, Office of Oncologic Diseases, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Sundeep Agrawal
- Division of Oncology, Office of Oncologic Diseases, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Laleh Amiri-Kordestani
- Division of Oncology, Office of Oncologic Diseases, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Daniel Woronow
- Division of Pharmacovigilance, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
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Chu T, Lu J, Bi M, Zhang H, Zhuang W, Yu Y, Shi J, Chen Z, Zhang X, Guo Q, Liu Q, Wu H, Fang J, Hu Y, Wang X, Han C, Li K, Han B. Equivalent efficacy study of QL1101 and bevacizumab on untreated advanced non-squamous non-small cell lung cancer patients: a phase 3 randomized, double-blind clinical trial. Cancer Biol Med 2021; 18:j.issn.2095-3941.2020.0212. [PMID: 33710815 PMCID: PMC8330542 DOI: 10.20892/j.issn.2095-3941.2020.0212] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/14/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE This phase 3 study aimed to test equivalence in efficacy and safety for QL1101, a bevacizumab analogue in Chinese patients with untreated locally advanced non-squamous non-small cell lung cancer (NSCLC). METHODS Eligible patients were randomly assigned 1:1 to receive carboplatin and paclitaxel in combination with either QL1101 or bevacizumab, 15 mg/kg every 3-week for 6 cycles. This was followed by maintenance treatment with single agent QL1101 every 3-week. The primary end-point was objective response rate (ORR), with secondary end-points being progression-free survival (PFS), overall survival (OS), disease control rate (DCR), and adverse events (AEs). RESULTS Of 675 patients, 535 eligible patients were randomized to the QL1101 group (n = 269) and bevacizumab group (n = 266). ORRs were 52.8% and 56.8%, respectively, for the QL1101 and bevacizumab groups, with an ORR hazard ratio 0.93 (95% confidence interval: 0.8-0131.1). The PFS, OS, DCR, and AEs were comparable between the 2 groups, which remained the same after stratification according to epidermal growth factor receptor mutation or smoking history. CONCLUSIONS QL1101 showed similar efficacy and safety profiles as compared to bevacizumab among Chinese patients with untreated locally advanced non-squamous NSCLC.
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Affiliation(s)
- Tianqing Chu
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Jun Lu
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Minghong Bi
- Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
| | - Helong Zhang
- Department of Oncology, Tangdu Hospital, Air Force Medical University of PLA, Xi’an 710038, China
| | - Wu Zhuang
- Department of Medical Thoracic Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, China
| | - Yan Yu
- Department of Oncology, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Jianhua Shi
- Department of Oncology, Linyi Cancer Hospital, Linyi 276000, China
| | - Zhendong Chen
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei 230601, China
| | - Xiaochun Zhang
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266071, China
| | - Qisen Guo
- Department of Internal Medicine, Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, China
| | - Quan Liu
- Department of Oncology, Affiliated Hospital of Jiang Nan University, Wuxi 214122, China
| | - Huijuan Wu
- Department of Internal Medicine, Henan Province Tumor Hospital, Zhengzhou University, Zhengzhou 450008, China
| | - Jian Fang
- Department of Thoracic Oncology II, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Yi Hu
- Department of Oncology, Chinese PLA General Hospital, Beijing 100039, China
| | - Xiuwen Wang
- Department of Oncology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Cuicui Han
- Department of Clinical Research Centre, Qilu Pharmaceutical Co., Ltd, Jinan 250101, China
| | - Kai Li
- Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
| | - Baohui Han
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
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Jin R, Mahtani RL, Accortt N, Lawrence T, Sandschafer D, Loaiza-Bonilla A. Clinical and treatment characteristics of patients treated with the first therapeutic oncology biosimilars bevacizumab-awwb and trastuzumab-anns in the US. Ther Adv Med Oncol 2021; 13:17588359211041961. [PMID: 35003333 PMCID: PMC8734207 DOI: 10.1177/17588359211041961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 08/09/2021] [Indexed: 11/23/2022] Open
Abstract
Background: In July 2019, bevacizumab-awwb and trastuzumab-anns were marketed in the USA as the first therapeutic oncology biosimilars. We aimed to investigate the initial real-world use of bevacizumab-awwb and trastuzumab-anns for cancer management in US oncology practices. Methods: A retrospective, observational analysis of data from US cancer patients (⩾18 years of age) was carried out to describe the use of bevacizumab-awwb and trastuzumab-anns during the first 12 months following their market entry, using structured data from the Flatiron Health electronic health record-derived database. Results: A total of 2952 and 2997 patients with recorded use of bevacizumab-awwb and trastuzumab-anns, respectively, were included in the analysis. The first use of bevacizumab-awwb and trastuzumab-anns was in a patient with metastatic colorectal cancer (mCRC) within 10 days of market availability and in a patient with early stage breast cancer (eBC) within 4 days, respectively. The use of these biosimilars was observed across all approved cancer indications; 68% of bevacizumab-awwb users were those diagnosed with mCRC and 72% of trastuzumab-anns users were those diagnosed with eBC. Approximately half the patients were previously exposed to reference product (RP) prior to initiation of bevacizumab-awwb or trastuzumab-anns. Among pre-exposed patients, the majority received the biosimilars [bevacizumab-awwb (63–85%) or trastuzumab-anns (75–81%)] within 28 days of the last infusion of the RP. For both biosimilars, no major differences were observed in patient characteristics between RP-naïve and pre-exposed patients. Conclusion: Initial evidence from the first 12 months following market entry suggests rapid clinical adoption of bevacizumab-awwb and trastuzumab-anns across all approved tumor types. Usage of these two biosimilars was observed in both RP-naïve patients and patients who were previously treated with RP, with no distinctive differences in patient characteristics between the two groups. A video abstract is available for this article as part of the Kanjintionline supplemental material.
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Affiliation(s)
- Ran Jin
- Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA
| | - Reshma L. Mahtani
- Sylvester Cancer Center, University of Miami, Deerfield Beach, FL, USA
| | - Neil Accortt
- Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA
| | - Tatiana Lawrence
- US Medical Assets, Amgen Inc., Thousand Oaks, CA, USA*Joint first authors
| | - Darcie Sandschafer
- US Medical Assets, Amgen Inc., Thousand Oaks, CA, USA*Joint first authors
| | - Arturo Loaiza-Bonilla
- Department of Medical Oncology, Cancer Treatment Centers of America, Comprehensive Care and Research Center, 600 Celebrate Life Parkway, Newnan, GA 30265, USA
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Li Z, Zheng Z, Li C, Li Z, Wu J, Zhang B. Therapeutic drugs and drug delivery systems targeting stromal cells for cancer therapy: a review. J Drug Target 2020; 28:714-726. [DOI: 10.1080/1061186x.2020.1744157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Zhaohuan Li
- School of Pharmacy, Weifang Medical University, Weifang, China
| | - Zengjuan Zheng
- School of Pharmacy, Weifang Medical University, Weifang, China
| | - Chenglei Li
- School of Pharmacy, Weifang Medical University, Weifang, China
| | - Zhipeng Li
- School of Bioscience and Technology, Weifang Medical University, Weifang, China
| | - Jingliang Wu
- School of Bioscience and Technology, Weifang Medical University, Weifang, China
| | - Bo Zhang
- School of Pharmacy, Weifang Medical University, Weifang, China
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Sharma S, Deep A, Rana AC, Yadav M, Sharma AK. Possible Biomarkers and Therapeutic Targets for the Management of Cervical Cancer. CURRENT CANCER THERAPY REVIEWS 2020. [DOI: 10.2174/1573394715666190126142508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction:
Cervical cancer is the most prevalent cancer in the world due to unusual
extension of cervical cell. Cervical cancer occurs due to exposure of HPV (Human papillomavirus).
According to WHO, it is the 4th most ordinary cancer in women. In 2018, approx 6.6% of
population was affected around the world and 570,000 new cases were reported. In low and
middle-income countries, 90% of cervical cancer deaths occur.
Methods:
Despite various factors that cause cervical cancer are included exposure to HPV,
dysregulation of CASPASE enzyme, elevated expression of IAPs (Inhibitor apoptotic protein), E6
and E7 gene of HPV, inhibition of p53, BAK, p16 upregulation, CDK-inactivation causing cervical
cancer, role of VEGF, role of estrogen and its receptor in cervical cancer.
Results:
Cervical cancer can be screened by Pep test. There are various therapies that can be used
to treat cervical cancer. As these therapies have various side effects, so the world is moving to
herbal formulations to treat cervical cancer.
Conclusion:
In this study, we will discuss cervical cancer, its cause, symptoms, pathophysiology
and treatments. Early screening and detection can help in reducing the overall burden of cervical
cancer in the near future.
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Affiliation(s)
- Sombeer Sharma
- Department of Pharmaceutical Sciences, Chaudhary Bansi Lal University, Bhiwani-127021, Haryana, India
| | - Aakash Deep
- Department of Pharmaceutical Sciences, Chaudhary Bansi Lal University, Bhiwani-127021, Haryana, India
| | - Avtar C. Rana
- Department of Pharmaceutical Sciences, Chaudhary Bansi Lal University, Bhiwani-127021, Haryana, India
| | - Monu Yadav
- Department of Pharmaceutical Sciences, Chaudhary Bansi Lal University, Bhiwani-127021, Haryana, India
| | - Arun K. Sharma
- Department of Pharmacology, Amity Institute of Pharmacy, Amity University, Gurugram, Haryana 122051, India
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Sreenivasan S, Kumar D, Malani H, Rathore AS. Does interaction of monoclonal antibody charge variants with VEGF-A and ELISA reagents affect its quantification? Anal Biochem 2020; 590:113513. [DOI: 10.1016/j.ab.2019.113513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 10/16/2019] [Accepted: 11/21/2019] [Indexed: 02/03/2023]
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A randomized, double-blind, single-dose study to evaluate the biosimilarity of QL1101 with bevacizumab in healthy male subjects. Cancer Chemother Pharmacol 2020; 85:555-562. [PMID: 31907645 PMCID: PMC7036053 DOI: 10.1007/s00280-019-04014-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 12/14/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE This is the first study to compare the pharmacokinetics of QL1101, a proposed bevacizumab biosimilar, with Avastin® sourced from Roche Diagnostics GmbH. METHODS In this double-blind, single-dose, parallel-group study, healthy male subjects were randomized 1:1 to receive QL1101 or Avastin® 3 mg/kg intravenously. Pharmacokinetic assessments were conducted for 85 days, with additional safety and immunogenicity assessments until day 90. Primary study endpoints were area under the concentration-time curve (AUC) from time zero to infinity (AUC0-∞), AUC from time zero to the last quantifiable concentration (AUC0-last), and maximum serum concentration (Cmax). Pharmacokinetic equivalence was shown if the 90% confidence intervals (CIs) of the geometric mean ratios (GMRs) of the C0-max, AUC0-last, and AUC0-∞ were within the predefined bioequivalence margin of 80-125.00%. RESULTS A total of 82 subjects were randomized to the following groups: 42 to QL1101 and 40 to Avastin®. The 90% CIs of the GMRs of AUC0-∞, AUC0-last, and Cmax of QL1101 and Avastin® were (97.8%, 107.0%), (94.5%, 106.9%), and (94.1%, 107.3%), respectively, which were all within the bioequivalence margin. The incidence of adverse events was 90.5% and 95.0% in the QL1101 and Avastin® groups, respectively. Mean serum concentration-time profiles, secondary pharmacokinetic parameters, and safety and immunogenicity profiles were comparable across the two treatment groups. CONCLUSIONS The study demonstrated the pharmacokinetic equivalence of QL1101 to Avastin®. QL1101 (3 mg/kg, iv) is safe and tolerable in healthy Chinese subjects. These data support the further clinical evaluation of QL1101 as a bevacizumab biosimilar.
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Konstantinidou S, Papaspiliou A, Kokkotou E. Current and future roles of biosimilars in oncology practice. Oncol Lett 2019; 19:45-51. [PMID: 31897113 PMCID: PMC6923870 DOI: 10.3892/ol.2019.11105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/30/2019] [Indexed: 12/29/2022] Open
Abstract
Biologics have been used increasingly in the treatment and supportive care of cancer; however, their high cost places a significant burden on healthcare systems. The expiration of patents for biologics has led to the development of biosimilars, with the aim of reducing cost and increasing accessibility to novel treatments, which are affordable for a greater number of patients. Biosimilars are highly similar but not identical to the reference products; therefore, strict regulatory requirements have been formed for their approval. This ensures that there are no clinically meaningful differences compared with respective biologics, with regard to purity, safety and efficacy. In 2003, a regulatory framework for the approval of biosimilars was established in Europe, whereas the USA did not implement a framework until 2009, when the Biologics Price Competition and Innovation Act was formed. A number of biosimilars have currently been approved in oncology and the number is expected to rise in the near future. More than 10 years of evidence has revealed that biosimilars are safe and effective; however healthcare professionals need to be further educated to eliminate potential misconceptions and integrate biosimilars into routine clinical practice. The present review aims to provide an overview of the biosimilars used in Europe and the USA, present their main benefits and challenges, and discuss their current and future roles in medical oncology.
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Affiliation(s)
- Sofia Konstantinidou
- Oncology Unit, The Third Department of Medicine, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Angeliki Papaspiliou
- Oncology Unit, The Third Department of Medicine, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Eleni Kokkotou
- Oncology Unit, The Third Department of Medicine, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
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Arvinte T, Palais C, Poirier E, Cudd A, Rajendran S, Brokx S, Dowd J. Part 1: Physicochemical characterization of bevacizumab in undiluted 25 mg/mL drug product solutions: Comparison of originator with a biosimilar candidate. J Pharm Biomed Anal 2019; 175:112742. [PMID: 31344647 DOI: 10.1016/j.jpba.2019.06.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/28/2019] [Accepted: 06/28/2019] [Indexed: 10/26/2022]
Abstract
The biosimilarity assessment of the physicochemical properties of high-concentration biopharmaceuticals is usually performed with measurements on diluted solutions, at concentrations below 1 mg/mL. In this study 13 orthogonal, spectroscopy and particle size determination methods were used to characterize the structure and aggregation of undiluted, 25 mg/mL bevacizumab drug products Avastin® manufactured in the USA and in Europe, and ABX-BEV, a bevacizumab biosimilar candidate produced by Apobiologix Inc. Secondary structure, conformation and the potential occurrence of chemical degradation of the monoclonal antibodies were characterized and compared using infrared spectroscopy, intrinsic fluorescence and ANS fluorescence spectroscopy. Protein aggregation and particulate matter in the monoclonal antibody solutions were compared using UV-Vis absorbance, 90° light-scattering, nanoparticle tracking analysis, Nile red fluorescence microscopy, particle flow imaging, ultrasound resonance technology and a new scanner-based method that visualizes protein aggregates inside unopened vials. A data wheel representation was used to plot in one figure the results from the multiple analytical methods and to highlight differences between samples. The 25 mg/mL Avastin® drug product is stored at 2-8 °C during its 2-year shelf life. After a thermal stress of 4 weeks at 40 °C the ABX-BEV solution was turbid, containing particles of 20-100 μm diameter, accompanied by strong changes in antibody structural properties. Characterization of unstressed samples stored at 2-8 °C showed that the physicochemical properties of bevacizumab in ABX-BEV and the two originator drug products were similar, the observed differences between the originators being in the same range as those between ABX-BEV and the originator. To investigate the similarity of the antibodies under stress conditions, a freeze-thaw study was performed. Although freeze-thawing of bevacizumab products is prohibited by the package insert, after two freeze-thaw cycles (24 °C to -80 °C) small changes in the structural and aggregation properties of bevacizumab were observed, changes that were similar for the originator and ABX-BEV. Our study showed a good similarity of the investigated physicochemical properties of bevacizumab in originator and ABX-BEV products. It also provides an analytical approach, based on orthogonal methods, to compare high-concentration formulations of monoclonal antibodies.
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Affiliation(s)
- Tudor Arvinte
- Therapeomic Inc., BioPark Rosental WRO-1055, Mattenstrasse 22, 4002 Basel, Switzerland; Department of Pharmaceutical Sciences, University of Geneva - University of Lausanne, Rue Michel Servet 1, 1211 Geneva, Switzerland.
| | - Caroline Palais
- Therapeomic Inc., BioPark Rosental WRO-1055, Mattenstrasse 22, 4002 Basel, Switzerland
| | - Emilie Poirier
- Therapeomic Inc., BioPark Rosental WRO-1055, Mattenstrasse 22, 4002 Basel, Switzerland
| | - Amelia Cudd
- Therapeomic Inc., BioPark Rosental WRO-1055, Mattenstrasse 22, 4002 Basel, Switzerland
| | | | | | - Jason Dowd
- Apobiologix Inc., Toronto, Ontario, Canada
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Busse A, Lüftner D. What Does the Pipeline Promise about Upcoming Biosimilar Antibodies in Oncology? Breast Care (Basel) 2019; 14:10-16. [PMID: 31019437 PMCID: PMC6465746 DOI: 10.1159/000496834] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The introduction of biosimilars of biological agents for which the patents and exclusivity periods have expired is an attractive way of reducing healthcare spending through price competition with the reference product. In oncology, biosimilars of growth factors for supportive therapy were the pioneers; now, monoclonal antibody biosimilars are conquering the market. In Europe, this is currently limited to biosimilars of the monoclonal antibodies trastuzumab and rituximab. However, the pipeline is full and several monoclonal antibody biosimilars in oncology are now in late-stage development. We are expecting not only more biosimilar versions of the top 3 blockbuster monoclonal antibodies, trastuzumab, rituximab and bevacizumab, to enter the market; as patent expiration of multiple other cancer biologicals will occur in the next few years, the biosimilar landscape will become much more diversified. Several biosimilars of monoclonal antibodies used in targeted therapy such as cetuximab, pertuzumab, or denosumab are in early development.
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Affiliation(s)
- Antonia Busse
- Medical Department of Hematology, Oncology and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
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Yamada T, Saito T, Hill Y, Shimizu Y, Tsukakoshi K, Mizuno H, Hayashi H, Ikebukuro K, Toyo'oka T, Todoroki K. High-Throughput Bioanalysis of Bevacizumab in Human Plasma Based on Enzyme-Linked Aptamer Assay Using Anti-Idiotype DNA Aptamer. Anal Chem 2019; 91:3125-3130. [PMID: 30667211 DOI: 10.1021/acs.analchem.8b05725] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
We propose a highly selective, sensitive, accurate, and high-throughput bioanalysis method for bevacizumab utilizing an anti-idiotype DNA aptamer. With this method, bevacizumab in a plasma sample was reacted in a 96-well plate immobilized with the aptamer and further reacted with a protein A-HRP conjugate. The resulting HRP activity was colorimetrically detected using a microplate reader. The calibration curve of bevacizumab ranged from 0.05 to 5.0 μg/mL, and showed a good correlation coefficient ( r2 = 1.000). The limit of detection was 2.09 ng/mL. We also demonstrated both the possibility of highly sensitive detection using luminol chemiluminescence and the repeated use of affinity plates. The proposed method is applicable for planning optimal therapeutic programs and for an evaluation of the biological equivalencies in the development of biosimilars.
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Affiliation(s)
- Tomohiro Yamada
- Laboratory of Analytical and Bio-Analytical Chemistry, School of Pharmaceutical Sciences , University of Shizuoka , 52-1 Yada , Suruga-ku, Shizuoka 422-8526 , Japan
| | - Taro Saito
- Department of Biotechnology and Life Science, Graduate School of Engineering , Tokyo University of Agriculture and Technology , 2-24-16 Naka-cho , Koganei , Tokyo 184-8588 , Japan
| | - Yoshia Hill
- Laboratory of Analytical and Bio-Analytical Chemistry, School of Pharmaceutical Sciences , University of Shizuoka , 52-1 Yada , Suruga-ku, Shizuoka 422-8526 , Japan
| | - Yutaka Shimizu
- Department of Biotechnology and Life Science, Graduate School of Engineering , Tokyo University of Agriculture and Technology , 2-24-16 Naka-cho , Koganei , Tokyo 184-8588 , Japan
| | - Kaori Tsukakoshi
- Department of Biotechnology and Life Science, Graduate School of Engineering , Tokyo University of Agriculture and Technology , 2-24-16 Naka-cho , Koganei , Tokyo 184-8588 , Japan
| | - Hajime Mizuno
- Laboratory of Analytical and Bio-Analytical Chemistry, School of Pharmaceutical Sciences , University of Shizuoka , 52-1 Yada , Suruga-ku, Shizuoka 422-8526 , Japan
| | - Hideki Hayashi
- Laboratory of Pharmacy Practice and Social Science , Gifu Pharmaceutical University , Daigaku-nishi 1-25-4 , Gifu 501-1196 , Japan
| | - Kazunori Ikebukuro
- Department of Biotechnology and Life Science, Graduate School of Engineering , Tokyo University of Agriculture and Technology , 2-24-16 Naka-cho , Koganei , Tokyo 184-8588 , Japan
| | - Toshimasa Toyo'oka
- Laboratory of Analytical and Bio-Analytical Chemistry, School of Pharmaceutical Sciences , University of Shizuoka , 52-1 Yada , Suruga-ku, Shizuoka 422-8526 , Japan
| | - Kenichiro Todoroki
- Laboratory of Analytical and Bio-Analytical Chemistry, School of Pharmaceutical Sciences , University of Shizuoka , 52-1 Yada , Suruga-ku, Shizuoka 422-8526 , Japan
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Wynne C, Schwabe C, Batra SS, Lopez-Lazaro L, Kankanwadi S. A comparative pharmacokinetic study of DRL_BZ, a candidate biosimilar of bevacizumab, with Avastin ® (EU and US) in healthy male subjects. Br J Clin Pharmacol 2018; 84:2352-2364. [PMID: 29943831 DOI: 10.1111/bcp.13691] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/31/2018] [Accepted: 06/11/2018] [Indexed: 11/30/2022] Open
Abstract
AIM The aim of this study was to compare the pharmacokinetics (PK) of DRL_BZ with that of EU-approved (reference medicinal product; RMP) and US-licensed (reference product; RP) bevacizumab (Avastin® ) in healthy male subjects. METHODS In this double-blind, parallel-group, Phase 1 study (BZ-01-001), men aged 20-45 years were randomized 1:1:1 to receive a single intravenous infusion of 1 mg kg-1 of bevacizumab as DRL_BZ, RMP or RP. A total of 149 subjects were randomized (DRL_BZ, 50; RMP, 50; RP, 49). Primary endpoints included maximum observed serum concentration (Cmax ), area under the concentration-time curve from time zero (pre-dose) extrapolated to infinity (AUC(0-∞) ), and area under the concentration-time curve from time zero (pre-dose) to last quantifiable concentration (AUC(0-t) ). Secondary objectives were to compare the safety and immunogenicity of DRL_BZ with those of the reference products. RESULTS Primary PK parameters were comparable across groups, and 90% confidence intervals for the geometric mean ratios of the primary PK endpoints were within the pre-specified equivalence margins (80-125%) for all pairwise comparisons (DRL_BZ vs. RMP, DRL_BZ vs. RP and RMP vs. RP). No deaths or serious adverse events were reported. Similar numbers of subjects reported similar numbers of treatment-emergent adverse events in the three treatment groups. One subject who received DRL_BZ had anti-drug antibodies at the Day 85 visit; however, no anti-drug antibodies were detected in this subject at the 12-month follow-up visit. CONCLUSIONS PK, safety and immunogenicity of DRL_BZ were comparable to EU-approved and US-licensed bevacizumab in healthy male subjects.
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Affiliation(s)
- Chris Wynne
- Christchurch Clinical Studies Trust Ltd., 31 Tuam Street, Post Office Box 2856, Christchurch, 8011, New Zealand
| | - Christian Schwabe
- Auckland Clinical Studies Ltd., ACS House, 3 Ferncroft Street, Grafton, New Zealand
| | - Sonica Sachdeva Batra
- Biologics, Dr. Reddy's Lab. Ltd., Survey No. 47, Bachupally, Medchal Malkajgiri District,, Telangana, Hyderabad, 500 090, India
| | - Luis Lopez-Lazaro
- Biologics, Dr. Reddy's Lab. SA, Elisabethenanlage 11, Basel, 4051, Switzerland
| | - Suresh Kankanwadi
- Biologics, Dr. Reddy's Lab. SA, Elisabethenanlage 11, Basel, 4051, Switzerland
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