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Segal NH, Logan TF, Hodi FS, McDermott D, Melero I, Hamid O, Schmidt H, Robert C, Chiarion-Sileni V, Ascierto PA, Maio M, Urba WJ, Gangadhar TC, Suryawanshi S, Neely J, Jure-Kunkel M, Krishnan S, Kohrt H, Sznol M, Levy R. Results from an Integrated Safety Analysis of Urelumab, an Agonist Anti-CD137 Monoclonal Antibody. Clin Cancer Res 2017; 23:1929-1936. [PMID: 27756788 DOI: 10.1158/1078-0432.ccr-16-1272] [Citation(s) in RCA: 253] [Impact Index Per Article: 36.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/10/2016] [Accepted: 08/29/2016] [Indexed: 11/16/2022]
Abstract
Purpose: Urelumab is an agonist antibody to CD137 with potential application as an immuno-oncology therapeutic. Data were analyzed to assess safety, tolerability, and pharmacodynamic activity of urelumab, including the dose selected for ongoing development in patients with advanced solid tumors and lymphoma.Experimental Design: A total of 346 patients with advanced cancers who had progressed after standard treatment received at least one dose of urelumab in one of three dose-escalation, monotherapy studies. Urelumab was administered at doses ranging from 0.1 to 15 mg/kg. Safety analyses included treatment-related and serious adverse events (AEs), as well as treatment-related AEs leading to discontinuation and death, with a focus on liver function test abnormalities and hepatic AEs.Results: Urelumab doses between 1 and 15 mg/kg given every 3 weeks resulted in a higher frequency of treatment-related AEs than 0.1 or 0.3 mg/kg every 3 weeks. Dose was the single most important factor contributing to transaminitis development, which was more frequent and severe at doses ≥1 mg/kg. At the MTD of 0.1 mg/kg every 3 weeks, urelumab was relatively well tolerated, with fatigue (16%) and nausea (13%) being the most common treatment-related AEs, and was associated with immunologic and pharmacodynamic activity demonstrated by the induction of IFN-inducible genes and cytokines.Conclusions: Integrated evaluation of urelumab safety data showed significant transaminitis was strongly associated with doses of ≥1 mg/kg. However, urelumab 0.1 mg/kg every 3 weeks was demonstrated to be safe, with pharmacodynamic activity supporting continued clinical evaluation of this dose as monotherapy and in combination with other immuno-oncology agents. Clin Cancer Res; 23(8); 1929-36. ©2016 AACR.
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Affiliation(s)
- Neil H Segal
- Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | | | | | - Omid Hamid
- The Angeles Clinic and Research Institute, Los Angeles, California
| | | | - Caroline Robert
- Gustave Roussy and Paris-Sud University Villejuif, Villejuif, France
| | | | - Paolo A Ascierto
- Istituto Nazionale Tumori Fondazione "G. Pascale," Naples, Italy
| | | | - Walter J Urba
- Earle A. Chiles Research Institute, Providence Portland Medical Center, Portland, Oregon
| | - Tara C Gangadhar
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | | | | | - Holbrook Kohrt
- Stanford University School of Medicine, Stanford, California
| | - Mario Sznol
- Yale Comprehensive Cancer Center, New Haven, Connecticut
| | - Ronald Levy
- Stanford University School of Medicine, Stanford, California.
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