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Geurts VCM, Voorwerk L, Balduzzi S, Salgado R, Van de Vijver K, van Dongen MGJ, Kemper I, Mandjes IAM, Heuver M, Sparreboom W, Haanen JBAG, Sonke GS, Horlings HM, Kok M. Unleashing NK- and CD8 T cells by combining monalizumab and trastuzumab for metastatic HER2-positive breast cancer: Results of the MIMOSA trial. Breast 2023; 70:76-81. [PMID: 37393645 DOI: 10.1016/j.breast.2023.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 07/04/2023] Open
Abstract
The large majority of patients with HER2-positive metastatic breast cancer (MBC) will eventually develop resistance to anti-HER2 therapy and die of this disease. Despite, relatively high levels of stromal tumor infiltrating lymphocytes (sTILs), PD1-blockade has only shown modest responses. Monalizumab targets the inhibitory immune checkpoint NKG2A, thereby unleashing NK- and CD8 T cells. We hypothesized that monalizumab synergizes with trastuzumab by promoting antibody-dependent cell-mediated cytotoxicity. In the phase II MIMOSA-trial, HER2-positive MBC patients were treated with trastuzumab and 750 mg monalizumab every two weeks. Following a Simon's two-stage design, 11 patients were included in stage I of the trial. Treatment was well tolerated with no dose-limiting toxicities. No objective responses were observed. Therefore, the MIMOSA-trial did not meet its primary endpoint. In summary, despite the strong preclinical rationale, the novel combination of monalizumab and trastuzumab does not induce objective responses in heavily pre-treated HER2-positive MBC patients.
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Affiliation(s)
- V C M Geurts
- Division of Tumor Biology & Immunology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - L Voorwerk
- Division of Tumor Biology & Immunology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - S Balduzzi
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - R Salgado
- Department of Pathology, ZAS, Antwerp, Belgium; Division of Research, Peter Mac Callum Cancer Center, Melbourne, Victoria, Australia.
| | - K Van de Vijver
- Department of Pathology, University Hospital Ghent, Cancer Research Institute Ghent (CRIG), Ghent, Belgium.
| | - M G J van Dongen
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - I Kemper
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - I A M Mandjes
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - M Heuver
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | | | - J B A G Haanen
- Division of Molecular Oncology & Immunology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - G S Sonke
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - H M Horlings
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - M Kok
- Division of Tumor Biology & Immunology, Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
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van Dongen MGJ, Kok M. Mise en place: toward neoadjuvant chemoimmunotherapy for early triple-negative breast cancer. Ann Oncol 2020; 31:556-557. [PMID: 32171753 DOI: 10.1016/j.annonc.2020.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 02/27/2020] [Indexed: 11/26/2022] Open
Affiliation(s)
- M G J van Dongen
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Clinical Pharmacology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - M Kok
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Tumor Biology & Immunology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
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van Dongen MGJ, Geerts BF, Bhanot S, Morgan ES, de Kam ML, Moerland M, Romijn JA, Cohen AF, Burggraaf J. Characterization of a standardized glucagon challenge test as a pharmacodynamic tool in pharmacological research. Horm Metab Res 2014; 46:269-73. [PMID: 24402684 DOI: 10.1055/s-0033-1363223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim of this study was to characterize a glucagon challenge test as a tool in diabetes research by assessing the inter- and intra-individual variability, and investigating the activity of the autonomic nervous system (ANS) during the challenge, as this might have an indirect impact on glucose homeostasis. The study was performed in 24 healthy volunteers separated in 2 groups. The first group of 12 volunteers underwent a 5-h glucagon challenge during a pancreatic clamp procedure with infusion of [6,6-2H2]-glucose infusion in combination with heart rate variability measurements. In the second group, 12 other healthy volunteers underwent two 6-h glucagon challenges separated by 6 weeks, and fat biopsies were taken for analysis of glucagon receptor expression. Serum glucose rose rapidly after glucagon infusion, and reached a plateau at 90 min. The time profiles suggested rapid development of tolerance for glucagon-induced hyperglycemia. During the glucagon challenge intra- and inter-individual variabilities for hepatic glucose production, the rate of disappearance of glucose, and plasma glucose were approximately 10-15% for all variables. Hyperglucagonemia did not affect heart rate variability. Human adipose tissue had a low, but variable, expression of glucagon receptor mRNA. This standardized glucagon challenge test has a good reproducibility with only limited variability over 6 weeks. It is a robust tool to explore in detail the contribution of glucagon in normal and altered glucose homeostasis and can also be used to evaluate the effects of drugs antagonizing glucagon action in humans without confounding changes in ANS tone.
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Affiliation(s)
| | - B F Geerts
- Leiden University Medical Center, Leiden, The Netherlands
| | - S Bhanot
- Isis Pharmaceuticals Inc, Carlsbad, CA, USA
| | - E S Morgan
- Isis Pharmaceuticals Inc, Carlsbad, CA, USA
| | - M L de Kam
- Centre for Human Drug Research, Leiden, The Netherlands
| | - M Moerland
- Centre for Human Drug Research, Leiden, The Netherlands
| | - J A Romijn
- Academic Medical Center, Amsterdam, The Netherlands
| | - A F Cohen
- Centre for Human Drug Research, Leiden, The Netherlands
| | - J Burggraaf
- Centre for Human Drug Research, Leiden, The Netherlands
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Dillingh MR, van den Blink B, Moerland M, van Dongen MGJ, Levi M, Kleinjan A, Wijsenbeek MS, Lupher ML, Harper DM, Getsy JA, Hoogsteden HC, Burggraaf J. Recombinant human serum amyloid P in healthy volunteers and patients with pulmonary fibrosis. Pulm Pharmacol Ther 2013; 26:672-6. [PMID: 23380438 DOI: 10.1016/j.pupt.2013.01.008] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 01/22/2013] [Accepted: 01/27/2013] [Indexed: 11/28/2022]
Abstract
PRM-151, recombinant human Pentraxin-2 (PTX-2) also referred to as serum amyloid P (SAP), is under development for treatment of fibrosis. A First-in-Human (FIH) trial was performed to assess the safety, tolerability, and pharmacokinetics of single ascending intravenous doses of PRM-151 administered to healthy subjects, using a randomized, blinded, placebo controlled study design. Each cohort included three healthy subjects (PRM-151:placebo; 2:1). SAP levels were assessed using a validated ELISA method, non-discriminating between endogenous and exogenous SAP. At a dose level of 10 mg/kg, at which a physiologic plasma level of SAP was reached, two additional healthy volunteers and three pulmonary fibrosis (PF) patients were enrolled enabling comparison of the pharmacokinetic SAP profile between healthy volunteers and PF patients. In addition, the percentage of fibrocytes (CD45+/Procollagen-1+ cells) in whole blood samples was assessed to demonstrate biological activity of PRM-151 in the target population. PRM-151 administration was generally well tolerated. In two pulmonary fibrosis patients non-specific, transient skin reactions (urticaria and erythema) were observed. PRM-151 administration resulted in a 6-to 13-fold increase in mean baseline plasma SAP levels at dose levels of 5, 10, and 20 mg/kg. The estimated t1/2 of PRM-151 in healthy volunteers was 30 h. Pharmacokinetic profiles were comparable between healthy volunteers and PF patients. PRM-151 administration resulted in a 30-50% decrease in fibrocyte numbers 24 h post-dose. This suggests that administration of PRM-151 may be associated with a reduction of fibrocytes in PF patients, a population for which current pharmacotherapeutic options are limited. The pharmacological action of PRM-151 should be confirmed in future research.
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Affiliation(s)
- M R Dillingh
- Centre for Human Drug Research, Zernikedreef 8, 2333 CL Leiden, The Netherlands.
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