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Takeuchi T, Chino Y, Mano Y, Kawanishi M, Sato Y, Uchida S, Tanaka Y. Population Pharmacokinetics of Ozoralizumab in Patients with Rheumatoid Arthritis. J Clin Pharmacol 2024; 64:418-427. [PMID: 37909264 DOI: 10.1002/jcph.2380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/30/2023] [Indexed: 11/03/2023]
Abstract
Ozoralizumab is a bispecific NANOBODY compound that binds tumor necrosis factor alpha (TNFα) and human serum albumin. Ozoralizumab inhibits the TNFα physiological activity while maintaining long-term plasma retention owing to its human serum albumin-binding ability. A population pharmacokinetic (PK) model was developed using data from 494 Japanese patients with rheumatoid arthritis in Phase II/III and Phase III trials to assess the effects of potential PK covariates. The ozoralizumab PK after subcutaneous administration was described using a 1-compartment model with first-order absorption and first-order elimination processes. A proportional error model was used for inter- and intra-individual variabilities, with covariance set between inter-individual variabilities of the apparent clearance and apparent distribution volume. Body weight, sex, antidrug antibody status, estimated glomerular filtration rate, and concomitant methotrexate use were identified as covariates for apparent clearance, while body weight and sex were covariates for apparent distribution volume in the final model. Body weight had the greatest effect on the PK of ozoralizumab, while the other covariates had minor effects. When administered at 30 mg every 4 weeks, the predicted steady-state plasma trough concentration in a patient weighing 83.2 kg exceeded the trough concentration required to maintain efficacy of ozoralizumab, and the estimated exposure in a patient weighing 42.5 kg did not exceed the mean exposure at 80 mg, a well-tolerated dose, throughout 52 weeks. We developed a population PK model that adequately described the ozoralizumab PK in Japanese patients with rheumatoid arthritis, and none of the evaluated covariates showed clinically relevant effects on the PK of ozoralizumab.
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Affiliation(s)
- Tsutomu Takeuchi
- Saitama Medical University, Saitama, Japan
- Keio University School of Medicine, Tokyo, Japan
| | | | - Yoko Mano
- Taisho Pharmaceutical Co., Ltd., Tokyo, Japan
| | | | - Yuri Sato
- Taisho Pharmaceutical Co., Ltd., Tokyo, Japan
| | | | - Yoshiya Tanaka
- University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Li X, Li B, Wang M, Fang M, Lou J, Liu J, Chen H, Ding Y. Safety, Tolerability, Pharmacokinetics, and Immunogenicity of the Anti-IFNAR1 Monoclonal Antibody QX006N: A First-in-Human Single Ascending Dose Study in Healthy Chinese Volunteers. BioDrugs 2024; 38:313-321. [PMID: 38148466 DOI: 10.1007/s40259-023-00637-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND AND OBJECTIVE QX006N is a novel, humanized, IgG4κ monoclonal antibody targeting IFNAR1, developed for the treatment of systemic lupus erythematosus. This study aims to investigate the pharmacokinetics, safety, tolerability, and immunogenicity of QX006N when administered intravenously to healthy Chinese individuals. METHODS A double-blind, randomized, placebo-controlled, single-ascending-dose, phase I clinical trial was conducted comprising five cohorts (n = 10 per cohort, except n = 5 for the first cohort). Subjects in each cohort were randomly assigned in a 4:1 ratio to receive a single intravenous infusion of QX006N (0.3 mg/kg, 1.0 mg/kg, 3.0 mg/kg, 6.0 mg/kg, or 10.0 mg/kg) or placebo for 30 minutes. Tolerability assessments included adverse events, vital signs, 12-lead electrocardiogram, physical examination, and clinical laboratory tests. The serum concentration of QX006N was measured using the enzyme-linked immunosorbent assay method, and the anti-drug antibodies were detected using the electrochemiluminescence assay method. RESULTS QX006N demonstrated a favorable safety and tolerability profile throughout the study. All treatment-emergent adverse events were of Grade 1-2 (CTCAE Version 5.0), and no serious adverse events, deaths, or drug discontinuations because of treatment-emergent adverse events were observed. All drug-related treatment-emergent adverse events showed no clear dose-related trends. Following an intravenous infusion of QX006N at doses that ranged from 0.3 mg/kg to 10 mg/kg, the half-life increased from 24.7 to 208 hours in a dose-dependent manner, while clearance decreased from 0.0828 to 0.0065 L/h. The maximum concentration exhibited nearly dose-proportional increases, and the area under the curve displayed a more than dose-proportional increment with non-linear pharmacokinetic characteristics. The incidence of anti-drug antibodies was observed to increase over time for doses that ranged from 1.0 mg/kg to 10.0 mg/kg of QX006N, reaching its peak at day 57 (range 62.50-87.50%). Conversely, the incidence of anti-drug antibodies in the QX006N 0.3-mg/kg and placebo cohorts remained low. CONCLUSIONS QX006N demonstrated acceptable safety, tolerability, and pharmacokinetic characteristics in healthy subjects when administered as a single intravenous infusion at doses that ranged from 0.3 mg/kg to 10.0 mg/kg. Based on the pharmacokinetic and safety outcomes, a recommended effective dose of 300 mg is proposed for future phase Ib studies. CLINICAL TRIAL REGISTRATION This study has been registered at http://www.chinadrugtrials.org.cn/ under identifier CTR20212834.
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Affiliation(s)
- Xiaojiao Li
- Phase I Clinical Trial Center, First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, 130021, China
| | - Bing Li
- Phase I Clinical Trial Center, First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, 130021, China
| | - Meng Wang
- Phase I Clinical Trial Center, First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, 130021, China
| | - Min Fang
- Qyuns Therapeutics Co., Ltd., Jiangsu, China
| | - Jinfeng Lou
- Phase I Clinical Trial Center, First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, 130021, China
| | - Jingrui Liu
- Phase I Clinical Trial Center, First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, 130021, China
| | - Hong Chen
- Phase I Clinical Trial Center, First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, 130021, China
| | - Yanhua Ding
- Phase I Clinical Trial Center, First Hospital of Jilin University, No. 1 Xinmin Street, Changchun, 130021, China.
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Li Z, Du X, Huang SM, Wang YMC. Pharmacokinetics-Bridging Between Autoinjectors and Prefilled Syringes for Subcutaneous Injection: Case Examples Revealing a Knowledge Gap. Clin Pharmacol Ther 2024; 115:404-407. [PMID: 38167787 DOI: 10.1002/cpt.3145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024]
Abstract
Comparative pharmacokinetics (PK) studies have efficiently served as the bridge between autoinjectors and prefilled syringes given the underlying principles that comparable exposure could translate to comparable efficacy and safety. This article discusses approaches used to address uncertainties associated with the observation of noncomparable PK leading to the successful introduction of new autoinjector devices for monoclonal antibody and Fc-fusion protein products. Information from seven case examples suggests a knowledge gap that warrants attention in autoinjector development.
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Affiliation(s)
- Zhe Li
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration (OCP/CDER/FDA), Silver Spring, Maryland, USA
| | - Xiulian Du
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration (OCP/CDER/FDA), Silver Spring, Maryland, USA
| | - Shiew Mei Huang
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration (OCP/CDER/FDA), Silver Spring, Maryland, USA
| | - Yow-Ming C Wang
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration (OCP/CDER/FDA), Silver Spring, Maryland, USA
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Hu Z, Liu S, Zhao Y, Du S, Hamuro L, Shen J, Roy A, Zhu L. Nivolumab and ipilimumab population pharmacokinetics in support of pediatric dose recommendations-Going beyond the body-size effect. CPT Pharmacometrics Syst Pharmacol 2024; 13:476-493. [PMID: 38115545 PMCID: PMC10941504 DOI: 10.1002/psp4.13098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/22/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
Body size has historically been considered the primary source of difference in the pharmacokinetics (PKs) of monoclonal antibodies (mAbs) between children aged greater than or equal to 2 years and adults. The contribution of age-associated differences (e.g., ontogeny) beyond body-size differences in the pediatric PKs of mAbs has not been comprehensively evaluated. In this study, the population PK of two mAbs (nivolumab and ipilimumab) in pediatric oncology patients were characterized. The effects of age-related covariates on nivolumab or ipilimumab PKs were assessed using data from 13 and 10 clinical studies, respectively, across multiple tumor types, including melanoma, lymphoma, central nervous system tumors (CNSTs), and other solid tumors. Clearance was lower in pediatric patients (aged 1-17 years) with solid tumors or CNST than in adults after adjusting for other covariates, including the effect of body size. In contrast, clearance was similar in pediatric patients with lymphoma to that in adults with lymphoma. The pediatric effects characterized have increased the accuracy of the predictions of the model, facilitating its use in subsequent exposure comparisons between pediatric and adult patients, as well as for exposure-response analyses to inform pediatric dosing. This study approach may be applicable to the optimization of pediatric dosing of other mAbs and possibly other biologics.
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Affiliation(s)
- Zheyi Hu
- Bristol Myers SquibbPrincetonNew JerseyUSA
| | - Sihang Liu
- Bristol Myers SquibbPrincetonNew JerseyUSA
| | - Yue Zhao
- Bristol Myers SquibbPrincetonNew JerseyUSA
| | | | | | - Jun Shen
- Bristol Myers SquibbPrincetonNew JerseyUSA
| | - Amit Roy
- Bristol Myers SquibbPrincetonNew JerseyUSA
| | - Li Zhu
- Bristol Myers SquibbPrincetonNew JerseyUSA
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Cook KD, Tran T, Thomas VA, Devanaboyina SC, Rock DA, Pearson JT. Correlation of In Vitro Kinetic Stability to Preclinical In Vivo Pharmacokinetics for a Panel of Anti-PD-1 Monoclonal Antibody Interleukin 21 Mutein Immunocytokines. Drug Metab Dispos 2024; 52:228-235. [PMID: 38135505 DOI: 10.1124/dmd.123.001555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023] Open
Abstract
The development of therapeutic fusion protein drugs is often impeded by the unintended consequences that occur from fusing together domains from independent naturally occurring proteins, consequences such as altered biodistribution, tissue uptake, or rapid clearance and potential immunogenicity. For therapeutic fusion proteins containing globular domains, we hypothesized that aberrant in vivo behavior could be related to low kinetic stability of these domains leading to local unfolding and susceptibility to partial proteolysis and/or salvage and uptake. Herein we describe an assay to measure kinetic stability of therapeutic fusion proteins by way of their sensitivity to the protease thermolysin. The results indicate that in vivo pharmacokinetics of a panel of anti-programmed cell death protein 1 monocolonal antibody:interleukin 21 immunocytokines in both mice and nonhuman primates are highly correlated with their in vitro susceptibility to thermolysin-mediated proteolysis. This assay can be used as a tool to quickly identify in vivo liabilities of globular domains of therapeutic proteins, thus aiding in the optimization and development of new multispecific drug candidates. SIGNIFICANCE STATEMENT: This work describes a novel assay utilizing protein kinetic stability to identify preclinical in vivo pharmacokinetic liabilities of multispecific therapeutic fusion proteins. This provides an efficient, inexpensive method to ascertain inherent protein stability in vitro before conducting in vivo studies, which can rapidly increase the speed of preclinical drug development.
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Affiliation(s)
- Kevin D Cook
- Amgen Research, Pharmacokinetics & Drug Metabolism, South San Francisco, California
| | - Thuy Tran
- Amgen Research, Pharmacokinetics & Drug Metabolism, South San Francisco, California
| | - Veena A Thomas
- Amgen Research, Pharmacokinetics & Drug Metabolism, South San Francisco, California
| | | | - Dan A Rock
- Amgen Research, Pharmacokinetics & Drug Metabolism, South San Francisco, California
| | - Josh T Pearson
- Amgen Research, Pharmacokinetics & Drug Metabolism, South San Francisco, California
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Dhenin J, Lafont V, Dupré M, Krick A, Mauriac C, Chamot-Rooke J. Monitoring mAb proteoforms in mouse plasma using an automated immunocapture combined with top-down and middle-down mass spectrometry. Proteomics 2024; 24:e2300069. [PMID: 37480175 DOI: 10.1002/pmic.202300069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 07/23/2023]
Abstract
Monoclonal antibodies (mAbs) have established themselves as the leading biopharmaceutical therapeutic modality. Once the developability of a mAb drug candidate has been assessed, an important step is to check its in vivo stability through pharmacokinetics (PK) studies. The gold standard is ligand-binding assay (LBA) and liquid chromatography-mass spectrometry (LC-MS) performed at the peptide level (bottom-up approach). However, these analytical techniques do not allow to address the different mAb proteoforms that can arise from biotransformation. In recent years, top-down and middle-down mass spectrometry approaches have gained popularity to characterize proteins at the proteoform level but are not yet widely used for PK studies. We propose here a workflow based on an automated immunocapture followed by top-down and middle-down liquid chromatography-tandem mass spectrometry (LC-MS/MS) approaches to characterize mAb proteoforms spiked in mouse plasma. We demonstrate the applicability of our workflow on a large concentration range using pembrolizumab as a model. We also compare the performance of two state-of-the-art Orbitrap platforms (Tribrid Eclipse and Exploris 480) for these studies. The added value of our workflow for an accurate and sensitive characterization of mAb proteoforms in mouse plasma is highlighted.
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Affiliation(s)
- Jonathan Dhenin
- Institut Pasteur, Université Paris Cité, CNRS UAR2024, Mass Spectrometry for Biology, Paris, France
- Université Paris Cité, Sorbonne Paris Cité, Paris, France
- DMPK, Sanofi R&D, Chilly-Mazarin, France
| | | | | | | | | | - Julia Chamot-Rooke
- Institut Pasteur, Université Paris Cité, CNRS UAR2024, Mass Spectrometry for Biology, Paris, France
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Wang J, Chen T, Ruszaj DM, Mager DE, Straubinger RM. Integrated PK/PD Modeling Relates Smoothened Inhibitor Biomarkers to The Heterogeneous Intratumor Disposition of Cetuximab in Pancreatic Cancer Tumor Models. J Pharm Sci 2024; 113:72-84. [PMID: 37844759 DOI: 10.1016/j.xphs.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 10/18/2023]
Abstract
Therapeutic antibodies have shown little efficacy in the treatment of pancreatic ductal adenocarcinomas (PDAC). Tumor desmoplasia, hypovascularity, and poor perfusion result in insufficient tumor cell exposure, contributing to treatment failure. Smoothened inhibitors of hedgehog signaling (sHHi) increase PDAC tumor permeability, perfusion, and drug delivery, and provide a tool to develop a quantitative, mechanistic understanding as to how the temporal dynamics of tumor priming can impact intratumor distribution of monoclonal antibodies (mAb). A linked pharmacokinetic (PK)/pharmacodynamic (PD) model was developed to integrate the plasma and tumor PK of a sHHi priming agent with its effects upon downstream stromal biomarkers Gli1, hyaluronic acid, and interstitial fluid pressure in PDAC patient-derived xenograft (PDX) tumors. In parallel, in situ tumor concentrations of cetuximab (CTX: anti-epidermal growth factor receptor; EGFR) were quantified as a marker for tumor delivery of mAb or antibody-drug conjugates. A minimal, physiologically-based pharmacokinetic (mPBPK) model was constructed to link sHHi effects upon mechanistic effectors of tumor barrier compromise with the intratumor distribution of CTX, and CTX occupancy of EGFR in tumors. Integration of the mPBPK model of mAb deposition and intratumor distribution with the PK/PD model of tumor responses to priming not only identified physiological parameters that are critical for tumor antibody distribution, but also provides insight into dosing regimens that could achieve maximal tumor disposition of therapeutic antibodies under conditions of transient PDAC tumor permeability barrier compromise that mechanistically-diverse tumor priming strategies may achieve.
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Affiliation(s)
- Jun Wang
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Ting Chen
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Donna M Ruszaj
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Donald E Mager
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Enhanced Pharmacodynamics, LLC, Buffalo, NY, USA
| | - Robert M Straubinger
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA; Department of Cell Stress Biochemistry and Biophysics, Roswell Park Comprehenhsive Cancer Center, Buffalo, NY, USA; Department of Pharmacology and Therapeutics, Roswell Park Comprehenhsive Cancer Center, Buffalo, NY, USA.
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8
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Naoi S, Yamane M, Nemoto T, Kato M, Saito R, Tachibana T. Physiologically based pharmacokinetic (PBPK) model that describes enhanced FcRn-dependent distribution of monoclonal antibodies (mAbs) by pI-engineering in mice. Drug Metab Pharmacokinet 2023; 53:100506. [PMID: 38029470 DOI: 10.1016/j.dmpk.2023.100506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/22/2023] [Accepted: 03/15/2023] [Indexed: 12/01/2023]
Abstract
We previously reported that monoclonal antibodies (mAbs) with a high isoelectric point (pI) value tended to exhibit fast plasma clearance (CL) and large steady-state volume of distribution (Vdss) in mice. However, the positive correlation between pI, CL, and Vdss cannot be described by the reported physiologically based pharmacokinetic (PBPK) models, in which FcRn-mediated transcytosis of mAbs is set to be minimal compared to convection-mediated transport. To address this issue, physiological parameters (lymph flow rate, reflection coefficient, endothelial uptake clearance, and FcRn concentration) were optimized based on the pharmacokinetic profiles of mAbs with various pI values in wild type and FcRn-deficient (beta-2-microglobulin knockout [KO]) mice. Simulations using the PBPK model developed in this study showed a positive correlation between pI, CL and Vdss observed in wild-type mice. Therefore, this model successfully characterized our hypothetical mechanism that an electrostatic positive interaction between mAbs and the endothelial membrane enhances FcRn-mediated transcytosis of mAbs, resulting in large Vdss. We sought to determine the right contribution of the two pathways of antibody distribution to the interstitial space and established a new model that could effectively capture the effect of pI on FcRn-mediated distribution of mAbs in the body.
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Affiliation(s)
- Sotaro Naoi
- Chugai Pharmaceutical Co., Ltd., 1-135, Komakado, Gotemba, Shizuoka, 412-8513, Japan.
| | - Mizuki Yamane
- Chugai Pharmaceutical Co., Ltd., 200, Kajiwara, Kamakura, Kanagawa, 247-8530, Japan
| | - Takayuki Nemoto
- Chugai Pharmaceutical Co., Ltd., 200, Kajiwara, Kamakura, Kanagawa, 247-8530, Japan
| | - Motohiro Kato
- Research Institute of Pharmaceutical Sciences, Musashino University, 1-1-20, Shinmachi, Nishitokyo, Tokyo, 202-8585, Japan
| | - Ryoichi Saito
- Chugai Pharmaceutical Co., Ltd., 200, Kajiwara, Kamakura, Kanagawa, 247-8530, Japan
| | - Tatsuhiko Tachibana
- Chugai Pharmaceutical Co., Ltd., 1-135, Komakado, Gotemba, Shizuoka, 412-8513, Japan
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9
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Corpstein CD, Hou P, Park K, Li T. Multiphysics Simulation of Local Transport and Absorption Coupled with Pharmacokinetic Modeling of Systemic Exposure of Subcutaneously Injected Drug Solution. Pharm Res 2023; 40:2873-2886. [PMID: 37344601 DOI: 10.1007/s11095-023-03546-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023]
Abstract
INTRODUCTION Subcutaneous (SC) injectables have become more acceptable and feasible for administration of biologics and small molecules. However, efficient development of these products is limited to costly and time-consuming techniques, partially because absorption mechanisms and kinetics at the local site of injection remain poorly understood. OBJECTIVE To bridge formulation critical quality attributes (CQA) of injectables with local physiological conditions to predict systemic exposure of these products. METHODOLOGY We have previously developed a multiscale, multiphysics computational model to simulate lymphatic absorption and whole-body pharmacokinetics of monoclonal antibodies. The same simulation framework was applied in this study to compute the capillary absorption of solubilized small molecule drugs that are injected subcutaneously. Sensitivity analyses were conducted to probe the impact by key simulation parameters on the local and systemic exposures. RESULTS This framework was capable of determining which parameters had the biggest impact on small molecule absorption in the SC. Particularly, membrane permeability of a drug was found to have the biggest impact on drug absorption kinetics, followed by capillary density and drug diffusivity. CONCLUSION Our modelling framework proved feasible in predicting local transport and systemic absorption from the injection site of small molecules. Understanding the effect of these properties and how to model them may help to greatly expedite the development process.
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Affiliation(s)
- Clairissa D Corpstein
- Department of Industrial and Physical Pharmacy, Purdue University, 525 Stadium Mall Dr. RHPH Building, West Lafayette, Indiana, IN, 47907, USA
| | - Peng Hou
- Department of Industrial and Physical Pharmacy, Purdue University, 525 Stadium Mall Dr. RHPH Building, West Lafayette, Indiana, IN, 47907, USA
| | - Kinam Park
- Department of Industrial and Physical Pharmacy, Purdue University, 525 Stadium Mall Dr. RHPH Building, West Lafayette, Indiana, IN, 47907, USA
| | - Tonglei Li
- Department of Industrial and Physical Pharmacy, Purdue University, 525 Stadium Mall Dr. RHPH Building, West Lafayette, Indiana, IN, 47907, USA.
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Liao MZ, Deng R, Gibiansky L, Lu T, Agarwal P, Dere R, Lee C, Hirata J, Herbaux C, Salles G, Li C, Miles D. Ethnic sensitivity assessment: Polatuzumab vedotin pharmacokinetics in Asian and non-Asian patients with previously untreated diffuse large B-cell lymphoma in POLARIX. Clin Transl Sci 2023; 16:2744-2755. [PMID: 37864313 PMCID: PMC10719464 DOI: 10.1111/cts.13669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/13/2023] [Accepted: 10/02/2023] [Indexed: 10/22/2023] Open
Abstract
This ethnic sensitivity analysis used data from the phase III POLARIX study (NCT03274492) to assess polatuzumab vedotin pharmacokinetics (PKs) in Asian versus non-Asian patients with previously untreated diffuse large B-cell lymphoma and examined the appropriateness of extrapolating global study findings to Asian patients. PK and population PK (PopPK) analyses assessed polatuzumab vedotin analyte exposures by ethnicity (Asian [n = 84] vs. non-Asian [n = 345] patients) and region (patients enrolled from Asia [n = 80] vs. outside Asia [n = 349]). In patients from Asia versus outside Asia, observed mean antibody-conjugated monomethyl auristatin E (acMMAE) concentrations were comparable (1.2% lower at cycle [C]1 postdose, 4.4% higher at C4 predose; and 6.8% lower at C4 postdose in patients from Asia). Observed mean unconjugated MMAE was lower in patients from Asia by 6.5% (C1 postdose), 20.0% (C4 predose), and 15.3% (C4 postdose). In the PopPK analysis, C6 area under the curve and peak plasma concentrations were also comparable for acMMAE (6.3% and 3.0% lower in Asian vs. non-Asian patients, respectively) and lower for unconjugated MMAE by 19.1% and 16.7%, respectively. By region, C6 mean acMMAE concentrations were similar, and C6 mean unconjugated MMAE concentrations were lower, in patients enrolled from Asia versus outside Asia, by 3.9%-7.0% and 17.3%-19.7%, respectively. In conclusion, polatuzumab vedotin PKs were similar between Asian and non-Asian patients by ethnicity and region, suggesting PKs are not sensitive to Asian ethnicity and dose adjustments are not required in Asian patients to maintain efficacy and safety.
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Affiliation(s)
| | - Rong Deng
- Genentech, Inc.South San FranciscoCaliforniaUSA
| | | | - Tong Lu
- Genentech, Inc.South San FranciscoCaliforniaUSA
| | | | | | - Calvin Lee
- Genentech, Inc.South San FranciscoCaliforniaUSA
| | | | | | - Gilles Salles
- Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Chunze Li
- Genentech, Inc.South San FranciscoCaliforniaUSA
| | - Dale Miles
- Genentech, Inc.South San FranciscoCaliforniaUSA
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11
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Puszkiel A, Bousquet G, Stanke-Labesque F, Stocco J, Decq P, Chevillard L, Goutagny S, Declèves X. A Minimal PBPK Model for Plasma and Cerebrospinal Fluid Pharmacokinetics of Trastuzumab after Intracerebroventricular Administration in Patients with HER2-Positive Brain Metastatic Localizations. Pharm Res 2023; 40:2687-2697. [PMID: 37821769 DOI: 10.1007/s11095-023-03614-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Dosing regimens of trastuzumab administered by intracerebroventricular (icv) route to patients with HER2-positive brain localizations remain empirical. The objectives of this study were to describe pharmacokinetics (PK) of trastuzumab in human plasma and cerebrospinal fluid (CSF) after simultaneous icv and intravenous (iv) administration using a minimal physiologically-based pharmacokinetic model (mPBPK) and to perform simulations of alternative dosing regimens to achieve therapeutic concentrations in CSF. METHODS Plasma and CSF PK data were collected in two patients with HER2-positive brain localizations. A mPBPK model for mAbs consisting of four compartments (tight and leaky tissues, plasma and lymph) was enriched by an additional compartment for ventricular CSF. The comparison between observed and model-predicted concentrations was evaluated using prediction error (PE). RESULTS The developed mPBPK model described plasma and CSF trastuzumab concentrations reasonably well with mean PE for plasma and CSF data of 41.8% [interquartile range, IQR = -9.48; 40.6] and 18.3% [-36.7; 60.6], respectively, for patient 1 and 11.4% [-10.8; 28.7] and 22.5% [-27.7; 77.9], respectively, for patient 2. Trastuzumab showed fast clearance from CSF to plasma with Cmin,ss of 0.56 and 0.85 mg/L for 100 and 150 mg q1wk, respectively. Repeated dosing of 100 and 150 mg q3day resulted in Cmin,ss of 10.3 and 15.4 mg/L, respectively. Trastuzumab CSF target concentrations are achieved rapidly and maintained above 60 mg/L from 7 days after a continuous perfusion at 1.0 mg/h. CONCLUSION Continuous icv infusion of trastuzumab at 1.0 mg/h could be an alternative dosing regimen to rapidly achieve intraventricular CSF therapeutic concentrations.
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Affiliation(s)
- Alicja Puszkiel
- Université Paris Cité, Inserm UMRS1144, Paris, France
- Laboratory of Pharmacology and Toxicology, Cochin University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Guilhem Bousquet
- Oncology Department, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
- Université Paris Cité, Inserm UMR_S942 MASCOT, Paris, France
- Université Sorbonne Paris Nord, Villetaneuse, France
| | - Françoise Stanke-Labesque
- Laboratory of Pharmacology, Toxicology and Pharmacogenetics, Grenoble-Alpes University Hospital, 38043, Grenoble, France
- Université Grenoble Alpes, HP2 INSERM U1300, Grenoble, France
| | - Jeanick Stocco
- Department of Pharmacy, Beaujon Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Philippe Decq
- Department of Neurosurgery, Beaujon University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - Stéphane Goutagny
- Université Paris Cité, Inserm UMRS1144, Paris, France
- Department of Neurosurgery, Beaujon University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Xavier Declèves
- Université Paris Cité, Inserm UMRS1144, Paris, France.
- Laboratory of Pharmacology and Toxicology, Cochin University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.
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Okada H, Ishikawa K, Itoh Y, Noda Y, Eto T, Pilla Reddy V, Chen CCK, Gibbs M, Johnsson E. Safety, tolerability, and pharmacokinetics of half-life extended SARS-CoV-2-neutralizing monoclonal antibodies AZD7442 (tixagevimab/cilgavimab) in healthy Japanese adults. J Infect Chemother 2023; 29:1061-1067. [PMID: 37524201 DOI: 10.1016/j.jiac.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/03/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of AZD7442 (tixagevimab/cilgavimab) in healthy Japanese adults. METHODS In this randomized, double-blind, placebo-controlled, phase 1 study, AZD7442 was administered intramuscularly (300 or 600 mg) or intravenously (300 or 1000 mg) to healthy Japanese adults. Primary endpoints were safety, tolerability, and pharmacokinetics. Anti-drug antibodies and neutralizing antibody activities were secondary endpoints. RESULTS A total of 40 participants were randomized to receive AZD7442 (n = 30) or placebo (n = 10). Adverse events (AEs) occurred in 12 (40%) and 3 (30%) participants, respectively; there were no deaths, serious AEs, or AEs leading to study withdrawal. Tixagevimab and cilgavimab had mean half-lives of 82.1-95.9 and 77.9-92.0 days, respectively, which were generally similar regardless of administration route. SARS-CoV-2-neutralizing antibody titers were >4-fold higher than baseline levels from Day 8 to Day 211 in participants receiving AZD7442. CONCLUSIONS AZD7442 was well tolerated in healthy Japanese adults, with predictable pharmacokinetics and an extended half-life, consistent with previous studies. CLINICALTRIALS gov, NCT04896541.
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Affiliation(s)
- Hiroshi Okada
- Medical Science, BioPharmaceuticals R&D, AstraZeneca, Osaka, Japan.
| | | | - Yohji Itoh
- Data Science and Innovation, R&D, AstraZeneca, Osaka, Japan
| | - Yoshinori Noda
- Clinical Science, BioPharmaceuticals R&D, AstraZeneca, Osaka, Japan
| | | | - Venkatesh Pilla Reddy
- Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Cecil Chi-Keung Chen
- Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, South San Francisco, CA, USA
| | - Michael Gibbs
- Clinical Development, Vaccines & Immunotherapies, AstraZeneca, Cambridge, UK
| | - Eva Johnsson
- Vaccines & Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
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Chua L, Friedrich S, Zhang XC. Mirikizumab Pharmacokinetics in Patients with Moderately to Severely Active Ulcerative Colitis: Results from Phase III LUCENT Studies. Clin Pharmacokinet 2023; 62:1479-1491. [PMID: 37610533 PMCID: PMC10520102 DOI: 10.1007/s40262-023-01281-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND AND OBJECTIVE Mirikizumab is a humanized anti-interleukin-23-p19 monoclonal antibody being developed for ulcerative colitis and Crohn's disease. This analysis characterized mirikizumab pharmacokinetics using phase II and III trial data from patients with moderately to severely active ulcerative colitis. METHODS Serum pharmacokinetic data in patients receiving mirikizumab 50-1000 mg intravenously every 4 weeks as induction treatment and mirikizumab 200 mg subcutaneously every 4 or 12 weeks as maintenance treatment across three trials (N = 1362) were analyzed using non-linear mixed-effects modeling. Covariate effects on mirikizumab exposure were evaluated using simulation-based estimations. RESULTS Mirikizumab pharmacokinetics was best described by a linear two-compartment model with first-order absorption. Clearance, volume of distribution for central and peripheral compartments, and half-life were estimated at approximately 0.022 L/h (linear), 3.11 L and 1.69 L, and 9.5 days, respectively. Statistically significant effects of body weight and serum albumin levels on clearance, body weight on central and peripheral volumes of distribution, and body mass index on bioavailability were observed but effects were small relative to random inter-individual variability (% coefficient of variation: 18-64%). The subcutaneous bioavailability of mirikizumab was 48%. CONCLUSIONS Mirikizumab displayed pharmacokinetic characteristics typical of a monoclonal antibody where clearance increased with body weight and decreased with the albumin level, and bioavailability decreased with body mass index. These effects were small relative to random variability, indicating that a dose adjustment for patient factors is not required. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov: NCT02589665 (28 October, 2015), NCT03518086 (8 May, 2018), NCT03524092 (14 May, 2018).
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Affiliation(s)
- Laiyi Chua
- Global PK/PD and Pharmacometrics, Eli Lilly and Company, 893 Delaware Street, Indianapolis, IN, 46225, USA
| | - Stuart Friedrich
- Global PK/PD and Pharmacometrics, Eli Lilly and Company, 893 Delaware Street, Indianapolis, IN, 46225, USA
| | - Xin Cindy Zhang
- Global PK/PD and Pharmacometrics, Eli Lilly and Company, 893 Delaware Street, Indianapolis, IN, 46225, USA.
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Liu S, Li Z, Huisman M, Shah DK. Clinical validation of translational antibody PBPK model using tissue distribution data generated with 89Zr-immuno-PET imaging. J Pharmacokinet Pharmacodyn 2023; 50:377-394. [PMID: 37382712 DOI: 10.1007/s10928-023-09869-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 06/09/2023] [Indexed: 06/30/2023]
Abstract
The main objective of this manuscript was to validate the ability of the monoclonal antibody physiologically-based pharmacokinetic (PBPK) model to predict tissue concentrations of antibodies in the human. To accomplish this goal, preclinical and clinical tissue distribution and positron emission tomography imaging data generated using zirconium-89 (89Zr) labeled antibodies were obtained from the literature. First, our previously published translational PBPK model for antibodies was expanded to describe the whole-body biodistribution of 89Zr labeled antibody and the free 89Zr, as well as residualization of free 89Zr. Subsequently, the model was optimized using mouse biodistribution data, where it was observed that free 89Zr mainly residualizes in the bone and the extent of antibody distribution in certain tissues (e.g., liver and spleen) may be altered by labeling with 89Zr. The mouse PBPK model was scaled to rat, monkey, and human by simply changing the physiological parameters, and a priori simulations performed by the model were compared with the observed PK data. It was found that model predicted antibody PK in majority of the tissues in all the species superimposed over the observed data, and the model was also able to predict the PK of antibody in human tissues reasonably well. As such, the work presented here provides unprecedented evaluation of the antibody PPBK model for its ability to predict tissue PK of antibodies in the clinic. This model can be used for preclinical-to-clinical translation of antibodies and for prediction of antibody concentrations at the site-of-action in the clinic.
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Affiliation(s)
- Shufang Liu
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, The State University of New York at Buffalo, 455 Pharmacy Building, Buffalo, NY, 14214-8033, USA
| | - Zhe Li
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, The State University of New York at Buffalo, 455 Pharmacy Building, Buffalo, NY, 14214-8033, USA
| | - Marc Huisman
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Dhaval K Shah
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, The State University of New York at Buffalo, 455 Pharmacy Building, Buffalo, NY, 14214-8033, USA.
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Yokoyama M, Suzuki E, Oitate M, Watanabe N. A Quantitative Prediction Method for the Human Pharmacokinetics of Fc-Fusion Proteins. Eur J Drug Metab Pharmacokinet 2023; 48:541-552. [PMID: 37530974 DOI: 10.1007/s13318-023-00845-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Fc fusion is an effective strategy for extending the half-lives of therapeutic proteins. This study aimed to evaluate the applicability of a human pharmacokinetics prediction method for Fc-fusion proteins by extending on reported methods for monoclonal antibodies (mAbs). METHODS To predict human pharmacokinetic profiles following intravenous (IV) dosing, the pharmacokinetic data for 11 Fc-fusion proteins in monkeys were analysed by two approaches: a species-invariant time method with a range of allometric exponents in clearance (CL, 0.7-1.0) and a two-compartment model reported for mAbs. The pharmacokinetic profiles following subcutaneous (SC) dosing were predicted by simple dose normalisation from monkeys or using the geometric means of the absorption rate constant (Ka) and bioavailability (BA) for mAbs or Fc-fusion proteins in humans and compared. RESULTS In the case of IV administration, the area under the curve could be predicted for more than 85% of Fc-fusion proteins within a twofold difference from the observed value using the species-invariant time method (scaling exponent for CL, 0.95). For SC dosing, incorporating the geometric means of absorption parameters for both mAbs (BA 68.2%, Ka 0.287 day-1) and Fc-fusion proteins (BA 63.0%, Ka 0.209 day-1) in humans provided better accuracy than simple normalisation from monkeys. CONCLUSION We have successfully predicted the human pharmacokinetic profiles of Fc-fusion proteins for both IV and SC administration within twofold of the observed value from monkey pharmacokinetic data by extending on reported methods for mAbs. This method will facilitate drug discovery and development of Fc-fusion proteins.
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Affiliation(s)
- Miki Yokoyama
- Drug Metabolism and Pharmacokinetics Research Laboratories, Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo, 140-8710, Japan.
| | - Eiko Suzuki
- Drug Metabolism and Pharmacokinetics Research Laboratories, Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo, 140-8710, Japan
| | - Masataka Oitate
- Drug Metabolism and Pharmacokinetics Research Laboratories, Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo, 140-8710, Japan
| | - Nobuaki Watanabe
- Drug Metabolism and Pharmacokinetics Research Laboratories, Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo, 140-8710, Japan
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Lobet S, Paintaud G, Azzopardi N, Passot C, Caulet M, Chautard R, Desvignes C, Capitain O, Tougeron D, Lecomte T, Ternant D. Relationship Between Cetuximab Target-Mediated Pharmacokinetics and Progression-Free Survival in Metastatic Colorectal Cancer Patients. Clin Pharmacokinet 2023; 62:1263-1274. [PMID: 37442917 DOI: 10.1007/s40262-023-01270-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Cetuximab, an anti-epidermal growth factor receptor (EGFR) monoclonal immunoglobulin (Ig)G1 antibody, has been approved for the treatment of metastatic colorectal cancer (mCRC). The influence of target-antigen on cetuximab pharmacokinetics has never been investigated using target-mediated drug disposition (TMDD) modelling. This study aimed to investigate the relationship between cetuximab concentrations, target kinetics and progression-free survival (PFS). METHODS In this ancillary study (NCT00559741), 91 patients with mCRC treated with cetuximab were assessed. Influence of target levels on cetuximab pharmacokinetics was described using TMDD modelling. The relationship between cetuximab concentrations, target kinetics and time-to-progression (TTP) was described using a joint pharmacokinetic-TTP model, where unbound target levels were assumed to influence hazard of progression by an Emax model. Mitigation strategies of concentration-response relationship, i.e., time-varying endogenous clearance and mutual influences of clearance and time-to-progression were investigated. RESULTS Cetuximab concentration-time data were satisfactorily described using the TMDD model with quasi-steady-state approximation and time-varying endogenous clearance. Estimated target parameters were baseline target levels (R0 = 43 nM), and complex elimination rate constant (kint = 0.95 day-1). Estimated time-varying clearance parameters were time-invariant component of CL (CL0= 0.38 L/day-1), time-variant component of CL (CL1= 0.058 L/day-1) and first-order rate of CL1 decreasing over time (kdes = 0.049 day-1). Part of concentration-TTP was TTP-driven, where clearance and TTP were inversely correlated. In addition, increased target occupancy was associated with increased TTP. CONCLUSION This is the first study describing the complex relationship between cetuximab target-mediated pharmacokinetics and PFS in mCRC patients using a joint PK-time-to-progression model. Further studies are needed to provide a more in-depth description of this relationship.
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Affiliation(s)
- Sarah Lobet
- Inserm UMR 1069, Nutrition Croissance et Cancer (N2C), Tours University, Tours, France
| | - Gilles Paintaud
- EA4245 Transplantation, Immunologie, Inflammation (T2i), Tours University, Tours, France
- Centre Pilote de suivi Biologique des traitements par Anticorps (CePiBAc), Tours University Hospital, Tours, France
- Pharmacology-Toxicology Department, Tours University Hospital, Tours, France
| | | | - Christophe Passot
- Oncopharmacology-Pharmacogenetics Department INSERM U892, Institut de Cancérologie de l'Ouest site Paul Papin, Angers, France
| | - Morgane Caulet
- Gastroenterology and Digestive oncology Department, Tours University Hospital, Tours, France
| | - Romain Chautard
- Inserm UMR 1069, Nutrition Croissance et Cancer (N2C), Tours University, Tours, France
- Gastroenterology and Digestive oncology Department, Tours University Hospital, Tours, France
| | - Céline Desvignes
- EA4245 Transplantation, Immunologie, Inflammation (T2i), Tours University, Tours, France
- Centre Pilote de suivi Biologique des traitements par Anticorps (CePiBAc), Tours University Hospital, Tours, France
| | - Olivier Capitain
- Oncopharmacology-Pharmacogenetics Department INSERM U892, Institut de Cancérologie de l'Ouest site Paul Papin, Angers, France
| | - David Tougeron
- Gastroenterology Department, Poitiers University Hospital, Poitiers, France
- PRoDiCeT, Poitiers University, Poitiers, France
| | - Thierry Lecomte
- Inserm UMR 1069, Nutrition Croissance et Cancer (N2C), Tours University, Tours, France
- Gastroenterology and Digestive oncology Department, Tours University Hospital, Tours, France
| | - David Ternant
- EA4245 Transplantation, Immunologie, Inflammation (T2i), Tours University, Tours, France.
- Centre Pilote de suivi Biologique des traitements par Anticorps (CePiBAc), Tours University Hospital, Tours, France.
- Pharmacology-Toxicology Department, Tours University Hospital, Tours, France.
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Reig-Lopez J, Tang W, Fernandez-Teruel C, Merino-Sanjuan M, Mangas-Sanjuan V, Boulton DW, Sharma P. Application of population physiologically based pharmacokinetic modelling to optimize target expression and clearance mechanisms of therapeutic monoclonal antibodies. Br J Clin Pharmacol 2023; 89:2691-2702. [PMID: 37055941 DOI: 10.1111/bcp.15745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/12/2023] [Accepted: 03/31/2023] [Indexed: 04/15/2023] Open
Abstract
AIMS To use population physiologically based pharmacokinetic (PopPBPK) modelling to optimize target expression, kinetics and clearance of HER1/2 directed therapeutic monoclonal antibodies (mAbs). Thus, to propose a general workflow of PopPBPK modelling and its application in clinical pharmacology. METHODS Full PBPK model of pertuzumab (PTZ) was developed in patient population using Simcyp V21R1 incorporating mechanistic targeted-mediated drug disposition process by fitting known clinical PK and sparse receptor proteomics data to optimize target expression and kinetics of HER2 receptor. Trastuzumab (TTZ) PBPK modelling was used to validate the optimized HER2 target. Additionally, the simulator was also used to develop a full PBPK model for the HER1-directed mAb cetuximab (CTX) to assess the underlying targeted-mediated drug disposition-independent elimination mechanisms. RESULTS HER2 final parameterisation coming from the PBPK modelling of PTZ was successfully cross validated through PBPK modelling of TTZ with average fold error (AFE), absolute AFE and percent prediction error values for area under the concentration-time curve (AUC) and maximum plasma concentration (Cmax ) of 1.13, 1.16 and 16, and 1.01, 1.07 and 7, respectively. CTX PBPK model performance was validated after the incorporation of an additional systemic clearance of 0.033 L/h as AFE and absolute AFE showed an acceptable predictive power of AUC and Cmax with percent prediction error of 13% for AUC and 10% for Cmax . CONCLUSIONS Optimisation of both system and drug related parameters were performed through PBPK modelling to improve model performance of therapeutic mAbs (PTZ, TTZ and CTX). General workflow was proposed to develop and apply PopPBPK to support clinical development of mAbs targeting same receptor.
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Affiliation(s)
- Javier Reig-Lopez
- Pharmacy and Pharmaceutical Technology and Parasitology Department, Faculty of Pharmacy, University of Valencia, Valencia, Spain
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge, UK
| | - Weifeng Tang
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Carlos Fernandez-Teruel
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge, UK
| | - Matilde Merino-Sanjuan
- Pharmacy and Pharmaceutical Technology and Parasitology Department, Faculty of Pharmacy, University of Valencia, Valencia, Spain
- Interuniversity Research Institute for Molecular Recognition and Technological Development, Polytechnic University of Valencia-University of Valencia, Valencia, Spain
| | - Victor Mangas-Sanjuan
- Pharmacy and Pharmaceutical Technology and Parasitology Department, Faculty of Pharmacy, University of Valencia, Valencia, Spain
- Interuniversity Research Institute for Molecular Recognition and Technological Development, Polytechnic University of Valencia-University of Valencia, Valencia, Spain
| | - David W Boulton
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Pradeep Sharma
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge, UK
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He J, Du W, Yang H, Wang J, Cai C, Ma Q, Li N, Yu J, Wu X, Wu J, Chen Y, Cao G, Zhang J. Safety and pharmacokinetics of IBI112, an IL-23 monoclonal antibody, in Chinese healthy volunteers: a first-in-human phase 1 study. Expert Opin Investig Drugs 2023; 32:669-675. [PMID: 37358916 DOI: 10.1080/13543784.2023.2230122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/23/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Interleukin (IL) 23p19 monoclonal antibodies were efficacious and safe in the treatment of psoriasis. A first-in-human (FIH) study was conducted to evaluate the safety, tolerability, pharmacokinetics (PK) and immunogenicity of IBI112, a novel IL-23p19 monoclonal antibody. METHODS In this FIH, randomized, double-blind, placebo-controlled, single-ascending-dose study, a subcutaneous (SC, 5-600 mg) or intravenous (IV, 100 and 600 mg) or placebo was administered to eligible healthy subjects. Safety was assessed by physical examinations, vital signs, laboratory tests, and electrocardiograms. Furthermore, non-compartment analysis and population PK modeling were conducted to characterize PK, and model-based simulation was applied to justify dose selection for psoriasis patients. RESULTS A total of 46 subjects were enrolled, with 35 receiving IBI112 and 11 receiving placebo. No serious adverse events (SAEs) and no clinically significant adverse events were identified. After a single SC of IBI112, the median Tmax was 4-10.5 days, and the half-life (t1/2) ranged from 21.8 to 35.8 days. IBI112 exposures (Cmax and AUCinf) approached dose proportionality across 5-300 mg range. CONCLUSION IBI112 was well tolerated and safe at SC or IV dose up to 600 mg and showed a linear PK characteristics at SC dose from 5 to 300 mg. CLINICAL TRIAL REGISTRATION ClinicalTrial.gov NCT04511624.
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Affiliation(s)
- Jinjie He
- Phase I Clinical Research Center, Huashan Hospital of Fudan University, Shanghai, China
| | - Weijuan Du
- The Clinical Pharmacology Department, Innovent Biologics (Suzhou), Suzhou, China
| | - Haijing Yang
- Phase I Clinical Research Center, Huashan Hospital of Fudan University, Shanghai, China
| | - Jingjing Wang
- Phase I Clinical Research Center, Huashan Hospital of Fudan University, Shanghai, China
| | - Chenghang Cai
- The Clinical Pharmacology Department, Innovent Biologics (Suzhou), Suzhou, China
| | - Qingyang Ma
- The Clinical Pharmacology Department, Innovent Biologics (Suzhou), Suzhou, China
| | - Nanyang Li
- Phase I Clinical Research Center, Huashan Hospital of Fudan University, Shanghai, China
| | - Jicheng Yu
- Phase I Clinical Research Center, Huashan Hospital of Fudan University, Shanghai, China
| | - Xiaojie Wu
- Phase I Clinical Research Center, Huashan Hospital of Fudan University, Shanghai, China
| | - Jufang Wu
- Phase I Clinical Research Center, Huashan Hospital of Fudan University, Shanghai, China
| | - Yuancheng Chen
- Phase I Clinical Research Center, Huashan Hospital of Fudan University, Shanghai, China
| | - Guoying Cao
- Phase I Clinical Research Center, Huashan Hospital of Fudan University, Shanghai, China
| | - Jing Zhang
- Phase I Clinical Research Center, Huashan Hospital of Fudan University, Shanghai, China
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Curreri AM, Kim J, Dunne M, Angsantikul P, Goetz M, Gao Y, Mitragotri S. Deep Eutectic Solvents for Subcutaneous Delivery of Protein Therapeutics. Adv Sci (Weinh) 2023; 10:e2205389. [PMID: 36642846 PMCID: PMC9982585 DOI: 10.1002/advs.202205389] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/17/2022] [Indexed: 05/14/2023]
Abstract
Proteins are among the most common therapeutics for the treatment of diabetes, autoimmune diseases, cancer, and metabolic diseases, among others. Despite their common use, current protein therapies, most of which are injectables, have several limitations. Large proteins such as monoclonal antibodies (mAbs) suffer from poor absorption after subcutaneous injections, thus forcing their administration by intravenous injections. Even small proteins such as insulin suffer from slow pharmacokinetics which poses limitations in effective management of diabetes. Here, a deep eutectic-based delivery strategy is used to offer a generalized approach for improving protein absorption after subcutaneous injections. The lead formulation enhances absorption of mAbs after subcutaneous injections by ≈200%. The same composition also improves systemic absorption of subcutaneously injected insulin faster than Humalog, the current gold-standard of rapid acting insulin. Mechanistic studies reveal that the beneficial effect of deep eutectics on subcutaneous absorption is mediated by their ability to reduce the interactions of proteins with the subcutaneous matrix, especially collagen. Studies also confirm that these deep eutectics are safe for subcutaneous injections. Deep eutectic-based formulations described here open new possibilities for subcutaneous injections of therapeutic proteins.
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Affiliation(s)
- Alexander M. Curreri
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
| | - Jayoung Kim
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
| | - Michael Dunne
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
| | - Pavimol Angsantikul
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
- Present address:
The Population CouncilOne Dag Hammarskjold PlazaNew YorkNY10017USA
| | - Morgan Goetz
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
| | - Yongsheng Gao
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
| | - Samir Mitragotri
- John A. Paulson School of Engineering and Applied SciencesHarvard University150 Western AveAllstonMA02134USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University3 Blackfan StBostonMA02115USA
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Datta-Mannan A, Molitoris BA, Feng Y, Martinez MM, Sandoval RM, Brown RM, Merkel D, Croy JE, Dunn KW. Intravital Microscopy Reveals Unforeseen Biodistribution Within the Liver and Kidney Mechanistically Connected to the Clearance of a Bifunctional Antibody. Drug Metab Dispos 2023; 51:403-412. [PMID: 36460476 PMCID: PMC11022859 DOI: 10.1124/dmd.122.001049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/16/2022] [Accepted: 11/07/2022] [Indexed: 12/03/2022] Open
Abstract
Bifunctional antibody (BfAb) therapeutics offer the potential for novel functionalities beyond those of the individual monospecific entities. However, combining these entities into a single molecule can have unpredictable effects, including changes in pharmacokinetics that limit the compound's therapeutic profile. A better understanding of how molecular modifications affect in vivo tissue interactions could help inform BfAb design. The present studies were predicated on the observation that a BfAb designed to have minimal off-target interactions cleared from the circulation twice as fast as the monoclonal antibody (mAb) from which it was derived. The present study leverages the spatial and temporal resolution of intravital microscopy (IVM) to identify cellular interactions that may explain the different pharmacokinetics of the two compounds. Disposition studies of mice demonstrated that radiolabeled compounds distributed similarly over the first 24 hours, except that BfAb accumulated approximately two- to -three times more than mAb in the liver. IVM studies of mice demonstrated that both distributed to endosomes of liver endothelia but with different kinetics. Whereas mAb accumulated rapidly within the first hour of administration, BfAb accumulated only modestly during the first hour but continued to accumulate over 24 hours, ultimately reaching levels similar to those of the mAb. Although neither compound was freely filtered by the mouse or rat kidney, BfAb, but not mAb, was found to accumulate over 24 hours in endosomes of proximal tubule cells. These studies demonstrate how IVM can be used as a tool in drug design, revealing unpredicted cellular interactions that are undetectable by conventional analyses. SIGNIFICANCE STATEMENT: Bifunctional antibodies offer novel therapeutic functionalities beyond those of the individual monospecific entities. However, combining these entities into a single molecule can have unpredictable effects, including undesirable changes in pharmacokinetics. Studies of the dynamic distribution of a bifunctional antibody and its parent monoclonal antibody presented here demonstrate how intravital microscopy can expand our understanding of the in vivo disposition of therapeutics, detecting off-target interactions that could not be detected by conventional pharmacokinetics approaches or predicted by conventional physicochemical analyses.
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Affiliation(s)
- Amita Datta-Mannan
- Exploratory Medicine and Pharmacology (A.D-M.), Clinical Laboratory Services (R.M.B.), and Biotechnology Discovery Research (Y.F., D.M., J.E.C.), Lilly Research Laboratories, Indianapolis, Indiana and Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, Indiana (K.W.D.)
| | - Bruce A Molitoris
- Exploratory Medicine and Pharmacology (A.D-M.), Clinical Laboratory Services (R.M.B.), and Biotechnology Discovery Research (Y.F., D.M., J.E.C.), Lilly Research Laboratories, Indianapolis, Indiana and Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, Indiana (K.W.D.)
| | - Yiqing Feng
- Exploratory Medicine and Pharmacology (A.D-M.), Clinical Laboratory Services (R.M.B.), and Biotechnology Discovery Research (Y.F., D.M., J.E.C.), Lilly Research Laboratories, Indianapolis, Indiana and Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, Indiana (K.W.D.)
| | - Michelle M Martinez
- Exploratory Medicine and Pharmacology (A.D-M.), Clinical Laboratory Services (R.M.B.), and Biotechnology Discovery Research (Y.F., D.M., J.E.C.), Lilly Research Laboratories, Indianapolis, Indiana and Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, Indiana (K.W.D.)
| | - Ruben M Sandoval
- Exploratory Medicine and Pharmacology (A.D-M.), Clinical Laboratory Services (R.M.B.), and Biotechnology Discovery Research (Y.F., D.M., J.E.C.), Lilly Research Laboratories, Indianapolis, Indiana and Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, Indiana (K.W.D.)
| | - Robin M Brown
- Exploratory Medicine and Pharmacology (A.D-M.), Clinical Laboratory Services (R.M.B.), and Biotechnology Discovery Research (Y.F., D.M., J.E.C.), Lilly Research Laboratories, Indianapolis, Indiana and Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, Indiana (K.W.D.)
| | - Daniel Merkel
- Exploratory Medicine and Pharmacology (A.D-M.), Clinical Laboratory Services (R.M.B.), and Biotechnology Discovery Research (Y.F., D.M., J.E.C.), Lilly Research Laboratories, Indianapolis, Indiana and Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, Indiana (K.W.D.)
| | - Johnny E Croy
- Exploratory Medicine and Pharmacology (A.D-M.), Clinical Laboratory Services (R.M.B.), and Biotechnology Discovery Research (Y.F., D.M., J.E.C.), Lilly Research Laboratories, Indianapolis, Indiana and Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, Indiana (K.W.D.)
| | - Kenneth W Dunn
- Exploratory Medicine and Pharmacology (A.D-M.), Clinical Laboratory Services (R.M.B.), and Biotechnology Discovery Research (Y.F., D.M., J.E.C.), Lilly Research Laboratories, Indianapolis, Indiana and Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, Indiana (K.W.D.)
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21
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Shebley M, Wang S, Ali I, Krishnan P, Tripathi R, Reardon JM, Cafardi J, Rahav G, Caraco Y, Slim J, Al Akhrass F, Yu M, Hu Y, Ferreira RDA, Alami NN. Phase 1 study of safety, pharmacokinetics, and antiviral activity of SARS-CoV-2 neutralizing monoclonal antibody ABBV-47D11 in patients with COVID-19. Pharmacol Res Perspect 2023; 11:e01036. [PMID: 36537346 PMCID: PMC9764278 DOI: 10.1002/prp2.1036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/06/2022] [Indexed: 12/24/2022] Open
Abstract
ABBV-47D11 is a neutralizing monoclonal antibody that targets a mutationally conserved hydrophobic pocket distal to the ACE2 binding site of SARS-CoV-2. This first-in-human safety, pharmacokinetics, and antiviral pharmacodynamic assessment in patients with COVID-19 provide an initial evaluation of this antibody that may allow further development. This multicenter, randomized, double-blind, and placebo-controlled single ascending dose study of ABBV-47D11 (180, 600, or 2400 mg) as an intravenous infusion, was in hospitalized and non-hospitalized (confined) adults with mild to moderate COVID-19. Primary outcomes were grade 3 or higher study drug-related adverse events and infusion-related reactions. Secondary outcomes were pharmacokinetic parameters and concentration-time profiles to Day 29, immunogenicity (anti-drug antibodies), and antiviral activity (change in RT-PCR viral load) from baseline to Days 15 and 29. ABBV-47D11 single doses up to 2400 mg were safe and tolerated and no safety signals were identified. The pharmacokinetics of ABBV-47D11 were linear and showed dose-proportional increases in serum concentrations with ascending doses. The exploratory anti-SARS-CoV-2 activity revealed a reduction of viral load at and above the 600 mg dose of ABBV-47D11 regardless of patient demographics and baseline characteristics, however; because of the high inter-individual variability and small sample size a statistical significance was not reached. There is potential for anti-SARS-CoV-2 activity with ABBV-47D11 doses of 600 mg or higher, which could be evaluated in future clinical trials designed and powered to assess viral load reductions and clinical benefit.
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Affiliation(s)
| | | | - Izna Ali
- AbbVie Inc.North ChicagoIllinoisUSA
| | | | | | | | | | - Galia Rahav
- Sheba Medical Center and Tel‐Aviv UniversityTel HashomerIsrael
| | - Yoseph Caraco
- Hadassah‐Hebrew University Medical CenterJerusalemIsrael
| | | | | | | | - Yiran Hu
- AbbVie Inc.North ChicagoIllinoisUSA
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22
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Pu J, Xue C, Huo S, Shen Q, Qu Y, Yang X, An B, Angel TE, Chen Z, Mehl JT, Tang H, Yang E, Sikorski TW, Qu J. Highly Accurate and Robust Absolute Quantification of Target Proteins in Formalin-Fixed Paraffin-Embedded (FFPE) Tissues by LC-MS. Anal Chem 2023; 95:924-934. [PMID: 36534410 PMCID: PMC10581745 DOI: 10.1021/acs.analchem.2c03473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Accurate, absolute liquid chromatography-mass spectrometry (LC-MS)-based quantification of target proteins in formalin-fixed paraffin-embedded (FFPE) tissues would greatly expand sample availability for pharmaceutical/clinical investigations but remains challenging owing to the following issues: (i) efficient/quantitative recovery of target signature peptides from FFPE tissues is essential but an optimal procedure for targeted, absolute quantification is lacking; (ii) most FFPE samples are long-term-stored; severe immunohistochemistry (IHC) signal losses of target proteins during storage were widely reported, while the effect of storage on LC-MS-based methods was unknown; and (iii) the proper strategy to prepare calibration/quality-control samples to ensure accurate targeted protein analysis in FFPE tissues remained elusive. Using targeted quantification of monoclonal antibody (mAb), antigen, and 40 tissue markers in FFPE tissues as a model system, we extensively investigate those issues and develope an LC-MS-based strategy enabling accurate and precise targeted protein quantification in FFPE samples. First, we demonstrated a surfactant cocktail-based procedure (f-SEPOD), providing high/reproducible recovery of target signature peptides from FFPE tissues. Second, a heat-accelerated degradation study within a roughly estimated 5 year storage period recapitulated the loss of protein IHC signals while LC-MS signals of all targets remained constant. This indicates that the storage of FFPE tissues mainly causes decreased immunoreactivity but unlikely chemical degradation of proteins, which strongly suggests that the storage of FFPE tissues does not cause significant quantitative bias for LC-MS-based methods. Third, while a conventional spike-and-extract approach for calibration caused substantial negative biases, a novel approach, using FFPE-treated calibration standards, enabled accurate and precise quantification. With the pipeline, we conducted the first-ever pharmacokinetics measurement of mAb and its target in FFPE tissues, where time courses by FFPE vs fresh tissues showed excellent correlation.
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Affiliation(s)
- Jie Pu
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, New York 14214, United States
| | - Chao Xue
- Department of Chemical and Biological Engineering, University at Buffalo, State University of New York, Buffalo, New York 14214, United States
| | - Shihan Huo
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, New York 14214, United States
| | - Qingqing Shen
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, New York 14214, United States
| | - Yang Qu
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, New York 14214, United States; New York State Center of Excellence in Bioinformatics and Life Sciences, Buffalo, New York 14203, United States
| | - Xinxin Yang
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, New York 14214, United States
| | - Bo An
- Bioanalysis, Immunogenicity & Biomarkers, In-Vitro/In-Vivo Translation, R&D Research, GlaxoSmithKline, Collegeville, Pennsylvania 19426, United States
| | - Thomas E. Angel
- Bioanalysis, Immunogenicity & Biomarkers, In-Vitro/In-Vivo Translation, R&D Research, GlaxoSmithKline, Collegeville, Pennsylvania 19426, United States
| | - Zhuo Chen
- Bioanalysis, Immunogenicity & Biomarkers, In-Vitro/In-Vivo Translation, R&D Research, GlaxoSmithKline, Collegeville, Pennsylvania 19426, United States
| | - John T. Mehl
- Bioanalysis, Immunogenicity & Biomarkers, In-Vitro/In-Vivo Translation, R&D Research, GlaxoSmithKline, Collegeville, Pennsylvania 19426, United States
| | - Huaping Tang
- Bioanalysis, Immunogenicity & Biomarkers, In-Vitro/In-Vivo Translation, R&D Research, GlaxoSmithKline, Collegeville, Pennsylvania 19426, United States
| | - Eric Yang
- Bioanalysis, Immunogenicity & Biomarkers, In-Vitro/In-Vivo Translation, R&D Research, GlaxoSmithKline, Collegeville, Pennsylvania 19426, United States
| | - Timothy W. Sikorski
- Bioanalysis, Immunogenicity & Biomarkers, In-Vitro/In-Vivo Translation, R&D Research, GlaxoSmithKline, Collegeville, Pennsylvania 19426, United States; Phone: (610) 270-4978
| | - Jun Qu
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, New York 14214, United States; New York State Center of Excellence in Bioinformatics and Life Sciences, Buffalo, New York 14203, United States
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23
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Haraya K, Tachibana T. Translational Approach for Predicting Human Pharmacokinetics of Engineered Therapeutic Monoclonal Antibodies with Increased FcRn-Binding Mutations. BioDrugs 2023; 37:99-108. [PMID: 36449140 PMCID: PMC9709760 DOI: 10.1007/s40259-022-00566-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Recently, increasing FcRn binding by Fc engineering has become a promising approach for prolonging the half-life of therapeutic monoclonal antibodies (mAbs). This study is the first to investigate the optimization of an allometric scaling approach for engineered mAbs based on cynomolgus monkey data to predict human pharmacokinetics. METHODS Linear two-compartmental model parameters (clearance [CL]; volume of distribution in the central compartment [Vc]; inter-compartmental clearance [Q]; volume of distribution in the peripheral compartment [Vp]) after the intravenous (IV) injection of engineered mAbs (M252Y/S254T/T256E or M428L/N434S mutations) in cynomolgus monkeys and humans were collected from published data. We explored the optimal exponent for allometric scaling to predict parameters in humans based on cynomolgus monkey data. Moreover, the plasma concentration-time profile of engineered mAbs after IV injection in humans was predicted using parameters estimated based on an optimized exponent. RESULTS For engineered mAbs, a significant positive correlation between cynomolgus monkeys and humans was observed for CL, but not for other parameters. Whereas conventional exponents (CL: 0.8, Q: 0.75, Vc: 1.0, Vp: 0.95) previously established for normal mAbs showed poor prediction accuracy for CL and Q of engineered mAbs, the newly optimized exponents (CL: 0.55, Q: 0.6, Vc: 0.95, Vp: 0.95) achieved superior predictability for engineered mAbs. Moreover, the optimized exponents accurately predicted plasma mAb concentration-time profiles after IV injection of engineered mAbs in humans. CONCLUSIONS We found that engineered mAbs require specially optimized exponents to accurately predict pharmacokinetic parameters and plasma concentration-time profiles after IV injections in humans based on cynomolgus monkey data. This optimized approach can contribute to a more accurate prediction of human pharmacokinetics in the development of engineered mAbs.
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Affiliation(s)
- Kenta Haraya
- Chugai Pharmaceutical Co., Ltd., 1-135 Komakado, Gotemba, Shizuoka, 412-8513, Japan.
| | - Tatsuhiko Tachibana
- Chugai Pharmaceutical Co., Ltd., 1-135 Komakado, Gotemba, Shizuoka, 412-8513, Japan
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24
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Jagdale P, Sepp A, Shah DK. Physiologically-based pharmacokinetic model for pulmonary disposition of protein therapeutics in humans. J Pharmacokinet Pharmacodyn 2022; 49:607-624. [PMID: 36266517 PMCID: PMC9589728 DOI: 10.1007/s10928-022-09824-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 09/06/2022] [Indexed: 10/28/2022]
Abstract
Lung related disorders like COPD and Asthma, as well as various infectious diseases, form a major therapeutic area which would benefit from a predictive and adaptable mathematical model for describing pulmonary disposition of biological modalities. In this study we fill that gap by extending the cross-species two-pore physiologically-based pharmacokinetic (PBPK) platform with more detailed respiratory tract that includes the airways and alveolar space with epithelial lining fluid. We parameterize the paracellular and FcRn-facilitated exchange pathways between the epithelial lining fluid and lung interstitial space by building a mechanistic model for the exchange between the two. The optimized two-pore PBPK model described pulmonary exposure of several systemically dosed mAbs for which data is available and is also in agreement with the observed levels of endogenous IgG and albumin. The proposed framework can be used to assess pharmacokinetics of new lung-targeting biologic therapies and guide their dosing to achieve desired exposure at the pulmonary site-of-action.
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Affiliation(s)
- Prabhas Jagdale
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, 455 Pharmacy Building, Buffalo, NY, 14214-8033, USA
| | - Armin Sepp
- Simcyp Division, Certara UK Ltd, 1 Concourse Way, Level 2-Acero, Sheffield, S1 2BJ, UK
| | - Dhaval K Shah
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, 455 Pharmacy Building, Buffalo, NY, 14214-8033, USA.
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25
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Wu RL, Idris AH, Berkowitz NM, Happe M, Gaudinski MR, Buettner C, Strom L, Awan SF, Holman LA, Mendoza F, Gordon IJ, Hu Z, Campos Chagas A, Wang LT, Da Silva Pereira L, Francica JR, Kisalu NK, Flynn BJ, Shi W, Kong WP, O'Connell S, Plummer SH, Beck A, McDermott A, Narpala SR, Serebryannyy L, Castro M, Silva R, Imam M, Pittman I, Hickman SP, McDougal AJ, Lukoskie AE, Murphy JR, Gall JG, Carlton K, Morgan P, Seo E, Stein JA, Vazquez S, Telscher S, Capparelli EV, Coates EE, Mascola JR, Ledgerwood JE, Dropulic LK, Seder RA. Low-Dose Subcutaneous or Intravenous Monoclonal Antibody to Prevent Malaria. N Engl J Med 2022; 387:397-407. [PMID: 35921449 PMCID: PMC9806693 DOI: 10.1056/nejmoa2203067] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND New approaches for the prevention and elimination of malaria, a leading cause of illness and death among infants and young children globally, are needed. METHODS We conducted a phase 1 clinical trial to assess the safety and pharmacokinetics of L9LS, a next-generation antimalarial monoclonal antibody, and its protective efficacy against controlled human malaria infection in healthy adults who had never had malaria or received a vaccine for malaria. The participants received L9LS either intravenously or subcutaneously at a dose of 1 mg, 5 mg, or 20 mg per kilogram of body weight. Within 2 to 6 weeks after the administration of L9LS, both the participants who received L9LS and the control participants underwent controlled human malaria infection in which they were exposed to mosquitoes carrying Plasmodium falciparum (3D7 strain). RESULTS No safety concerns were identified. L9LS had an estimated half-life of 56 days, and it had dose linearity, with the highest mean (±SD) maximum serum concentration (Cmax) of 914.2±146.5 μg per milliliter observed in participants who had received 20 mg per kilogram intravenously and the lowest mean Cmax of 41.5±4.7 μg per milliliter observed in those who had received 1 mg per kilogram intravenously; the mean Cmax was 164.8±31.1 in the participants who had received 5 mg per kilogram intravenously and 68.9±22.3 in those who had received 5 mg per kilogram subcutaneously. A total of 17 L9LS recipients and 6 control participants underwent controlled human malaria infection. Of the 17 participants who received a single dose of L9LS, 15 (88%) were protected after controlled human malaria infection. Parasitemia did not develop in any of the participants who received 5 or 20 mg per kilogram of intravenous L9LS. Parasitemia developed in 1 of 5 participants who received 1 mg per kilogram intravenously, 1 of 5 participants who received 5 mg per kilogram subcutaneously, and all 6 control participants through 21 days after the controlled human malaria infection. Protection conferred by L9LS was seen at serum concentrations as low as 9.2 μg per milliliter. CONCLUSIONS In this small trial, L9LS administered intravenously or subcutaneously protected recipients against malaria after controlled infection, without evident safety concerns. (Funded by the National Institute of Allergy and Infectious Diseases; VRC 614 ClinicalTrials.gov number, NCT05019729.).
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Affiliation(s)
- Richard L Wu
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Azza H Idris
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Nina M Berkowitz
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Myra Happe
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Martin R Gaudinski
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Christian Buettner
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Larisa Strom
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Seemal F Awan
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - LaSonji A Holman
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Floreliz Mendoza
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Ingelise J Gordon
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Zonghui Hu
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Andrezza Campos Chagas
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Lawrence T Wang
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Lais Da Silva Pereira
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Joseph R Francica
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Neville K Kisalu
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Barbara J Flynn
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Wei Shi
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Wing-Pui Kong
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Sarah O'Connell
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Sarah H Plummer
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Allison Beck
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Adrian McDermott
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Sandeep R Narpala
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Leonid Serebryannyy
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Mike Castro
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Rosa Silva
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Marjaan Imam
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Iris Pittman
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Somia P Hickman
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Andrew J McDougal
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Ashly E Lukoskie
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Jittawadee R Murphy
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Jason G Gall
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Kevin Carlton
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Patricia Morgan
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Ellie Seo
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Judy A Stein
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Sandra Vazquez
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Shinyi Telscher
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Edmund V Capparelli
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Emily E Coates
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - John R Mascola
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Julie E Ledgerwood
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Lesia K Dropulic
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Robert A Seder
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
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Vugmeyster Y, Grisic AM, Brockhaus B, Rueckert P, Ruisi M, Dai H, Khandelwal A. Avelumab Dose Selection for Clinical Studies in Pediatric Patients with Solid Tumors. Clin Pharmacokinet 2022; 61:985-995. [PMID: 35484319 PMCID: PMC9287219 DOI: 10.1007/s40262-022-01111-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 01/04/2023]
Abstract
Background and Objective A phase I/II trial evaluated the safety, antitumor activity, and pharmacokinetics of avelumab (anti-PD-L1 antibody) in pediatric patients with refractory/relapsed solid tumors (NCT03451825). This study aimed to inform avelumab dose selection in pediatric populations using population pharmacokinetic modeling and simulations. Methods Patients aged < 18 years with refractory/relapsed solid tumors enrolled in phase I received avelumab 10 or 20 mg/kg intravenously every 2 weeks. A pediatric population pharmacokinetic model was developed via the frequentist prior approach. Results Pharmacokinetic parameters from 21 patients who received avelumab 10 mg/kg (n = 6) or 20 mg/kg (n = 15) were analyzed. Patients had a wide range of weights and ages (medians, 37.3 kg and 12 years). Exposures with 10-mg/kg dosing were lower vs adult dosing, particularly in patients weighing < 40 kg, whereas 20-mg/kg dosing achieved or exceeded adult exposures, irrespective of body weight. A two-compartment linear model with time-varying clearance using body weight as a covariate, with the frequentist prior approach, best described pediatric data. In this model, optimal overlap in exposure with adult data was achieved with 800 mg every 2 weeks for patients aged ≥ 12 years and weighing ≥ 40 kg, and 15 mg/kg every 2 weeks for patients aged < 12 years or weighing < 40 kg. Conclusions Based on exposure matching, the recommended doses for further avelumab studies, including combination studies, are 15 mg/kg every 2 weeks for pediatric patients aged < 12 years or weighing < 40 kg and the adult flat dose of 800 mg every 2 weeks for pediatric patients aged ≥ 12 years and weighing ≥ 40 kg. Clinical Trial Registration ClinicalTrials.gov NCT03451825. Supplementary Information The online version contains supplementary material available at 10.1007/s40262-022-01111-8.
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Affiliation(s)
- Yulia Vugmeyster
- EMD Serono Research & Development Institute, Inc. (an affiliate of Merck KGaA), Billerica, MA, USA
| | - Ana-Marija Grisic
- Merck Healthcare KGaA, Frankfurter Strasse 250, 64293, Darmstadt, Germany
| | - Brigitte Brockhaus
- Merck Healthcare KGaA, Frankfurter Strasse 250, 64293, Darmstadt, Germany
| | - Peter Rueckert
- Merck Healthcare KGaA, Frankfurter Strasse 250, 64293, Darmstadt, Germany
| | - Mary Ruisi
- EMD Serono Research & Development Institute, Inc. (an affiliate of Merck KGaA), Billerica, MA, USA
| | - Haiqing Dai
- EMD Serono Research & Development Institute, Inc. (an affiliate of Merck KGaA), Billerica, MA, USA
| | - Akash Khandelwal
- Merck Healthcare KGaA, Frankfurter Strasse 250, 64293, Darmstadt, Germany.
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27
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Hardiansyah D, Ng CM. Minimal Physiologically-based Pharmacokinetic Model to Investigate the Effect of Charge on the Pharmacokinetics of Humanized anti-HCV-E2 IgG Antibodies in Sprague-Dawley Rats. Pharm Res 2022; 39:481-496. [PMID: 35246757 DOI: 10.1007/s11095-022-03204-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 02/15/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To develop a minimal physiologically-based pharmacokinetic (mPBPK) model in quantifying the relationships between the charge and pharmacokinetics (PK) of therapeutic monoclonal IgG antibody (TMAb). METHODS PK data used in this study were native IgG and five humanized anti-HCVE2-IgG antibodies in rats. Different models that related the effect of charge on interstitial distribution, transcapillary transport, and cellular uptake for FcRn-mediated metabolism were tested. External validation was conducted to assess if the charge-parameter relationships derived from rats could be used to predict the PK of TMAbs in mice. The final mPBPK model was used to construct the relationships between the FcRn binding and charge on the PK of TMAbs. RESULTS Increasing the isoelectric point (pI) of IgG was associated with higher interstitial space distribution and cellular uptake. The transcapillary transport of IgG from plasma to interstitial space remains constant with pI values below 7.96 and then increased linearly with pI. The model-based simulation results suggested that improving the FcRn binding affinity can overcome the problems of low plasma/interstitial space exposures associated with TMAbs with higher pI values by reducing the FcRn-mediated metabolism and hence increasing drug exposure in the interstitial space that has close contact with many solid tumors. CONCLUSIONS The final mPBPK model was developed and used to construct complex quantitative relationships between the pI/FcRn binding affinity and PK of TMAbs and such relationships are useful to select the discovery of a "sweet spot" of designing future generation of TMAbs with optimal PK properties to achieve desirable plasma and tissue drug exposures.
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Affiliation(s)
- Deni Hardiansyah
- Physics Department, Faculty of Mathematics and Natural Sciences, Universitas Indonesia, Depok, 16424, Indonesia
| | - Chee Meng Ng
- NewGround Pharmaceutical Consulting LLC, Foster City, CA, 94404, USA.
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28
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Wechalekar A, Antoni G, Al Azzam W, Bergström M, Biswas S, Chen C, Cheriyan J, Cleveland M, Cookson L, Galette P, Janiczek RL, Kwong RY, Lukas MA, Millns H, Richards D, Schneider I, Solomon SD, Sörensen J, Storey J, Thompson D, van Dongen G, Vugts DJ, Wall A, Wikström G, Falk RH. Pharmacodynamic evaluation and safety assessment of treatment with antibodies to serum amyloid P component in patients with cardiac amyloidosis: an open-label Phase 2 study and an adjunctive immuno-PET imaging study. BMC Cardiovasc Disord 2022; 22:49. [PMID: 35152886 PMCID: PMC8843022 DOI: 10.1186/s12872-021-02407-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/26/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In a Phase I study treatment with the serum amyloid P component (SAP) depleter miridesap followed by monoclonal antibody to SAP (dezamizumab) showed removal of amyloid from liver, spleen and kidney in patients with systemic amyloidosis. We report results from a Phase 2 study and concurrent immuno-positron emission tomography (PET) study assessing efficacy, pharmacodynamics, pharmacokinetics, safety and cardiac uptake (of dezamizumab) following the same intervention in patients with cardiac amyloidosis. METHODS Both were uncontrolled open-label studies. After SAP depletion with miridesap, patients received ≤ 6 monthly doses of dezamizumab in the Phase 2 trial (n = 7), ≤ 2 doses of non-radiolabelled dezamizumab plus [89Zr]Zr-dezamizumab (total mass dose of 80 mg at session 1 and 500 mg at session 2) in the immuno-PET study (n = 2). Primary endpoints of the Phase 2 study were changed from baseline to follow-up (at 8 weeks) in left ventricular mass (LVM) by cardiac magnetic resonance imaging and safety. Primary endpoint of the immuno-PET study was [89Zr]Zr-dezamizumab cardiac uptake assessed via PET. RESULTS Dezamizumab produced no appreciable or consistent reduction in LVM nor improvement in cardiac function in the Phase 2 study. In the immuno-PET study, measurable cardiac uptake of [89Zr]Zr-dezamizumab, although seen in both patients, was moderate to low. Uptake was notably lower in the patient with higher LVM. Treatment-associated rash with cutaneous small-vessel vasculitis was observed in both studies. Abdominal large-vessel vasculitis after initial dezamizumab dosing (300 mg) occurred in the first patient with immunoglobulin light chain amyloidosis enrolled in the Phase 2 study. Symptom resolution was nearly complete within 24 h of intravenous methylprednisolone and dezamizumab discontinuation; abdominal computed tomography imaging showed vasculitis resolution by 8 weeks. CONCLUSIONS Unlike previous observations of visceral amyloid reduction, there was no appreciable evidence of amyloid removal in patients with cardiac amyloidosis in this Phase 2 trial, potentially related to limited cardiac uptake of dezamizumab as demonstrated in the immuno-PET study. The benefit-risk assessment for dezamizumab in cardiac amyloidosis was considered unfavourable after the incidence of large-vessel vasculitis and development for this indication was terminated. Trial registration NCT03044353 (2 February 2017) and NCT03417830 (25 January 2018).
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Affiliation(s)
| | - Gunnar Antoni
- Institutionen för Medicinska Vetenskaper, Uppsala University, Uppsala, Sweden
| | - Wasfi Al Azzam
- GlaxoSmithKline, Philadelphia, USA
- Takeda, Lexington, MA, USA
| | | | - Swethajit Biswas
- GlaxoSmithKline, Stevenage, Hertfordshire, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Chao Chen
- GlaxoSmithKline, Stevenage, Hertfordshire, UK
| | - Joseph Cheriyan
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | | | | | | | | | | | - Duncan Richards
- GlaxoSmithKline, Stevenage, Hertfordshire, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Ian Schneider
- GlaxoSmithKline, Cambridge, UK
- Consolidated Consulting LTD, Cambridge, UK
| | | | - Jens Sörensen
- Institutionen för Medicinska Vetenskaper, Uppsala University, Uppsala, Sweden
| | | | | | | | | | - Anders Wall
- Institutionen för Medicinska Vetenskaper, Uppsala University, Uppsala, Sweden
| | - Gerhard Wikström
- Institutionen för Medicinska Vetenskaper, Uppsala University, Uppsala, Sweden
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Bordeau BM, Polli JR, Schweser F, Grimm HP, Richter WF, Balthasar JP. Dynamic Contrast-Enhanced Magnetic Resonance Imaging for the Prediction of Monoclonal Antibody Tumor Disposition. Int J Mol Sci 2022; 23:679. [PMID: 35054865 PMCID: PMC8775965 DOI: 10.3390/ijms23020679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/30/2021] [Accepted: 01/05/2022] [Indexed: 11/16/2022] Open
Abstract
The prediction of monoclonal antibody (mAb) disposition within solid tumors for individual patients is difficult due to inter-patient variability in tumor physiology. Improved a priori prediction of mAb pharmacokinetics in tumors may facilitate the development of patient-specific dosing protocols and facilitate improved selection of patients for treatment with anti-cancer mAb. Here, we report the use of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), with tumor penetration of the contrast agent gadobutrol used as a surrogate, to improve physiologically based pharmacokinetic model (PBPK) predictions of cetuximab pharmacokinetics in epidermal growth factor receptor (EGFR) positive xenografts. In the initial investigations, mice bearing Panc-1, NCI-N87, and LS174T xenografts underwent DCE-MRI imaging with the contrast agent gadobutrol, followed by intravenous dosing of an 125Iodine-labeled, non-binding mAb (8C2). Tumor concentrations of 8C2 were determined following the euthanasia of mice (3 h-6 days after 8C2 dosing). Potential predictor relationships between DCE-MRI kinetic parameters and 8C2 PBPK parameters were evaluated through covariate modeling. The addition of the DCE-MRI parameter Ktrans alone or Ktrans in combination with the DCE-MRI parameter Vp on the PBPK parameters for tumor blood flow (QTU) and tumor vasculature permeability (σTUV) led to the most significant improvement in the characterization of 8C2 pharmacokinetics in individual tumors. To test the utility of the DCE-MRI covariates on a priori prediction of the disposition of mAb with high-affinity tumor binding, a second group of tumor-bearing mice underwent DCE-MRI imaging with gadobutrol, followed by the administration of 125Iodine-labeled cetuximab (a high-affinity anti-EGFR mAb). The MRI-PBPK covariate relationships, which were established with the untargeted antibody 8C2, were implemented into the PBPK model with considerations for EGFR expression and cetuximab-EGFR interaction to predict the disposition of cetuximab in individual tumors (a priori). The incorporation of the Ktrans MRI parameter as a covariate on the PBPK parameters QTU and σTUV decreased the PBPK model prediction error for cetuximab tumor pharmacokinetics from 223.71 to 65.02%. DCE-MRI may be a useful clinical tool in improving the prediction of antibody pharmacokinetics in solid tumors. Further studies are warranted to evaluate the utility of the DCE-MRI approach to additional mAbs and additional drug modalities.
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Affiliation(s)
- Brandon M. Bordeau
- Department of Pharmaceutical Sciences, University at Buffalo, 450 Pharmacy Building, Buffalo, NY 14214, USA; (B.M.B.); (J.R.P.)
| | - Joseph Ryan Polli
- Department of Pharmaceutical Sciences, University at Buffalo, 450 Pharmacy Building, Buffalo, NY 14214, USA; (B.M.B.); (J.R.P.)
| | - Ferdinand Schweser
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA;
- Clinical and Translational Science Institute, Center for Biomedical Imaging, University at Buffalo, Buffalo, NY 14203, USA
| | - Hans Peter Grimm
- Roche Pharmaceutical Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland; (H.P.G.); (W.F.R.)
| | - Wolfgang F. Richter
- Roche Pharmaceutical Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Grenzacherstrasse 124, 4070 Basel, Switzerland; (H.P.G.); (W.F.R.)
| | - Joseph P. Balthasar
- Department of Pharmaceutical Sciences, University at Buffalo, 450 Pharmacy Building, Buffalo, NY 14214, USA; (B.M.B.); (J.R.P.)
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30
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Hu S, Datta-Mannan A, D’Argenio DZ. Physiologically Based Modeling to Predict Monoclonal Antibody Pharmacokinetics in Humans from in vitro Physiochemical Properties. MAbs 2022; 14:2056944. [PMID: 35491902 PMCID: PMC9067474 DOI: 10.1080/19420862.2022.2056944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/28/2022] [Accepted: 03/20/2022] [Indexed: 11/01/2022] Open
Abstract
A model-based framework is presented to predict monoclonal antibody (mAb) pharmacokinetics (PK) in humans based on in vitro measures of antibody physiochemical properties. A physiologically based pharmacokinetic (PBPK) model is used to explore the predictive potential of 14 in vitro assays designed to measure various antibody physiochemical properties, including nonspecific cell-surface interactions, FcRn binding, thermal stability, hydrophobicity, and self-association. Based on the mean plasma PK time course data of 22 mAbs from humans reported in the literature, we found a significant positive correlation (R = 0.64, p = .0013) between the model parameter representing antibody-specific vascular to endothelial clearance and heparin relative retention time, an in vitro measure of nonspecific binding. We also found that antibody-specific differences in paracellular transport due to convection and diffusion could be partially explained by antibody heparin relative retention time (R = 0.52, p = .012). Other physiochemical properties, including antibody thermal stability, hydrophobicity, cross-interaction and self-association, in and of themselves were not predictive of model-based transport parameters. In contrast to other studies that have reported empirically derived expressions relating in vitro measures of antibody physiochemical properties directly to antibody clearance, the proposed PBPK model-based approach for predicting mAb PK incorporates fundamental mechanisms governing antibody transport and processing, informed by in vitro measures of antibody physiochemical properties, and can be expanded to include more descriptive representations of each of the antibody processing subsystems, as well as other antibody-specific information.
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Affiliation(s)
- Shihao Hu
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA
| | - Amita Datta-Mannan
- Department of Exploratory Medicine and Pharmacology, Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA
| | - David Z. D’Argenio
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA
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Issafras H, Fan S, Tseng CL, Cheng Y, Lin P, Xiao L, Huang YJ, Tu CH, Hsiao YC, Li M, Chen YH, Ho CH, Li O, Wang Y, Chen S, Ji Z, Zhang E, Mao YT, Liu E, Yang S, Jiang W. Structural basis of HLX10 PD-1 receptor recognition, a promising anti-PD-1 antibody clinical candidate for cancer immunotherapy. PLoS One 2021; 16:e0257972. [PMID: 34972111 PMCID: PMC8719770 DOI: 10.1371/journal.pone.0257972] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 09/14/2021] [Indexed: 12/30/2022] Open
Abstract
Cancer immunotherapies, such as checkpoint blockade of programmed cell death protein-1 (PD-1), represents a breakthrough in cancer treatment, resulting in unprecedented results in terms of overall and progression-free survival. Discovery and development of novel anti PD-1 inhibitors remains a field of intense investigation, where novel monoclonal antibodies (mAbs) and novel antibody formats (e.g., novel isotype, bispecific mAb and low-molecular-weight compounds) are major source of future therapeutic candidates. HLX10, a fully humanized IgG4 monoclonal antibody against PD-1 receptor, increased functional activities of human T-cells and showed in vitro, and anti-tumor activity in several tumor models. The combined inhibition of PD-1/PDL-1 and angiogenesis pathways using anti-VEGF antibody may enhance a sustained suppression of cancer-related angiogenesis and tumor elimination. To elucidate HLX10's mode of action, we solved the structure of HLX10 in complex with PD-1 receptor. Detailed epitope analysis showed that HLX10 has a unique mode of recognition compared to the clinically approved PD1 antibodies Pembrolizumab and Nivolumab. Notably, HLX10's epitope was closer to Pembrolizumab's epitope than Nivolumab's epitope. However, HLX10 and Pembrolizumab showed an opposite heavy chain (HC) and light chain (LC) usage, which recognizes several overlapping amino acid residues on PD-1. We compared HLX10 to Nivolumab and Pembrolizumab and it showed similar or better bioactivity in vitro and in vivo, providing a rationale for clinical evaluation in cancer immunotherapy.
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MESH Headings
- Angiogenesis Inhibitors/therapeutic use
- Animals
- Antibodies, Monoclonal/chemistry
- Antibodies, Monoclonal/pharmacokinetics
- Antibodies, Monoclonal, Humanized/chemistry
- Antibodies, Monoclonal, Humanized/therapeutic use
- Bevacizumab/therapeutic use
- CD4-Positive T-Lymphocytes/immunology
- Cell Line, Tumor
- Cell Proliferation
- Epithelial-Mesenchymal Transition/drug effects
- Epitopes/immunology
- Humans
- Immunoglobulin Fab Fragments/metabolism
- Immunotherapy
- Interferon-gamma/metabolism
- Interleukin-2/metabolism
- Ligands
- Macaca fascicularis
- Mice, Inbred NOD
- Mice, SCID
- Models, Molecular
- Neoplasms/drug therapy
- Neoplasms/immunology
- Neoplasms/therapy
- Nivolumab/chemistry
- Nivolumab/therapeutic use
- Programmed Cell Death 1 Receptor/chemistry
- Programmed Cell Death 1 Receptor/immunology
- Protein Binding
- Rats
- Vascular Endothelial Growth Factor A/antagonists & inhibitors
- Vascular Endothelial Growth Factor A/metabolism
- Xenograft Model Antitumor Assays
- Mice
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Affiliation(s)
| | - Shilong Fan
- National Protein Science Facility, Tsinghua University, Beijing, China
| | | | | | - Peihua Lin
- Hengenix Inc., Fremont, CA, United States of America
| | - Lisa Xiao
- Shanghai Henlius Biotech, Inc., Shanghai, P. R. China
| | | | | | | | - Min Li
- National Protein Science Facility, Tsinghua University, Beijing, China
| | | | | | - Ou Li
- Hengenix Inc., Fremont, CA, United States of America
| | - Yanling Wang
- Hengenix Inc., Fremont, CA, United States of America
| | - Sandra Chen
- Anwita Biosciences, San Carlos, CA, United States of America
| | - Zhenyu Ji
- Shanghai Henlius Biotech, Inc., Shanghai, P. R. China
| | - Eric Zhang
- Shanghai Henlius Biotech, Inc., Shanghai, P. R. China
| | - Yi-Ting Mao
- Hengenix Inc., Fremont, CA, United States of America
| | - Eugene Liu
- Taipei Medical University, Taipei, Taiwan
| | - Shumin Yang
- Shanghai Henlius Biotech, Inc., Shanghai, P. R. China
| | - Weidong Jiang
- Hengenix Inc., Fremont, CA, United States of America
- Shanghai Henlius Biotech, Inc., Shanghai, P. R. China
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Henderson RD, Agosti JM, McCombe PA, Thorpe K, Heggie S, Heshmat S, Appleby MW, Ziegelaar BW, Crowe DT, Redlich GL. Phase 1b dose-escalation, safety, and pharmacokinetic study of IC14, a monoclonal antibody against CD14, for the treatment of amyotrophic lateral sclerosis. Medicine (Baltimore) 2021; 100:e27421. [PMID: 34678870 PMCID: PMC8542123 DOI: 10.1097/md.0000000000027421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/16/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The primary objective was to demonstrate the safety and tolerability of monoclonal antibody against CD14 (IC14) (atibuclimab) in amyotrophic lateral sclerosis patients. The secondary objectives were pharmacokinetics, pharmacodynamics, and preliminary effects on disease status and biomarkers. METHODS In this open-label, dose-escalation trial, IC14 was administered at 2 mg/kg intravenous (IV) followed by 1 mg/kg/d IV × 3 (n = 3) and in subsequent patients at 4 mg/kg IV followed by 2 mg/kg/d IV × 3 (n = 7) (NCT03487263). Disease status was measured using the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale, forced vital capacity, sniff nasal pressure, Edinburgh Cognitive and Behavioural ALS Screen, and Revised ALS-Specific Quality-of-Life Score. Disease biomarkers included cerebrospinal fluid and serum levels of neurofilament light chain (NfL) and urinary p75 neurotrophin receptor. RESULTS IC14 was safe and well tolerated. No antidrug antibodies were detected. The drug target saturation of monocyte CD14 receptors was rapid and sustained through day 8. There was no significant change in Revised Amyotrophic Lateral Sclerosis Functional Rating Scale, forced vital capacity, sniff nasal pressure, or Revised ALS-Specific Quality-of-Life Score following a single cycle of treatment. Cerebrospinal fluid NfL levels decreased in 6 of 9 patients sampled with declines of 15% to 40% between baseline (not significant [ns]) and day 8 in 3 patients. Serum NfL modestly decreased in 5 of 10 patients (ns) at day 8 and was sustained in 4 (4%-37%, ns) over 33 days of follow up. CONCLUSION IC14 quickly and durably saturated its target in all patients. This study demonstrated safety and tolerability in patients with amyotrophic lateral sclerosis. Even though only a single cycle of treatment was given, there were promising beneficial trends in the neurofilament light chain, a disease biomarker. The emerging understanding of the role of systemic inflammation in neurodegenerative diseases, and the potential for IC14 to serve as a safe, potent, and broad-spectrum inhibitor of immune dysregulation merits further clinical study. CLINICAL TRIAL REGISTRATION NCT03487263.
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Affiliation(s)
- Robert D. Henderson
- Royal Brisbane & Women's Hospital, Herston, Queensland, Australia
- University of Queensland, Centre for Clinical Research, Herston, Queensland, Australia
| | - Jan M. Agosti
- Implicit Bioscience, Seattle, WA
- Implicit Bioscience, Brisbane, Australia
| | - Pamela A. McCombe
- Royal Brisbane & Women's Hospital, Herston, Queensland, Australia
- University of Queensland, Centre for Clinical Research, Herston, Queensland, Australia
| | - Kathryn Thorpe
- Royal Brisbane & Women's Hospital, Herston, Queensland, Australia
| | - Susan Heggie
- Royal Brisbane & Women's Hospital, Herston, Queensland, Australia
| | - Saman Heshmat
- Royal Brisbane & Women's Hospital, Herston, Queensland, Australia
| | - Mark W. Appleby
- Implicit Bioscience, Seattle, WA
- Implicit Bioscience, Brisbane, Australia
| | - Brian W. Ziegelaar
- Implicit Bioscience, Seattle, WA
- Implicit Bioscience, Brisbane, Australia
| | - David T. Crowe
- Implicit Bioscience, Seattle, WA
- Implicit Bioscience, Brisbane, Australia
| | - Garry L. Redlich
- Implicit Bioscience, Seattle, WA
- Implicit Bioscience, Brisbane, Australia
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Beghin D. [Placental transfer of monoclonal antibodies: The example of anti-TNF alpha drugs]. Gynecol Obstet Fertil Senol 2021; 49:724-726. [PMID: 34214735 DOI: 10.1016/j.gofs.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Indexed: 06/13/2023]
Abstract
Anti-TNF alpha monoclonal antibodies are used in the treatment of chronic inflammatory diseases, which commonly affect women of childbearing age. Due to their similar structure to native immunoglobulins, the evaluation of their placental transfer by a pharmacological approach of the mechanisms involved is an interesting source of information, useful to the risk-benefit assessment of drugs in pregnant women.
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Affiliation(s)
- D Beghin
- Centre de référence sur les agents tératogènes (CRAT), DMU Épidémiologie et biostatistique, Santé publique, Pharmacie, Pharmacologie, Recherche, Information médicale, Thérapeutique et médicaments (ESPRIT), GHU, AP-HP, Sorbonne université - site Trousseau, 26, avenue Dr-Netter, 75571 Paris cedex 12, France.
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Gaudinski MR, Berkowitz NM, Idris AH, Coates EE, Holman LA, Mendoza F, Gordon IJ, Plummer SH, Trofymenko O, Hu Z, Campos Chagas A, O'Connell S, Basappa M, Douek N, Narpala SR, Barry CR, Widge AT, Hicks R, Awan SF, Wu RL, Hickman S, Wycuff D, Stein JA, Case C, Evans BP, Carlton K, Gall JG, Vazquez S, Flach B, Chen GL, Francica JR, Flynn BJ, Kisalu NK, Capparelli EV, McDermott A, Mascola JR, Ledgerwood JE, Seder RA. A Monoclonal Antibody for Malaria Prevention. N Engl J Med 2021; 385:803-814. [PMID: 34379916 PMCID: PMC8579034 DOI: 10.1056/nejmoa2034031] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Additional interventions are needed to reduce the morbidity and mortality caused by malaria. METHODS We conducted a two-part, phase 1 clinical trial to assess the safety and pharmacokinetics of CIS43LS, an antimalarial monoclonal antibody with an extended half-life, and its efficacy against infection with Plasmodium falciparum. Part A of the trial assessed the safety, initial side-effect profile, and pharmacokinetics of CIS43LS in healthy adults who had never had malaria. Participants received CIS43LS subcutaneously or intravenously at one of three escalating dose levels. A subgroup of participants from Part A continued to Part B, and some received a second CIS43LS infusion. Additional participants were enrolled in Part B and received CIS43LS intravenously. To assess the protective efficacy of CIS43LS, some participants underwent controlled human malaria infection in which they were exposed to mosquitoes carrying P. falciparum sporozoites 4 to 36 weeks after administration of CIS43LS. RESULTS A total of 25 participants received CIS43LS at a dose of 5 mg per kilogram of body weight, 20 mg per kilogram, or 40 mg per kilogram, and 4 of the 25 participants received a second dose (20 mg per kilogram regardless of initial dose). No safety concerns were identified. We observed dose-dependent increases in CIS43LS serum concentrations, with a half-life of 56 days. None of the 9 participants who received CIS43LS, as compared with 5 of 6 control participants who did not receive CIS43LS, had parasitemia according to polymerase-chain-reaction testing through 21 days after controlled human malaria infection. Two participants who received 40 mg per kilogram of CIS43LS and underwent controlled human malaria infection approximately 36 weeks later had no parasitemia, with serum concentrations of CIS43LS of 46 and 57 μg per milliliter at the time of controlled human malaria infection. CONCLUSIONS Among adults who had never had malaria infection or vaccination, administration of the long-acting monoclonal antibody CIS43LS prevented malaria after controlled infection. (Funded by the National Institute of Allergy and Infectious Diseases; VRC 612 ClinicalTrials.gov number, NCT04206332.).
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MESH Headings
- Adult
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/pharmacokinetics
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/pharmacokinetics
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antibodies, Protozoan/blood
- Antimalarials/administration & dosage
- Antimalarials/adverse effects
- Antimalarials/pharmacokinetics
- Antimalarials/therapeutic use
- Dose-Response Relationship, Drug
- Healthy Volunteers
- Humans
- Infusions, Intravenous/adverse effects
- Injections, Subcutaneous/adverse effects
- Malaria, Falciparum/prevention & control
- Middle Aged
- Plasmodium falciparum/immunology
- Plasmodium falciparum/isolation & purification
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Affiliation(s)
- Martin R Gaudinski
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Nina M Berkowitz
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Azza H Idris
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Emily E Coates
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - LaSonji A Holman
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Floreliz Mendoza
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Ingelise J Gordon
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Sarah H Plummer
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Olga Trofymenko
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Zonghui Hu
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Andrezza Campos Chagas
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Sarah O'Connell
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Manjula Basappa
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Naomi Douek
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Sandeep R Narpala
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Christopher R Barry
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Alicia T Widge
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Renunda Hicks
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Seemal F Awan
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Richard L Wu
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Somia Hickman
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Diane Wycuff
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Judy A Stein
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Christopher Case
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Brian P Evans
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Kevin Carlton
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Jason G Gall
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Sandra Vazquez
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Britta Flach
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Grace L Chen
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Joseph R Francica
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Barbara J Flynn
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Neville K Kisalu
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Edmund V Capparelli
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Adrian McDermott
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - John R Mascola
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Julie E Ledgerwood
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Robert A Seder
- From the Vaccine Research Center (M.R.G., N.M.B., A.H.I., E.E.C., L.A.H., F.M., I.J.G., S.H.P., O.T., S.O., M.B., N.D., S.R.N., C.R.B., A.T.W., R.H., S.F.A., R.L.W., S.H., D.W., J.A.S., K.C., J.G.G., S.V., B.F., G.L.C., J.R.F., B.J.F., N.K.K., A.M., J.R.M., J.E.L., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (M.R.G.), the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., B.P.E.), and the Vaccine Clinical Materials Program, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick (C.C.) - all in Maryland; and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
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Handula M, Chen KT, Seimbille Y. IEDDA: An Attractive Bioorthogonal Reaction for Biomedical Applications. Molecules 2021; 26:molecules26154640. [PMID: 34361793 PMCID: PMC8347371 DOI: 10.3390/molecules26154640] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 12/26/2022] Open
Abstract
The pretargeting strategy has recently emerged in order to overcome the limitations of direct targeting, mainly in the field of radioimmunotherapy (RIT). This strategy is directly dependent on chemical reactions, namely bioorthogonal reactions, which have been developed for their ability to occur under physiological conditions. The Staudinger ligation, the copper catalyzed azide-alkyne cycloaddition (CuAAC) and the strain-promoted [3 + 2] azide–alkyne cycloaddition (SPAAC) were the first bioorthogonal reactions introduced in the literature. However, due to their incomplete biocompatibility and slow kinetics, the inverse-electron demand Diels-Alder (IEDDA) reaction was advanced in 2008 by Blackman et al. as an optimal bioorthogonal reaction. The IEDDA is the fastest bioorthogonal reaction known so far. Its biocompatibility and ideal kinetics are very appealing for pretargeting applications. The use of a trans-cyclooctene (TCO) and a tetrazine (Tz) in the reaction encouraged researchers to study them deeply. It was found that both reagents are sensitive to acidic or basic conditions. Furthermore, TCO is photosensitive and can be isomerized to its cis-conformation via a radical catalyzed reaction. Unfortunately, the cis-conformer is significantly less reactive toward tetrazine than the trans-conformation. Therefore, extensive research has been carried out to optimize both click reagents and to employ the IEDDA bioorthogonal reaction in biomedical applications.
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Affiliation(s)
- Maryana Handula
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands;
| | - Kuo-Ting Chen
- Department of Chemistry, National Dong Hwa University, Shoufeng, Hualien 974301, Taiwan;
| | - Yann Seimbille
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands;
- Life Sciences Division, TRIUMF, 4004 Wesbrook Mall, Vancouver, BC V6T 2A3, Canada
- Correspondence: ; Tel.: +31-10-703-8961
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Raleigh MD, Beltraminelli N, Fallot S, LeSage MG, Saykao A, Pentel PR, Fuller S, Thisted T, Biesova Z, Horrigan S, Sampey D, Zhou B, Kalnik MW. Attenuating nicotine's effects with high affinity human anti-nicotine monoclonal antibodies. PLoS One 2021; 16:e0254247. [PMID: 34329335 PMCID: PMC8323890 DOI: 10.1371/journal.pone.0254247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/23/2021] [Indexed: 11/27/2022] Open
Abstract
Use of nicotine-specific monoclonal antibodies (mAbs) to sequester and reduce nicotine distribution to brain has been proposed as a therapeutic approach to treat nicotine addiction (the basis of tobacco use disorder). A series of monoclonal antibodies with high affinity for nicotine (nic•mAbs) was isolated from B-cells of vaccinated smokers. Genes encoding 32 unique nicotine binding antibodies were cloned, and the mAbs expressed and tested by surface plasmon resonance to determine their affinity for S-(–)-nicotine. The highest affinity nic•mAbs had binding affinity constants (KD) between 5 and 67 nM. The 4 highest affinity nic•mAbs were selected to undergo additional secondary screening for antigen-specificity, protein properties (including aggregation and stability), and functional in vivo studies to evaluate their capacity for reducing nicotine distribution to brain in rats. The 2 most potent nic•mAbs in single-dose nicotine pharmacokinetic experiments were further tested in a dose-response in vivo study. The most potent lead, ATI-1013, was selected as the lead candidate based on the results of these studies. Pretreatment with 40 and 80 mg/kg ATI-1013 reduced brain nicotine levels by 56 and 95%, respectively, in a repeated nicotine dosing experiment simulating very heavy smoking. Nicotine self-administration was also significantly reduced in rats treated with ATI-1013. A pilot rat 30-day repeat-dose toxicology study (4x200mg/kg ATI-1013) in the presence of nicotine indicated no drug-related safety concerns. These data provide evidence that ATI-1013 could be a potential therapy for the treatment of nicotine addiction.
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Affiliation(s)
- Michael D. Raleigh
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States of America
- Department of Pharmacology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | | | | | - Mark G. LeSage
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States of America
- Nic•mAb Strategic Alliance, San Diego, California, United States of America
| | - Amy Saykao
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States of America
| | - Paul R. Pentel
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States of America
- Nic•mAb Strategic Alliance, San Diego, California, United States of America
| | - Steve Fuller
- Nic•mAb Strategic Alliance, San Diego, California, United States of America
- Antidote Therapeutics, Inc., Woodbine, Maryland, United States of America
| | - Thomas Thisted
- Nic•mAb Strategic Alliance, San Diego, California, United States of America
- Antidote Therapeutics, Inc., Woodbine, Maryland, United States of America
| | - Zuzanna Biesova
- Antidote Therapeutics, Inc., Woodbine, Maryland, United States of America
| | - Stephen Horrigan
- Noble Life Sciences, Woodbine, Maryland, United States of America
| | - Darryl Sampey
- Nic•mAb Strategic Alliance, San Diego, California, United States of America
- Biofactura, Inc., Frederick, Maryland, United States of America
| | - Bin Zhou
- Nic•mAb Strategic Alliance, San Diego, California, United States of America
- The Scripps Research Institute, La Jolla, California, United States of America
| | - Matthew W. Kalnik
- Nic•mAb Strategic Alliance, San Diego, California, United States of America
- Antidote Therapeutics, Inc., Woodbine, Maryland, United States of America
- * E-mail:
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Huls F, Schroeder L, Keren DF. Expression of Daratumumab and Elotuzumab Migration by Capillary Electrophoresis Relative to Transferrin Improves Precision of Their Identification. J Appl Lab Med 2021; 5:419-422. [PMID: 32445376 DOI: 10.1093/jalm/jfz008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/19/2019] [Accepted: 11/21/2019] [Indexed: 11/14/2022]
Affiliation(s)
- Forest Huls
- Division of General Internal Medicine, Department of Medicine, the University of Alabama, Vestavia Hills, AL
| | - Lee Schroeder
- Department of Pathology, the University of Michigan, Ann Arbor, MI
| | - David F Keren
- Department of Pathology, the University of Michigan, Ann Arbor, MI
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Kang L, Li C, Rosenkrans ZT, Huo N, Chen Z, Ehlerding EB, Huo Y, Ferreira CA, Barnhart TE, Engle JW, Wang R, Jiang D, Xu X, Cai W. CD38-Targeted Theranostics of Lymphoma with 89Zr/ 177Lu-Labeled Daratumumab. Adv Sci (Weinh) 2021; 8:2001879. [PMID: 34026426 PMCID: PMC8132161 DOI: 10.1002/advs.202001879] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 12/30/2020] [Indexed: 05/05/2023]
Abstract
Lymphoma is a heterogeneous disease with varying clinical manifestations and outcomes. Many subtypes of lymphoma, such as Burkitt's lymphoma and diffuse large B cell lymphoma, are highly aggressive with dismal prognosis even after conventional chemotherapy and radiotherapy. As such, exploring specific biomarkers for lymphoma is of high clinical significance. Herein, a potential marker, CD38, is investigated for differentiating lymphoma. A CD38-targeting monoclonal antibody (mAb, daratumumab) is then radiolabeled with Zr-89 and Lu-177 for theranostic applications. As the diagnostic component, the Zr-89-labeled mAb is highly specific in delineating CD38-positive lymphoma via positron emission tomography (PET) imaging, while the Lu-177-labeled mAb serves well as the therapeutic component to suppress tumor growth after a one-time administration. These results strongly suggest that CD38 is a lymphoma-specific marker and prove that 89Zr/177Lu-labeled daratumumab facilitates immunoPET imaging and radioimmunotherapy of lymphoma in preclinical models. Further clinical evaluation and translation of this CD38-targeted theranostics may be of significant help in lymphoma patient stratification and management.
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MESH Headings
- ADP-ribosyl Cyclase 1/immunology
- ADP-ribosyl Cyclase 1/metabolism
- Animals
- Antibodies, Monoclonal/pharmacokinetics
- Antibodies, Monoclonal/pharmacology
- Cell Line, Tumor
- Humans
- Immunologic Factors/pharmacokinetics
- Lutetium/pharmacokinetics
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Membrane Glycoproteins/immunology
- Membrane Glycoproteins/metabolism
- Mice, Inbred BALB C
- Mice, SCID
- Positron Emission Tomography Computed Tomography/methods
- Precision Medicine/methods
- Radioisotopes/pharmacokinetics
- Radiopharmaceuticals/pharmacokinetics
- Radiopharmaceuticals/pharmacology
- Tissue Distribution
- Xenograft Model Antitumor Assays
- Zirconium/pharmacokinetics
- Mice
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Affiliation(s)
- Lei Kang
- Department of Nuclear MedicinePeking University First HospitalBeijing100034China
- Departments of Radiology and Medical PhysicsUniversity of Wisconsin – MadisonMadisonWI53705USA
| | - Cuicui Li
- Department of Nuclear MedicinePeking University First HospitalBeijing100034China
| | - Zachary T. Rosenkrans
- Department of Pharmaceutical SciencesUniversity of Wisconsin – MadisonMadisonWI53705USA
| | - Nan Huo
- Department of Medical Molecular BiologyBeijing Institute of BiotechnologyBeijing100850China
| | - Zhao Chen
- Department of Nuclear MedicinePeking University First HospitalBeijing100034China
| | - Emily B. Ehlerding
- Departments of Radiology and Medical PhysicsUniversity of Wisconsin – MadisonMadisonWI53705USA
| | - Yan Huo
- Department of Nuclear MedicinePeking University First HospitalBeijing100034China
| | - Carolina A. Ferreira
- Departments of Radiology and Medical PhysicsUniversity of Wisconsin – MadisonMadisonWI53705USA
| | - Todd E. Barnhart
- Departments of Radiology and Medical PhysicsUniversity of Wisconsin – MadisonMadisonWI53705USA
| | - Jonathan W. Engle
- Departments of Radiology and Medical PhysicsUniversity of Wisconsin – MadisonMadisonWI53705USA
| | - Rongfu Wang
- Department of Nuclear MedicinePeking University First HospitalBeijing100034China
| | - Dawei Jiang
- Departments of Radiology and Medical PhysicsUniversity of Wisconsin – MadisonMadisonWI53705USA
- Department of Nuclear MedicineUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China
| | - Xiaojie Xu
- Department of Medical Molecular BiologyBeijing Institute of BiotechnologyBeijing100850China
| | - Weibo Cai
- Departments of Radiology and Medical PhysicsUniversity of Wisconsin – MadisonMadisonWI53705USA
- Department of Pharmaceutical SciencesUniversity of Wisconsin – MadisonMadisonWI53705USA
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Gathe JC, Hardwicke RL, Garcia F, Weinheimer S, Lewis ST, Cash RB. Efficacy, Pharmacokinetics, and Safety Over 48 Weeks With Ibalizumab-Based Therapy in Treatment-Experienced Adults Infected With HIV-1: A Phase 2a Study. J Acquir Immune Defic Syndr 2021; 86:482-489. [PMID: 33427765 PMCID: PMC7899216 DOI: 10.1097/qai.0000000000002591] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/17/2020] [Indexed: 12/01/2022]
Abstract
ABSTRACT Ibalizumab, a humanized monoclonal antibody targeting CD4, blocks HIV-1 entry into cells and is the first Food and Drug Adminstration-approved long-acting agent for HIV-1 treatment. In this phase 2a study, 82 HIV-infected adults failing antiretroviral therapy were assigned an individually optimized background regimen (OBR) and randomized 1:1:1 to arm A (15 mg/kg ibalizumab q2wk), arm B (10 mg/kg weekly for 9 weeks, then q2wk), or placebo. Subjects with an inadequate response at week 16 were permitted to cross over to a new OBR plus 15 mg/kg ibalizumab q2wk. At week 16, viral load (VL) reduction was significantly greater than placebo (0.26 log10) in arms A (1.07 log10; P = 0.002) and B (1.33 log10; P < 0.001); CD4+ T cell counts increased significantly in arm A. After week 16, 11/27 (arm B) and 19/27 (placebo) subjects crossed over to OBR plus 15 mg/kg ibalizumab; 8/28 in arm A initiated a new OBR. Ibalizumab treatment resulted in VL reduction at week 24 (-0.77 and -1.19 log10 for arms A and B, respectively, versus -0.32 log10 for placebo) and 48 weeks (-0.54 and -0.77 versus -0.22 log10). Compared with placebo, VL differences were statistically significant for arm B at week 24 (P = 0.001) and week 48 (P = 0.027). CD4+ T cell counts increased significantly by week 48 in both arm A and arm B, relative to placebo. No ibalizumab-related serious adverse events were reported. The durable antiviral activity and tolerability of ibalizumab support its use in treating individuals harboring multidrug-resistant HIV-1.
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Affiliation(s)
| | - Robin L. Hardwicke
- University of Texas, John P and Katherine G McGovern Medical School, Houston, TX
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Chatelut E, Hendrikx JJMA, Martin J, Ciccolini J, Moes DJAR. Unraveling the complexity of therapeutic drug monitoring for monoclonal antibody therapies to individualize dose in oncology. Pharmacol Res Perspect 2021; 9:e00757. [PMID: 33745217 PMCID: PMC7981594 DOI: 10.1002/prp2.757] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/13/2022] Open
Abstract
Monoclonal antibodies (Mabs) have become key drugs in cancer treatment, either as targeted therapies or more recently as immune checkpoint inhibitors (ICIs). The fact that only some patients benefit from these drugs poses the usual question in the field of onco-hematology: that of the benefit of individual dosing and the potential of therapeutic drug monitoring (TDM) to carry out this individualization. However, Mabs present unique pharmacological characteristics for TDM, and the pharmacokinetic-pharmacodynamic relationship observed should be interpreted differently than that observed for conventional drugs and small molecules. This pharmacology practice review has been summarized from a public debate between the authors at the International TDM and Clinical Toxicology meeting in Banff, 2020, regarding the potential roles of TDM in the Mab/ICI setting.
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Affiliation(s)
- Etienne Chatelut
- CRCTUniversité de ToulouseInserm, and Institut Claudius‐RegaudIUCT‐OncopoleToulouseFrance
| | - Jeroen J. M. A. Hendrikx
- Department of Pharmacy and Pharmacology and Department of Nuclear MedicineThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - Jennifer Martin
- Centre for Drug Repurposing and Medicines ResearchThe University of NewcastleCallaghanNSWAustralia
| | - Joseph Ciccolini
- SMARTcCRCM Inserm U1068Aix Marseille University and La Timone university Hospital of MarseilleMarseilleFrance
| | - Dirk Jan A. R. Moes
- Department of Clinical Pharmacy and ToxicologyLeiden University Medical CenterLeidenThe Netherlands
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41
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Abstract
As an essential modulator of IgG disposition, the neonatal Fc receptor (FcRn) governs the pharmacokinetics and functions many therapeutic modalities. In this review, we thoroughly reexamine the hitherto elucidated biological and thermodynamic properties of FcRn to provide context for our assessment of more recent advances, which covers antigen-binding fragment (Fab) determinants of FcRn affinity, transgenic preclinical models, and FcRn targeting as an immune-complex (IC)-clearing strategy. We further comment on therapeutic antibodies authorized for treating SARS-CoV-2 (bamlanivimab, casirivimab, and imdevimab) and evaluate their potential to saturate FcRn-mediated recycling. Finally, we discuss modeling and simulation studies that probe the quantitative relationship between in vivo IgG persistence and in vitro FcRn binding, emphasizing the importance of endosomal transit parameters.
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Affiliation(s)
| | - Yanguang Cao
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, Chapel Hill, NC 27599, USA;
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42
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Dragovich PS, Pillow TH, Blake RA, Sadowsky JD, Adaligil E, Adhikari P, Chen J, Corr N, Dela Cruz-Chuh J, Del Rosario G, Fullerton A, Hartman SJ, Jiang F, Kaufman S, Kleinheinz T, Kozak KR, Liu L, Lu Y, Mulvihill MM, Murray JM, O'Donohue A, Rowntree RK, Sawyer WS, Staben LR, Wai J, Wang J, Wei B, Wei W, Xu Z, Yao H, Yu SF, Zhang D, Zhang H, Zhang S, Zhao Y, Zhou H, Zhu X. Antibody-Mediated Delivery of Chimeric BRD4 Degraders. Part 2: Improvement of In Vitro Antiproliferation Activity and In Vivo Antitumor Efficacy. J Med Chem 2021; 64:2576-2607. [PMID: 33596073 DOI: 10.1021/acs.jmedchem.0c01846] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Heterobifunctional compounds that direct the ubiquitination of intracellular proteins in a targeted manner via co-opted ubiquitin ligases have enormous potential to transform the field of medicinal chemistry. These chimeric molecules, often termed proteolysis-targeting chimeras (PROTACs) in the chemical literature, enable the controlled degradation of specific proteins via their direction to the cellular proteasome. In this report, we describe the second phase of our research focused on exploring antibody-drug conjugates (ADCs), which incorporate BRD4-targeting chimeric degrader entities. We employ a new BRD4-binding fragment in the construction of the chimeric ADC payloads that is significantly more potent than the corresponding entity utilized in our initial studies. The resulting BRD4-degrader antibody conjugates exhibit potent and antigen-dependent BRD4 degradation and antiproliferation activities in cell-based experiments. Multiple ADCs bearing chimeric BRD4-degrader payloads also exhibit strong, antigen-dependent antitumor efficacy in mouse xenograft assessments that employ several different tumor models.
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Affiliation(s)
- Peter S Dragovich
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Thomas H Pillow
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Robert A Blake
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Jack D Sadowsky
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Emel Adaligil
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Pragya Adhikari
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Jinhua Chen
- WuXi AppTec, 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, China
| | - Nicholas Corr
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | | | | | - Aaron Fullerton
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Steven J Hartman
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Fan Jiang
- Viva Biotech, Structural Biology, 334 Aidisheng Road, Zhangjiang High-Tech Park, Shanghai 201203, China
| | - Susan Kaufman
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Tracy Kleinheinz
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Katherine R Kozak
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Liling Liu
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Ying Lu
- WuXi AppTec, 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, China
| | - Melinda M Mulvihill
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Jeremy M Murray
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Aimee O'Donohue
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Rebecca K Rowntree
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - William S Sawyer
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Leanna R Staben
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - John Wai
- WuXi AppTec, 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, China
| | - Jian Wang
- WuXi AppTec, 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, China
| | - BinQing Wei
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Wentao Wei
- Viva Biotech, Structural Biology, 334 Aidisheng Road, Zhangjiang High-Tech Park, Shanghai 201203, China
| | - Zijin Xu
- WuXi AppTec, 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, China
| | - Hui Yao
- WuXi AppTec, 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, China
| | - Shang-Fan Yu
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Donglu Zhang
- Genentech Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Hongyan Zhang
- WuXi AppTec, 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, China
| | - Shenhua Zhang
- Viva Biotech, Structural Biology, 334 Aidisheng Road, Zhangjiang High-Tech Park, Shanghai 201203, China
| | - Yongxin Zhao
- WuXi AppTec, 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, China
| | - Hao Zhou
- WuXi AppTec, 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, China
| | - Xiaoyu Zhu
- WuXi AppTec, 288 Fute Zhong Road, Waigaoqiao Free Trade Zone, Shanghai 200131, China
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Dela Cruz Chuh J, Go M, Chen Y, Guo J, Rafidi H, Mandikian D, Sun Y, Lin Z, Schneider K, Zhang P, Vij R, Sharpnack D, Chan P, de la Cruz C, Sadowsky J, Seshasayee D, Koerber JT, Pillow TH, Phillips GD, Rowntree RK, Boswell CA, Kozak KR, Polson AG, Polakis P, Yu SF, Dragovich PS, Agard NJ. Preclinical optimization of Ly6E-targeted ADCs for increased durability and efficacy of anti-tumor response. MAbs 2021; 13:1862452. [PMID: 33382956 PMCID: PMC7784788 DOI: 10.1080/19420862.2020.1862452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/23/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
Early success with brentuximab vedotin in treating classical Hodgkin lymphoma spurred an influx of at least 20 monomethyl auristatin E (MMAE) antibody-drug conjugates (ADCs) into clinical trials. While three MMAE-ADCs have been approved, most of these conjugates are no longer being investigated in clinical trials. Some auristatin conjugates show limited or no efficacy at tolerated doses, but even for drugs driving initial remissions, tumor regrowth and metastasis often rapidly occur. Here we describe the development of second-generation therapeutic ADCs targeting Lymphocyte antigen 6E (Ly6E) where the tubulin polymerization inhibitor MMAE (Compound 1) is replaced with DNA-damaging agents intended to drive increased durability of response. Comparison of a seco-cyclopropyl benzoindol-4-one (CBI)-dimer (compound 2) to MMAE showed increased potency, activity across more cell lines, and resistance to efflux by P-glycoprotein, a drug transporter commonly upregulated in tumors. Both anti-Ly6E-CBI and -MMAE conjugates drove single-dose efficacy in xenograft and patient-derived xenograft models, but seco-CBI-dimer conjugates showed reduced tumor outgrowth following multiple weeks of treatment, suggesting that they are less susceptible to developing resistance. In parallel, we explored approaches to optimize the targeting antibody. In contrast to immunization with recombinant Ly6E or Ly6E DNA, immunization with virus-like particles generated a high-affinity anti-Ly6E antibody. Conjugates to this antibody improve efficacy versus a previous clinical candidate both in vitro and in vivo with multiple cytotoxics. Conjugation of compound 2 to the second-generation antibody results in a substantially improved ADC with promising preclinical efficacy.
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Affiliation(s)
- Josefa Dela Cruz Chuh
- Departments of Biochemical and Cellular Pharmacology, Genentech Inc, South San Francisco, CA, USA
| | - MaryAnn Go
- Research biology, Genentech Inc, South San Francisco, CA, USA
| | - Yvonne Chen
- Antibody Engineering, Genentech Inc, South San Francisco, CA, USA
| | - Jun Guo
- Research biology, Genentech Inc, South San Francisco, CA, USA
| | - Hanine Rafidi
- Preclinical & Translational Pharmacokinetics and Pharmacodynamics, Genentech Inc, South San Francisco, CA, USA
| | - Danielle Mandikian
- Preclinical & Translational Pharmacokinetics and Pharmacodynamics, Genentech Inc, South San Francisco, CA, USA
| | - Yonglian Sun
- Antibody Engineering, Genentech Inc, South San Francisco, CA, USA
| | - Zhonghua Lin
- Antibody Engineering, Genentech Inc, South San Francisco, CA, USA
| | - Kellen Schneider
- Antibody Engineering, Genentech Inc, South San Francisco, CA, USA
| | - Pamela Zhang
- Antibody Engineering, Genentech Inc, South San Francisco, CA, USA
| | - Rajesh Vij
- Antibody Engineering, Genentech Inc, South San Francisco, CA, USA
| | - Danielle Sharpnack
- Departments of Biochemical and Cellular Pharmacology, Genentech Inc, South San Francisco, CA, USA
| | - Pamela Chan
- Departments of Biochemical and Cellular Pharmacology, Genentech Inc, South San Francisco, CA, USA
| | | | - Jack Sadowsky
- Protein Chemistry, Genentech Inc, South San Francisco, CA, USA
| | - Dhaya Seshasayee
- Antibody Engineering, Genentech Inc, South San Francisco, CA, USA
| | - James T. Koerber
- Antibody Engineering, Genentech Inc, South San Francisco, CA, USA
| | - Thomas H. Pillow
- Discovery Chemistry, Genentech Inc, South San Francisco, CA, USA
| | | | | | - C. Andrew Boswell
- Preclinical & Translational Pharmacokinetics and Pharmacodynamics, Genentech Inc, South San Francisco, CA, USA
| | - Katherine R. Kozak
- Departments of Biochemical and Cellular Pharmacology, Genentech Inc, South San Francisco, CA, USA
| | | | - Paul Polakis
- Research biology, Genentech Inc, South San Francisco, CA, USA
| | - Shang-Fan Yu
- Research biology, Genentech Inc, South San Francisco, CA, USA
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Falck D, Thomann M, Lechmann M, Koeleman CAM, Malik S, Jany C, Wuhrer M, Reusch D. Glycoform-resolved pharmacokinetic studies in a rat model employing glycoengineered variants of a therapeutic monoclonal antibody. MAbs 2021; 13:1865596. [PMID: 33382957 PMCID: PMC7781607 DOI: 10.1080/19420862.2020.1865596] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 12/13/2020] [Accepted: 12/14/2020] [Indexed: 12/16/2022] Open
Abstract
Good pharmacokinetic (PK) behavior is a key prerequisite for sufficient efficacy of therapeutic monoclonal antibodies (mAbs). Fc glycosylation is a critical quality attribute (CQA) of mAbs, due to its impact on stability and effector functions. However, the effects of various IgG Fc glycoforms on antibody PK remain unclear. We used a combination of glycoengineering and glycoform-resolved PK measurements by mass spectrometry (MS) to assess glycoform effects on PK. Four differently glycoengineered mAbs, each still containing multiple glycoforms, were separately injected into rats. Rat models have been shown to be predictive of human PK. At different time points, blood was taken, from which the mAbs were purified and analyzed with a liquid chromatography-MS-based bottom-up glycoproteomics approach. This allowed us to follow changes in the glycosylation profiles of each glycoengineered mAb over time. Enzyme-linked immunosorbent assay measurements provided an absolute concentration in the form of a sum value for all glycoforms. Information from both readouts was then combined to calculate PK parameters per glycoform. Thereby, multiple glycoform kinetics were resolved within one mAb preparation. We confirmed increased clearance of high-mannose (Man5) and hybrid-type (Man5G0) glycoforms. Specifically, Man5 showed a 1.8 to 2.6-fold higher clearance than agalactosylated, complex glycans (G0F). Unexpectedly, clearance was even higher (4.7-fold) for the hybrid-type glycan Man5G0. In contrast, clearance of agalactosylated, monoantennary glycoforms (G0F-N) was only slightly increased over G0F (1.2 to 1.4-fold). Thus, monoantennary, hybrid-type and high-mannose glycoforms should be distinguished in CQA assessments. Strikingly, α2,3-linked sialylation did not affect clearance, contradicting the involvement of the asialoglycoprotein receptor in mAb clearance.
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Affiliation(s)
- David Falck
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Marco Thomann
- Pharma Technical Development Europe, Roche Diagnostics GmbH, Penzberg, Germany
| | - Martin Lechmann
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Munich, Penzberg, Germany
| | - Carolien A. M. Koeleman
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Sebastian Malik
- Pharma Technical Development Europe, Roche Diagnostics GmbH, Penzberg, Germany
| | - Cordula Jany
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Munich, Penzberg, Germany
| | - Manfred Wuhrer
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Dietmar Reusch
- Pharma Technical Development Europe, Roche Diagnostics GmbH, Penzberg, Germany
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Chang HY, Wu S, Li Y, Zhang W, Burrell M, Webster CI, Shah DK. Brain pharmacokinetics of anti-transferrin receptor antibody affinity variants in rats determined using microdialysis. MAbs 2021; 13:1874121. [PMID: 33499723 PMCID: PMC7849817 DOI: 10.1080/19420862.2021.1874121] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/28/2020] [Accepted: 01/06/2021] [Indexed: 01/10/2023] Open
Abstract
Receptor-mediated transcytosis (RMT) is used to enhance the delivery of monoclonal antibodies (mAb) into the central nervous system (CNS). While the binding to endogenous receptors on the brain capillary endothelial cells (BCECs) may facilitate the uptake of mAbs in the brain, a strong affinity for the receptor may hinder the efficiency of transcytosis. To quantitatively investigate the effect of binding affinity on the pharmacokinetics (PK) of anti-transferrin receptor (TfR) mAbs in different regions of the rat brain, we conducted a microdialysis study to directly measure the concentration of free mAbs at different sites of interest. Our results confirmed that bivalent anti-TfR mAb with an optimal dissociation constant (KD) value (76 nM) among four affinity variants can have up to 10-fold higher transcytosed free mAb exposure in the brain interstitial fluid (bISF) compared to lower and higher affinity mAbs (5 and 174 nM). This bell-shaped relationship between KD values and the increased brain exposure of mAbs was also visible when using whole-brain PK data. However, we found that mAb concentrations in postvascular brain supernatant (obtained after capillary depletion) were almost always higher than the concentrations measured in bISF using microdialysis. We also observed that the increase in mAb area under the concentration curve in CSF compartments was less significant, which highlights the challenge in using CSF measurement as a surrogate for estimating the efficiency of RMT delivery. Our results also suggest that the determination of mAb concentrations in the brain using microdialysis may be necessary to accurately measure the PK of CNS-targeted antibodies at the site-of-actions in the brain.
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Affiliation(s)
- Hsueh-Yuan Chang
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Shengjia Wu
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Yingyi Li
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Wanying Zhang
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, Buffalo, NY, USA
| | - Matthew Burrell
- Antibody Discovery and Protein Engineering, R&D, AstraZeneca, Cambridge, UK
| | - Carl I. Webster
- Antibody Discovery and Protein Engineering, R&D, AstraZeneca, Cambridge, UK
| | - Dhaval K. Shah
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, Buffalo, NY, USA
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46
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Fjord-Larsen L, Thougaard A, Wegener KM, Christiansen J, Larsen F, Schrøder-Hansen LM, Kaarde M, Ditlevsen DK. Nonclinical safety evaluation, pharmacokinetics, and target engagement of Lu AF82422, a monoclonal IgG1 antibody against alpha-synuclein in development for treatment of synucleinopathies. MAbs 2021; 13:1994690. [PMID: 34709986 PMCID: PMC8555527 DOI: 10.1080/19420862.2021.1994690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/30/2021] [Accepted: 10/13/2021] [Indexed: 10/26/2022] Open
Abstract
Alpha-synuclein is a 15 kDa protein associated with neurodegenerative diseases such as Parkinson disease and multiple-system atrophy where pathological forms of alpha-synuclein aggregate and become neurotoxic. Here we describe the nonclinical program to support a first-in-human (FIH) single ascending dose (SAD) study for Lu AF82422, a human recombinant, anti-alpha-synuclein monoclonal antibody (mAb) in development for treatment of synucleinopathies. Alpha-synuclein is primarily expressed in brain, peripheral nerves and in blood cells. A tissue cross-reactivity assessment showed that Lu AF82422 binding was generally restricted to nervous tissues. Flow cytometry analysis did not show extracellular surface binding of Lu AF82422 to human platelets, erythrocytes, granulocytes, or lymphocytes, but to a low fraction of monocytes, without any functional consequences on activation or phagocytic capacity. A single dose pharmacokinetic (PK) study in cynomolgus monkeys with dose levels of 1-30 mg/kg confirmed PK properties in the expected range for a mAb with a soluble target, and target engagement was shown as a decrease in free alpha-synuclein in plasma. Four-week repeat-dose toxicity studies were conducted in rats and cynomolgus monkeys at doses up to 600 mg/kg administered intravenously every 10 days. Results showed no treatment-related adverse findings and the no-observed-adverse-effect-level was the highest dose tested. Target engagement was shown in plasma and cerebrospinal fluid. Taken together, the nonclinical data indicated no safety signal of concern and provided adequate safety margins between observed safe doses in animals and the planned dose levels in the FIH SAD study.
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Affiliation(s)
- Lone Fjord-Larsen
- Department Regulatory Toxicology and Safety Assessment, H. Lundbeck A/S, Valby, Denmark
| | | | - Karen Malene Wegener
- Department Regulatory Toxicology and Safety Assessment, H. Lundbeck A/S, Valby, Denmark
| | | | - Frank Larsen
- Department PKPD Modelling and Simulation, H. Lundbeck A/S, Valby, Denmark
| | | | - Marianne Kaarde
- Department Regulatory Toxicology and Safety Assessment, H. Lundbeck A/S, Valby, Denmark
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Liu Q, Garg P, Hasdemir B, Wang L, Tuscano E, Sever E, Keane E, Hernandez AGL, Yuan TZ, Kwan E, Lai J, Szot G, Paruthiyil S, Axelrod F, K. Sato A. Functional GLP-1R antibodies identified from a synthetic GPCR-focused library demonstrate potent blood glucose control. MAbs 2021; 13:1893425. [PMID: 33706686 PMCID: PMC7971233 DOI: 10.1080/19420862.2021.1893425] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 02/04/2021] [Accepted: 02/17/2021] [Indexed: 11/15/2022] Open
Abstract
G protein-coupled receptors (GPCRs) are a group of seven-transmembrane receptor proteins that have proven to be successful drug targets. Antibodies are becoming an increasingly promising modality to target these receptors due to their unique properties, such as exquisite specificity, long half-life, and fewer side effects, and their improved pharmacokinetic and pharmacodynamic profiles compared to peptides and small molecules, which results from their more favorable biodistribution. To date, there are only two US Food and Drug Administration-approved GPCR antibody drugs, namely erenumab and mogamulizumab, and this highlights the challenges encountered in identifying functional antibodies against GPCRs. Utilizing Twist's precision DNA writing technologies, we have created a GPCR-focused phage display library with 1 × 1010 diversity. Specifically, we mined endogenous GPCR binding ligand and peptide sequences and incorporated these binding motifs into the heavy chain complementarity-determining region 3 in a synthetic antibody library. Glucagon-like peptide-1 receptor (GLP-1 R) is a class B GPCR that acts as the receptor for the incretin GLP-1, which is released to regulate insulin levels in response to food intake. GLP-1 R agonists have been widely used to increase insulin secretion to lower blood glucose levels for the treatment of type 1 and type 2 diabetes, whereas GLP-1 R antagonists have applications in the treatment of severe hypoglycemia associated with bariatric surgery and hyperinsulinomic hypoglycemia. Here we present the discovery and creation of both antagonistic and agonistic GLP-1 R antibodies by panning this GPCR-focused phage display library on a GLP-1 R-overexpressing Chinese hamster ovary cell line and demonstrate their in vitro and in vivo functional activity.
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Affiliation(s)
- Qiang Liu
- Twist Biopharma, South San Francisco, CA, USA
| | - Pankaj Garg
- Twist Biopharma, South San Francisco, CA, USA
- Alamar Biosciences, Fremont, CA, USA
| | - Burcu Hasdemir
- Twist Biopharma, South San Francisco, CA, USA
- Catalyst Biosciences, South San Francisco, CA, USA
| | - Linya Wang
- Twist Biopharma, South San Francisco, CA, USA
| | | | - Emily Sever
- Twist Biopharma, South San Francisco, CA, USA
| | - Erica Keane
- Twist Biopharma, South San Francisco, CA, USA
| | | | - Tom Z. Yuan
- Twist Biopharma, South San Francisco, CA, USA
| | - Eric Kwan
- Twist Biopharma, South San Francisco, CA, USA
| | - Joyce Lai
- Twist Biopharma, South San Francisco, CA, USA
| | - Greg Szot
- Diabetes Center, University of California San Francisco, San Francisco, CA, USA
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Lu D, Lu T, Shi R, Gibiansky L, Agarwal P, Shemesh CS, Dere RC, Ogbu U, Hirata J, Chanu P, Girish S, Jin JY, Li C, Miles D. Application of a Two-Analyte Integrated Population Pharmacokinetic Model to Evaluate the Impact of Intrinsic and Extrinsic Factors on the Pharmacokinetics of Polatuzumab Vedotin in Patients with Non-Hodgkin Lymphoma. Pharm Res 2020; 37:252. [PMID: 33258982 PMCID: PMC7708381 DOI: 10.1007/s11095-020-02933-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/21/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE The established two-analyte integrated population pharmacokinetic model was applied to assess the impact of intrinsic/extrinsic factors on the pharmacokinetics (PK) of polatuzumab vedotin (pola) in patients with non-Hodgkin lymphoma (NHL) following bodyweight-based dosing. METHODS Model simulations based on individual empirical Bayes estimates were used to evaluate the impact of intrinsic/extrinsic factors as patient subgroups on Cycle 6 exposures. Intrinsic factors included bodyweight, age, sex, hepatic and renal functions. Extrinsic factors included rituximab/obinutuzumab or bendamustine combination with pola and manufacturing process. The predicted impact on exposures along with the established exposure-response relationships were used to assess clinical relevance. RESULTS No clinically meaningful differences in Cycle 6 pola exposures were found for the following subgroups: bodyweight 100-146 kg versus 38-<100 kg, age ≥ 65 years versus <65 years, female versus male, mild hepatic impairment versus normal, mild-to-moderate renal impairment versus normal. Co-administration of rituximab/obinutuzumab or bendamustine, and change in the pola manufacturing process, also had no meaningful impact on PK. CONCLUSIONS In patients with NHL, bodyweight-based dosing is adequate, and no further dose adjustment is recommended for the heavier subgroup (100-146 kg). In addition, no dose adjustments are recommended for other subgroups based on intrinsic/extrinsic factors evaluated.
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Affiliation(s)
- Dan Lu
- Department of Clinical Pharmacology, Genentech, Inc, South San Francisco, California, USA.
- Genentech Research and Early Development, 1 DNA Way, MS46-3a, South San Francisco, California, 94080, USA.
| | - Tong Lu
- Department of Clinical Pharmacology, Genentech, Inc, South San Francisco, California, USA
| | - Rong Shi
- Department of Clinical Pharmacology, Genentech, Inc, South San Francisco, California, USA
| | | | - Priya Agarwal
- Department of Clinical Pharmacology, Genentech, Inc, South San Francisco, California, USA
| | - Colby S Shemesh
- Department of Clinical Pharmacology, Genentech, Inc, South San Francisco, California, USA
| | - Randall C Dere
- Department of Bioanalytical Sciences, Genentech, Inc, South San Francisco, California, USA
| | - Uzor Ogbu
- Product Development Oncology, Genentech, Inc, South San Francisco, California, USA
| | - Jamie Hirata
- Product Development Oncology, Genentech, Inc, South San Francisco, California, USA
| | - Pascal Chanu
- Department of Clinical Pharmacology, Genentech, Inc/F. Hoffmann-La Roche Ltd, Lyon, France
| | - Sandhya Girish
- Department of Clinical Pharmacology, Genentech, Inc, South San Francisco, California, USA
| | - Jin Yan Jin
- Department of Clinical Pharmacology, Genentech, Inc, South San Francisco, California, USA
| | - Chunze Li
- Department of Clinical Pharmacology, Genentech, Inc, South San Francisco, California, USA
| | - Dale Miles
- Department of Clinical Pharmacology, Genentech, Inc, South San Francisco, California, USA
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49
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Sánchez-Félix M, Burke M, Chen HH, Patterson C, Mittal S. Predicting bioavailability of monoclonal antibodies after subcutaneous administration: Open innovation challenge. Adv Drug Deliv Rev 2020; 167:66-77. [PMID: 32473188 DOI: 10.1016/j.addr.2020.05.009] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 12/27/2022]
Abstract
Despite the increasing trend towards subcutaneous delivery of monoclonal antibodies, factors influencing the subcutaneous bioavailability of these molecules remain poorly understood. To address critical knowledge gaps and issues during development of subcutaneous dosage forms for monoclonal antibodies, the Subcutaneous Drug Delivery and Development Consortium was convened in 2018 as a pre-competitive collaboration of recognized industry experts. One of the Consortium's eight problem statements highlights the challenges of predicting human bioavailability of subcutaneously administered monoclonal antibodies due to a lack of reliable in vitro and preclinical in vivo predictive models. In this paper, we assess the current landscape in subcutaneous bioavailability prediction for monoclonal antibodies and discuss the gaps and opportunities associated with bioavailability models for biotherapeutics. We also issue an open challenge to industry and academia, encouraging the development of reliable models to enable subcutaneous bioavailability prediction of therapeutic large molecules in humans and improve translation from preclinical species.
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Affiliation(s)
- Manuel Sánchez-Félix
- Novartis Institutes for BioMedical Research, 700 Main Street, Cambridge, MA 02139, USA.
| | - Matt Burke
- Radius Health, Inc, 550 E. Swedesford Road, Suite 370, Wayne, PA 19087, USA.
| | - Hunter H Chen
- Regeneron Pharmaceuticals, Inc, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA.
| | - Claire Patterson
- Seda Pharmaceutical Development Services, Ltd., Alderley Park, Alderley Edge, Cheshire SK10 4TG, UK.
| | - Sachin Mittal
- Merck & Co., Inc, 2000 Galloping Hill Rd, Kenilworth, NJ 07033, USA.
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50
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Austin CD, Gonzalez Edick M, Ferrando RE, Solon M, Baca M, Mesh K, Bradding P, Gauvreau GM, Sumino K, FitzGerald JM, Israel E, Bjermer L, Bourdin A, Arron JR, Choy DF, Olsson JK, Abreu F, Howard M, Wong K, Cai F, Peng K, Putnam WS, Holweg CT, Matthews JG, Kraft M, Woodruff PG. A randomized, placebo-controlled trial evaluating effects of lebrikizumab on airway eosinophilic inflammation and remodelling in uncontrolled asthma (CLAVIER). Clin Exp Allergy 2020; 50:1342-1351. [PMID: 32909660 PMCID: PMC7756263 DOI: 10.1111/cea.13731] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/16/2020] [Accepted: 08/31/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND The anti-interleukin 13 (IL-13) monoclonal antibody lebrikizumab improves lung function in patients with moderate-to-severe uncontrolled asthma, but its effects on airway inflammation and remodelling are unknown. CLAVIER was designed to assess lebrikizumab's effect on eosinophilic inflammation and remodelling. OBJECTIVE To report safety and efficacy results from enrolled participants with available data from CLAVIER. METHODS We performed bronchoscopy on patients with uncontrolled asthma before and after 12 weeks of randomized double-blinded treatment with lebrikizumab (n = 31) or placebo (n = 33). The pre-specified primary end-point was relative change in airway subepithelial eosinophils per mm2 of basement membrane (cells/mm2 ). Pre-specified secondary and exploratory outcomes included change in IL-13-associated biomarkers and measures of airway remodelling. RESULTS There was a baseline imbalance in tissue eosinophils and high variability between treatment groups. There was no discernible change in adjusted mean subepithelial eosinophils/mm2 in response to lebrikizumab (95% CI, -82.5%, 97.5%). As previously observed, FEV1 increased after lebrikizumab treatment. Moreover, subepithelial collagen thickness decreased 21.5% after lebrikizumab treatment (95% CI, -32.9%, -10.2%), and fractional exhaled nitric oxide, CCL26 and SERPINB2 mRNA expression in bronchial tissues also reduced. Lebrikizumab was well tolerated, with a safety profile consistent with other lebrikizumab asthma studies. CONCLUSIONS & CLINICAL RELEVANCE We did not observe reduced tissue eosinophil numbers in association with lebrikizumab treatment. However, in pre-specified exploratory analyses, lebrikizumab treatment was associated with reduced degree of subepithelial fibrosis, a feature of airway remodelling, as well as improved lung function and reduced key pharmacodynamic biomarkers in bronchial tissues. These results reinforce the importance of IL-13 in airway pathobiology and suggest that neutralization of IL-13 may reduce asthmatic airway remodelling. CLINICAL TRIAL REGISTRATION NCT02099656.
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Affiliation(s)
| | | | - Ronald E. Ferrando
- Genentech, Inc.South San FranciscoCAUSA
- Present address:
Stemcentrx/AbbVie, Inc.South San FranciscoCAUSA
| | | | | | | | - Peter Bradding
- University of Leicester and Glenfield HospitalLeicesterUK
| | | | - Kaharu Sumino
- Washington University School of Medicine in St. LouisSt LouisMOUSA
| | | | | | | | | | | | | | | | | | | | - Kit Wong
- Genentech, Inc.South San FranciscoCAUSA
| | - Fang Cai
- Genentech, Inc.South San FranciscoCAUSA
| | - Kun Peng
- Genentech, Inc.South San FranciscoCAUSA
| | | | | | - John G. Matthews
- Genentech, Inc.South San FranciscoCAUSA
- Present address:
23andMeMountain ViewCAUSA
| | - Monica Kraft
- University of Arizona College of MedicineTucsonAZUSA
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