Safety, anti-tumour activity, and pharmacokinetics of fixed-dose SHR-1210, an anti-PD-1 antibody in advanced solid tumours: a dose-escalation, phase 1 study

Hongnan Mo, Jing Huang, Jiachen Xu, Xuelian Chen, Dawei Wu, Dong Qu, Xi Wang, Bo Lan, Xingyuan Wang, Jianping Xu, Honggang Zhang, Yihebali Chi, Qing Yang, Binghe Xu, Hongnan Mo, Jing Huang, Jiachen Xu, Xuelian Chen, Dawei Wu, Dong Qu, Xi Wang, Bo Lan, Xingyuan Wang, Jianping Xu, Honggang Zhang, Yihebali Chi, Qing Yang, Binghe Xu

Abstract

Background: To assess the safety profile, pharmacokinetics, pharmacodynamics and preliminary antitumour activity of fixed-dose SHR-1210, a novel anti-PD-1 antibody, in advanced solid tumours.

Methods: A total of 36 patients with advanced solid tumours received intravenous SHR-1210 at 60 mg, 200 mg and 400 mg (4-week interval after first dose followed by a 2-week schedule) until disease progression or intolerable toxicity. The concentration of SHR-1210 was detected for pharmacokinetics, and receptor occupancy on circulating T lymphocytes was assessed for pharmacodynamics.

Results: No dose-limiting toxicities were observed. Maximum administered dose was not reached. Most adverse events were grade 1 or 2. Treatment-related severe adverse events were found in two patients. No treatment-related death was reported. Two complete responses (gastric cancer, bladder carcinoma) and seven partial responses were seen. In responders, the median follow-up time was 16.0 months (range 8.3-19.5), and the median duration of response was not reached (range 2.7-17.5+ months). The half-life of SHR-1210 was 2.94 d, 5.61 d and 11.0 d for 3 dose levels, respectively.

Conclusions: Our results demonstrated a promising antitumour activity and a manageable safety profile of SHR-1210, displayed an explicit PK evidence of the feasibility of fixed dose, and established the foundation for further exploration.

Conflict of interest statement

Q.Y. is a salaried employee of Jiangsu Hengrui Medicine Co. The remaining authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Antitumour activity of SHR-1210 in patients with advanced solid cancers. a The best change from baseline in the sum of the longest target lesion diameters per patient. b Duration of disease control. c Longitudinal change from baseline in the sum of the longest target lesion diameters. Responses were assessed in accordance with the RECIST v1.1 by independent review in all 36 patients. Colour code defines dose level of treatment with SHR-1210. Green, blue, purple bars represent dose levels 60 mg, 200 mg and 400 mg, respectively. The golden pentastar indicates patients with partial response. The red circle indicates patients with progressive disease at the first evaluation. The red triangle indicates patients with progressive disease after non-progressive disease. The black star represents the last dose of SHR-1210 patients receive. The black arrow indicates those patients who are still under treatment at the time of data collection
Fig. 2
Fig. 2
Mean serum concentration-time profiles of SHR-1210 and PD-1 receptor occupancy rates after a single infusion at 60 mg (a), 200 mg (b) and 400 mg (c)

References

    1. Dong H, et al. Tumor-associated B7-H1 promotes T-cell apoptosis: a potential mechanism of immune evasion. Nat. Med. 2002;8:793–800. doi: 10.1038/nm730.
    1. Dong H, Zhu G, Tamada K, Chen L. B7-H1, a third member of the B7 family, co-stimulates T-cell proliferation and interleukin-10 secretion. Nat. Med. 1999;5:1365–1369. doi: 10.1038/70932.
    1. Freeman GJ, et al. Engagement of the PD-1 immunoinhibitory receptor by a novel B7 family member leads to negative regulation of lymphocyte activation. J. Exp. Med. 2000;192:1027–1034. doi: 10.1084/jem.192.7.1027.
    1. Bardhan K, Anagnostou T, Boussiotis VA. The PD1:PD-L1/2 pathway from discovery to clinical implementation. Front. Immunol. 2016;7:550. doi: 10.3389/fimmu.2016.00550.
    1. Bai S, et al. A guide to rational dosing of monoclonal antibodies. Clin. Pharmacokinet. 2012;51:119–135. doi: 10.2165/11596370-000000000-00000.
    1. Wang DD, Zhang S, Zhao H, Men AY, Parivar K. Fixed dosing versus body size-based dosing of monoclonal antibodies in adult clinical trials. J. Clin. Pharmacol. 2009;49:1012–1024. doi: 10.1177/0091270009337512.
    1. Zhang S, Shi R, Li C, Parivar K, Wang DD. Fixed dosing versus body size-based dosing of therapeutic peptides and proteins in adults. J. Clin. Pharmacol. 2012;52:18–28. doi: 10.1177/0091270010388648.
    1. Bauml J, et al. Pembrolizumab for platinum- and cetuximab-refractory head and neck cancer: results from a single-arm, phase II study. J. Clin. Oncol. 2017;35:1542–1549. doi: 10.1200/JCO.2016.70.1524.
    1. Bellmunt J, et al. Pembrolizumab as second-line therapy for advanced urothelial carcinoma. N. Eng. J. Med. 2017;376:1015–1026. doi: 10.1056/NEJMoa1613683.
    1. Reck M, et al. Pembrolizumab versus chemotherapy for PD-L1-positive non-small-cell lung cancer. N. Eng. J. Med. 2016;375:1823–1833. doi: 10.1056/NEJMoa1606774.
    1. Huang J, Xu B, Mo H, Zhang W, Chen X, Wu D, et al. Safety, activity, and biomarkers of SHR-1210, an anti-PD-1 antibody, for patients with advanced esophageal carcinoma. Clin. Cancer Res. 2018;24:1296–1304. doi: 10.1158/1078-0432.CCR-17-2439.
    1. Sznol M, et al. Endocrine-related adverse events associated with immune checkpoint blockade and expert insights on their management. Cancer Treat. Rev. 2017;58:70–76. doi: 10.1016/j.ctrv.2017.06.002.
    1. Kudo T, et al. Nivolumab treatment for oesophageal squamous-cell carcinoma: an open-label, multicentre, phase 2 trial. Lancet Oncol. 2017;18:631–639. doi: 10.1016/S1470-2045(17)30181-X.
    1. Gibson J. Anti-PD-L1 for metastatic triple-negative breast cancer. Lancet Oncol. 2015;16:e264. doi: 10.1016/S1470-2045(15)70208-1.
    1. Nanda R, et al. Pembrolizumab in patients with advanced triple-negative breast cancer: phase I b KEYNOTE-012 study. J. Clin. Oncol. 2016;34:2460–2467. doi: 10.1200/JCO.2015.64.8931.
    1. Frenel JS, et al. Safety and efficacy of pembrolizumab in advanced, programmed death ligand 1-positive cervical cancer: results from the phase I b KEYNOTE-028 trial. J. Clin. Oncol. 2017;35:4035–4041. doi: 10.1200/JCO.2017.74.5471.
    1. Muro K, et al. Pembrolizumab for patients with PD-L1-positive advanced gastric cancer (KEYNOTE-012): a multicentre, open-label, phase 1b trial. Lancet Oncol. 2016;17:717–726. doi: 10.1016/S1470-2045(16)00175-3.
    1. Seiwert TY, et al. Safety and clinical activity of pembrolizumab for treatment of recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE-012): an open-label, multicentre, phase 1b trial. Lancet Oncol. 2016;17:956–965. doi: 10.1016/S1470-2045(16)30066-3.
    1. Nishino M, et al. Personalized tumor response assessment in the era of molecular medicine: cancer-specific and therapy-specific response criteria to complement pitfalls of RECIST. Am. J. Roentgenol. 2012;198:737–745. doi: 10.2214/AJR.11.7483.
    1. Nishino M, Tirumani SH, Ramaiya NH, Hodi FS. Cancer immunotherapy and immune-related response assessment: the role of radiologists in the new arena of cancer treatment. Eur. J. Radiol. 2015;84:1259–1268. doi: 10.1016/j.ejrad.2015.03.017.
    1. Wolchok JD, et al. Guidelines for the evaluation of immune therapy activity in solid tumors: immune-related response criteria. Clin. Cancer Res. 2009;15:7412–7420. doi: 10.1158/1078-0432.CCR-09-1624.
    1. Topalian SL, et al. Safety, activity, and immune correlates of anti-PD-1 antibody in cancer. N. Eng. J. Med. 2012;366:2443–2454. doi: 10.1056/NEJMoa1200690.
    1. Piraccini BM, et al. Periungual and subungual pyogenic granuloma. Br. J. Dermatol. 2010;163:941–953. doi: 10.1111/j.1365-2133.2010.09906.x.
    1. Piguet V, Borradori L. Pyogenic granuloma-like lesions during capecitabine therapy. Br. J. Dermatol. 2002;147:1270–1272. doi: 10.1046/j.1365-2133.2002.05000_6.x.
    1. Freshwater T, et al. Evaluation of dosing strategy for pembrolizumab for oncology indications. J. Immunother. Cancer. 2017;5:43. doi: 10.1186/s40425-017-0242-5.
    1. Chow LQM, et al. Antitumor activity of pembrolizumab in biomarker-unselected patients with recurrent and/or metastatic head and neck squamous cell carcinoma: results from the phase I b KEYNOTE-012 expansion cohort. J. Clin. Oncol. 2016;34:3838–3845. doi: 10.1200/JCO.2016.68.1478.
    1. Garon EB, et al. Pembrolizumab for the treatment of non-small-cell lung cancer. N. Eng. J. Med. 2015;372:2018–2028. doi: 10.1056/NEJMoa1501824.
    1. Lindauer A, et al. Translational pharmacokinetic/pharmacodynamic modeling of tumor growth inhibition supports dose-range selection of the anti-PD-1 antibody pembrolizumab. CPT: Pharmacomet. Syst. Pharmacol. 2017;6:11–20.
    1. Taube JM, et al. Association of PD-1, PD-1 ligands, and other features of the tumor immune microenvironment with response to anti-PD-1 therapy. Clin. Cancer Res. 2014;20:5064–5074. doi: 10.1158/1078-0432.CCR-13-3271.

Source: PubMed

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