title: Immune modulation with weekly dosing of an agonist CD40 antibody in a phase I study of patients with advanced solid tumors.
abstract: BACKGROUND
  Single-dose infusion of the agonistic anti-CD40 monoclonal antibody (mAb) CP-870,893 accomplishes immune activation and clinical responses in patients with advanced cancers, but repeat dosing of this agent has not been reported.
  
  
  RESULTS
  Twenty-seven patients were enrolled. The most common adverse event was transient, infusion-related cytokine release syndrome (CRS). Dose-limiting toxicities included grade 3 CRS and grade 3 urticaria; the maximum tolerated dose (MTD) was estimated to be 0.2 mg/kg. Seven patients (26%) had stable disease as the best clinical response; no partial or complete responses were observed. At the MTD, patient B lymphocytes exhibited persistently increased expression of costimulatory and adhesion molecules without resetting to baseline between doses. In 4 of 8 patients (50%) evaluated at the MTD, there were marked declines in total CD3(+) T lymphocytes, as well as CD4(+) and CD8(+) subsets.
  
  
  METHODS
  Patients with advanced solid tumor malignancies received weekly intravenous infusions of CP-870,893 in four dose level cohorts. Safety and immune pharmacodynamics were assessed.
  
  
  CONCLUSIONS
  Weekly infusions of the agonist CD40 antibody CP-870,893 were well-tolerated, but there was little clinical activity in advanced cancer patients. Correlative studies demonstrate chronic B cell activation and in some patients, T cell depletion. Longer dosing intervals may be desirable for optimal immune pharmacodynamics.
authors.affiliation: Abramson Cancer Center, University of Pennsylvania School of Medicine, Philadelphia, USA.
authors.forename: Jens
authors.initials: J
authors.lastname: Rüter
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Antonia
authors.forename: Howard A
authors.initials: HA
authors.lastname: Burris
authors.forename: Richard D
authors.initials: RD
authors.lastname: Huhn
authors.forename: Robert H
authors.initials: RH
authors.lastname: Vonderheide
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000493:pharmacokinetics / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019013:CD40 Antigens / Q000819:agonists*; D016207:Cytokines / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000276:immunology*; D012074:Remission Induction; D016176:T-Lymphocyte Subsets / Q000276:immunology; D014018:Tissue Distribution
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D019013:CD40 Antigens; D016207:Cytokines; C518149:selicrelumab