title: A phase I study of PRO131921, a novel anti-CD20 monoclonal antibody in patients with relapsed/refractory CD20+ indolent NHL: correlation between clinical responses and AUC pharmacokinetics.
abstract: PRO131921 is a third-generation, humanized anti-CD20 monoclonal antibody with increased antibody-dependent cytotoxicity and complement-dependent cytotoxicity compared to rituximab. In this phase I study, PRO131921 was administered as a single agent to patients with CD20+, relapsed or refractory, indolent non-Hodgkin lymphoma (NHL) who had been treated with a prior rituximab-containing regimen. The primary aim of this study was safety and tolerability of PRO131921. The secondary aim of the study, and focus of this report, was to determine the pharmacokinetics (PK) profile of PRO131921 and establish a correlation between drug exposure and clinical efficacy. Patients were treated with PRO131921 by intravenous infusion weekly for 4 weeks and the dose was escalated based on safety in a 3+3 design. Twenty-four patients were treated with PRO131921 at doses from 25mg/m(2) to 800 mg/m(2). Analysis of PK data demonstrated a correlation between higher normalized drug exposure (normalized AUC) and tumor shrinkage (p = .0035). Also, normalized AUC levels were higher among responders and subjects displaying tumor shrinkage versus subjects progressing or showing no regression (p = 0.030). In conclusion, PRO131921 demonstrated clinical activity in rituximab-relapsed and refractory indolent NHL patients. The observation that higher normalized AUC may be associated with improved clinical responses has potential implications in future trials of monoclonal antibody-based therapies, and emphasizes the importance of early PK studies to optimize antibody efficacy.
authors.affiliation: James P. Wilmot Cancer Center, University of Rochester, Rochester, NY, USA. Electronic address: carla_casulo@urmc.rochester.edu.
authors.forename: Carla
authors.initials: C
authors.lastname: Casulo
authors.affiliation: University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Vose
authors.affiliation: Genentech Inc., South San Francisco, CA, USA.
authors.forename: William Y
authors.initials: WY
authors.lastname: Ho
authors.affiliation: Department of Medicine, University of Wisconsin School of Medicine, Madison, WI, USA.
authors.forename: Brad
authors.initials: B
authors.lastname: Kahl
authors.affiliation: Colorado Blood Cancer Institute, Denver, CO, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Brunvand
authors.affiliation: John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA.
authors.forename: Andre
authors.initials: A
authors.lastname: Goy
authors.affiliation: Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Yvette
authors.initials: Y
authors.lastname: Kasamon
authors.affiliation: Division of Hematology and Oncology, Georgetown University Hospital, Washington, DC, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Cheson
authors.affiliation: James P. Wilmot Cancer Center, University of Rochester, Rochester, NY, USA.
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Friedberg
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D018951:Antigens, CD20 / Q000378:metabolism*; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D019540:Area Under Curve; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D018951:Antigens, CD20; D000970:Antineoplastic Agents; C550338:PRO131921 monoclonal antibody
keywords: Area under the curve;; Efficacy; Monoclonal antibody;; Pharmacokinetics;