Phase 1 Study of Tabalumab, a Human Anti-B-Cell Activating Factor Antibody, and Bortezomib in Patients with Relapsed/Refractory Multiple Myeloma.
OBJECTIVE
Tabalumab, a human mAb that neutralizes B-cell-activating factor (BAFF), demonstrated antitumor activity in xenograft models of multiple myeloma. Here we report on a phase I study of relapsed/refractory multiple myeloma patients in which the primary objective was to identify a tolerable and potentially efficacious dose of tabalumab when combined with bortezomib.


METHODS
Forty-eight patients were enrolled; 20 to the dose-escalation cohort, and 28 to cohort expansion in which a dose of 100 mg of tabalumab was evaluated. All patients had received either prior bortezomib or an immunomodulatory drug; the median number of prior therapies was 3. Bortezomib was administered intravenously on days 1, 4, 8, and 11 of a 21-day schedule. Tabalumab was given every 21 days for 3 cycles, then every 42 days thereafter.


RESULTS
The most common grade 3/4 toxicities included thrombocytopenia, neutropenia, pneumonia, and peripheral sensory neuropathy. There were no dose-limiting toxicities, and the maximum tolerated dose was not reached. Pharmacokinetic data suggested serum exposure increased in a greater than dose-proportional manner up to a dose of 100 mg. Out of 46 evaluable patients, 20 had confirmed responses. The median time to progression (9 patients censored) was 4.8 months, and the median response duration (4 patients censored) was 7.2 months.


CONCLUSIONS
A dose of 100 mg tabalumab in combination with bortezomib was well tolerated and active and is currently under further investigation. Clin Cancer Res; 22(23); 5688-95. ©2016 AACR.
Massachusetts General Hospital, Boston, Massachusetts. NRAJE@mgh.harvard.edu.
Noopur S
NS
Raje
University of Nebraska Medical Center, Omaha, Nebraska.
Edward A
EA
Faber
Dana Farber Cancer Institute, Boston, Massachusetts.
Paul G
PG
Richardson
David Geffen School of Medicine at UCLA, Los Angeles, California.
Gary
G
Schiller
University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Raymond J
RJ
Hohl
Fox Chase Cancer Center, Philadelphia, Pennsylvania.
Adam D
AD
Cohen
University of Alabama at Birmingham, Birmingham, Alabama.
Andres
A
Forero
Eli Lilly and Company, Indianapolis, Indiana.
Susan
S
Carpenter
Eli Lilly and Company, Indianapolis, Indiana.
Tuan S
TS
Nguyen
Eli Lilly and Company, Indianapolis, Indiana.
Ilaria
I
Conti
Eli Lilly and Company, Indianapolis, Indiana.
Christopher J
CJ
Kaiser
Eli Lilly and Company, Indianapolis, Indiana.
Damien M
DM
Cronier
Eli Lilly and Company, Indianapolis, Indiana.
James E
JE
Wooldridge
Dana Farber Cancer Institute, Boston, Massachusetts.
Kenneth C
KC
Anderson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D053264:B-Cell Activating Factor / Q000378:metabolism*; D001402:B-Lymphocytes / Q000187:drug effects / Q000378:metabolism; D000069286:Bortezomib / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000378:metabolism; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000378:metabolism
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D053264:B-Cell Activating Factor; D000069286:Bortezomib; C575974:tabalumab