An Randomized, Open-label, Multicenter Phase 2 Study Comparing the Efficacy and Safety of Disitamab Vedotin With Toripalimab Verus Disitamab Vedotin Monotherapy in Subjects With Endocrine-resistant Hormone Receptor-positive, HER2-Low Unresectable Locally Advanced or Metastatic Breast Cancer

This study will evaluate the efficacy, safety and tolerability of RC48-ADC with JS001 compared with RC48-ADC in endocrine-resistant hormone receptor (HR) positive, human epidermal growth factor receptor (HER)2-low advanced breast cancer.

开始日期2024-12-20

申办/合作机构

荣昌生物制药（烟台）股份有限公司

NCT06341400 / Recruiting临床1/2期IIT

Perioperative Efficacy of RC48 Combined With Toripalimab in Treatment of Cisplatin Ineligible MIBC

A single-arm, prospective, exploratory clinical trial to explore the pathological complete response (pCR) rate of immune checkpoint inhibitors combined with antibody conjugate drugs as the perioperative treatment of platinum-intolerant bladder cancer patients. Fifty-five patients with clinically or pathologically confirmed muscle-invasive bladder urothelial carcinoma (MIBC) who were ineligible for cisplatin-based chemotherapy or refused cisplatin-based chemotherapy were enrolled. Each subject will receive RC48-ADC and toripalimab intravenously every 2 weeks for a total of 4 cycles before surgery, 8 cycles after surgery. The efficacy was evaluated and followed up after 4 cycles of neoadjuvant therapy, 3 months postoperative, and every 3-6 months thereafter. The primary endpoint of this study was pathological complete response rate (pCR). The secondary endpoints were to explore the safety, disease-free survival (DFS), overall survival (OS), objective response rate (ORR) and disease control rate (DCR) of RC48 combined with toripalimab neoadjuvant therapy followed by radical cystectomy.

开始日期2024-05-20

申办/合作机构

南方医科大学珠江医院

NCT06157892 / Recruiting临床1/2期

A Phase 1b/2 Open-Label Study of Disitamab Vedotin Monotherapy or in Combination With Other Anticancer Therapies in Solid Tumors

This clinical trial is studying solid tumor cancers. A solid tumor is one that starts in part of your body like your lungs or liver instead of your blood. Once they've grown bigger in one spot or spread to other parts of the body, they're harder to treat. This is called advanced or metastatic cancer.
Participants in this study must have breast cancer or gastric cancer. Participants must have tumors that have HER2 on them. This allows the cancer to grow more quickly or spread faster. There are few treatment options for patients with advanced or metastatic solid tumors that express HER2.
This clinical trial uses an experimental drug called disitamab vedotin (DV). Disitamab vedotin is a type of antibody drug conjugate or ADC. ADCs are designed to stick to cancer cells and kill them.
This clinical trial uses a drug called tucatinib, which has been approved to treat cancer in the United States and some other countries. This drug is sold under the brand name TUKYSA®.
This study will test how safe and how well DV, with or without tucatinib, is for participants with solid tumors. This study will also test what side effects happen when participants take these drugs. A side effect is anything a drug does to the body besides treating the disease.

开始日期2024-04-30

申办/合作机构

Seagen Inc.

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项与维迪西妥单抗相关的文献（医药）

2024-02-01·eClinicalMedicine

Disitamab vedotin (RC48) plus toripalimab for HER2-expressing advanced gastric or gastroesophageal junction and other solid tumours: a multicentre, open label, dose escalation and expansion phase 1 trial

Article

作者: Qi, Changsong ; Wei, Jia ; Peng, Zhi ; Zhou, Jun ; Liu, Dan ; Li, Jian ; Shen, Lin ; Wang, Yakun ; Lu, Zhihao ; Yuan, Jiajia ; Fang, Jianmin ; Wang, Airong ; Gong, Jifang ; Zhang, Xiaotian ; Wang, Xicheng ; Lu, Ming ; Zhang, Ruyan ; Cao, Yanshuo

Background:

Although the antibody-drug conjugates (ADCs) have significantly improved the survival outcomes of patients with human epidermal receptor 2 (HER2)-expressing gastric or gastroesophageal junction (G/GEJ) cancer, the efficacy of ADC used as a single agent is limited. Therefore, it is necessary to investigate effective and safe combination regimens. Preclinical data indicated a synergetic antitumour effect of RC48 and programmed cell death protein 1 (PD-1) inhibitors. We aimed to evaluate the safety and efficacy of RC48 plus toripalimab in patients with HER2-expressing G/GEJ cancer and other solid tumours.

Methods:

This was a open-label, multicentre, phase 1 trial performed at three hospitals in China. Eligible patients had advanced G/GEJ cancer or other solid tumours with HER2 IHC≥1 or ISH positivity and were refractory to at least one line of treatment, or standard treatment was intolerable or unavailable for these patients. This study followed a "3 + 3" design with predefined RC48 dosages of 2.0 mg/kg and 2.5 mg/kg plus toripalimab 3 mg/kg, once every 2 weeks (q2w). The primary objectives were to evaluate the safety and determine the recommended phase II dose (RP2D), and the secondary objectives included assessing the pharmacokinetics (PK) and preliminary efficacy. This study was registered with ClinicalTrials.gov, NCT04280341.

Findings:

Between July 13, 2020 and August 30, 2022, 56 patients, including 30 patients with G/GEJ cancer and 26 patients with other solid tumours, were enrolled and received RC48 plus toripalimab (n = 7 for RC48 2.0 mg/kg, toripalimab 3 mg/kg, q2w; n = 49 for RC48 2.5 mg/kg, toripalimab 3 mg/kg, q2w). No dose-limiting toxic effects occurred. The RP2D was declared as RC48 2.5 mg/kg plus toripalimab 3 mg/kg, q2w. The most common grade 3 adverse events were a decreased neutrophil count (n = 13), and a decreased white blood cell count (n = 7). The efficacy assessment was completed for 52 patients. Among patients with G/GEJ cancer (n = 30), the confirmed objective response rate (ORR) was 43% (12/28, 95% CI 25, 63), median progression-free survival (PFS) was 6.2 months (95% CI 4.0, 6.9), median overall survival (OS) was 16.8 months (95% CI 7.2, NE). The ORR of patients with G/GEJ cancer receiving RP2D (n = 24) reached 50% (11/22, 95% CI 28, 72), with median PFS of 5.1 months (95% CI 1.4, 7.3) and median OS of 14.0 months (95% CI 6.3, NE). Among patients with G/GEJ cancer who received RP2D, a clinical benefit was observed in both HER2-positive and low HER2 expressing populations, with an ORR of 56% (5/9, 95% CI 21, 86) vs. 46% (6/13, 95% CI 19, 75), median PFS of 7.8 months (95% CI 0.9, NE) vs. 5.1 months (95% CI 1.2, 6.9), median OS of NE months (95% CI 4.3, NE) vs. 14.0 months (95% CI 5.1, NE), respectively. Antitumour activity was also observed for other solid tumours, including breast cancer (5/13) and endometrial carcinoma (1/1).

Interpretation:

Our findings suggested that RC48 plus toripalimab had a manageable safety profile and showed encouraging efficacy in pretreated patients with HER2-positive and low HER2-expressing G/GEJ cancer. The findings of our phase 1 clinical trial support further investigation of HER2-targeted ADC plus immunotherapy in HER2-expressing G/GEJ cancer and pancancer treatment in the future.

Funding:

Beijing Municipal Medical Research Institutes, Beijing Medical Research Institute (Z200015).

2024-01-19·Medicine

Long-term survival in a patient with multiple metastatic gastric cancer treated with PTX plus emvolimab and disitamab vedotin: case report and treatment experience: A case report

Article

作者: Yan, Zhiqiang ; Zhou, Yongjin ; Dai, Li ; Yang, Hongxin ; Wang, Haibin ; Zhang, Meifeng ; Jin, Xiangren ; Wang, Qian

Rationale::

Most Chinese patients with locally advanced gastric cancer at diagnosis have an overall 5-year survival rate of <50%. Surgical resection alone is not suitable for patients with locally advanced gastric cancer. Currently, comprehensive treatment is the focus of locally advanced gastric cancer.

Patients concerns::

The patient, a 56-year-old female, was admitted to the hospital because of “4 + months of double hydronephrosis found during a physical examination.” Who was admitted for computer tomography and gastroscopy examinations, and take pathological tissue specimens during endoscopic examination.

Diagnoses::

Computed tomography assessment indicated ulcerative gastric cancer with an abdominal implant, bladder, and bone metastases. An endoscopic examination revealed that the ulcer of the gastric angle was huge, and through relevant auxiliary examinations, the diagnosis of this disease is gastric cancer complicated with multiple metastases to bladder, rectum, lumbar spine, and peritoneum. Clinically diagnosed as cT4bN3M1.

Interventions::

The patient is currently undergoing first, second, and third line neoadjuvant therapy, combined with immunotherapy, targeted therapy, neoadjuvant intraperitoneal systemic chemotherapy, nutritional support, and other treatment plans.

Outcomes::

After 15 cycles of treatment, the progression-free survival had reached 15 months. The patient had an NRS2002 score of 1, an ECOG score of I, a quality of life score of 55, albumin of 35.27 g/L, and a decrease in abdominal and pelvic fluid accumulation and exudation compared to before.

Lessons::

We demonstrated high survival of almost 3 years in a patient with gastric cancer that was complicated by bone, peritoneal, rectal, and bladder metastases. The combination of immunotherapy, targeted therapy, and neoadjuvant intraperitoneal systemic chemotherapy, along with the maintenance of nutritional status and CTCs could be a valuable modality for the subsequent treatment and observation of similar patients.

2023-12-01·The Breast

Exploring the clinical outcomes and safety profile of inetetamab treatment in metastatic breast cancer patients: A multicenter assessment of a Chinese-origin recombinant Anti-HER2 monoclonal antibody

Article

作者: Feng, Ronghua ; Xie, Ning ; Shui, Zhengrong ; Zeng, Mengsi ; Xiao, Huawu ; Ouyang, Quchang ; Yang, Xiaohong ; Wu, Hui ; Li, Jing ; Tang, Yu ; Wu, Tao ; Hu, Xuming ; Cao, Min ; Lu, Jun ; Liu, Liping ; Tian, Can ; Hu, Zhe-Yu ; Liu, Binliang ; Gao, Jianxiang

BACKGROUND:

Inetetamab is a novel recombinant humanized anti-HER2 monoclonal antibody. This study aimed to evaluate the efficacy and safety of inetetamab and predictive factors for response in HER2-positive metastatic breast cancer (MBC) patients.

METHODS:

A cohort of HER2-positive MBC patients who received inetetamab-based therapy between June 2020 and August 2021 was evaluated. The primary endpoint was progression-free survival (PFS), and the secondary endpoints included objective response rate (ORR) and disease control rate (DCR). Adverse events (AEs) were graded according to the National Cancer Institute Common Toxicity Criteria.

RESULTS:

A total of 141 patients were included in the final analysis. The median PFS of the entire cohort was 7.1 months. The median number of treatment lines administered was three. The ORR was 36.9 %, and the DCR was 80.9 %. The most frequently employed treatment strategy was inetetamab + chemotherapy (49/141, 34.8 %), followed by inetetamab + HER2-tyrosine kinase inhibitors (HER2-TKIs) + chemotherapy, inetetamab + pertuzumab + chemotherapy, inetetamab + endocrine treatment and inetetamab + HER2-TKIs. Cox multivariate analysis revealed that PFS was associated with liver metastasis (hazard ratio [HR] 2.112, 95 % confidence interval [CI] 1.334-3.343, p = 0.001), previous HER2-TKI treatment (HR 2.019, 95 % CI 1.133-3.597, p = 0.017) and estrogen receptor positivity (HR 0.587, 95 % CI 0.370-0.934, p = 0.024). The toxicity was tolerable, with neutropenia being the most common treatment-related grade 3/4 AE (14.9 %).

CONCLUSION:

Inetetamab demonstrates effectiveness with a manageable safety profile, offering a promising therapeutic option for HER2-positive breast cancer patients who have shown resistance to prior anti-HER2 treatments.

599

项与维迪西妥单抗相关的新闻（医药）

2024-04-25

·BiG生物创新社

ASCO 2024丨这些中国临床专家，将分享最新重磅研究

2024年美国临床肿瘤学会(ASCO)年会将于5月31日到6月4日在芝加哥举办，是世界上规模最大、学术水平最高、最具权威性的临床肿瘤学会议，会议汇集了全球肿瘤学医生和专业人士、患者倡导者、工业界代表和主要媒体，共同探讨当前国际最前沿的研究发现和临床试验成果。ASCO成立于1964年,是世界上最大、最具影响力的肿瘤专业学术组织,致力于癌症的预防、治疗及改善对患者的护理。ASCO在全球150多个国家和地区拥有超过45,000名成员。4月24日晚，ASCO官网公布了本次大会的研究标题，几十余名中国专家将在世界舞台上展示其研究成果，报告涵盖了多个瘤种的最新治疗策略和技术，展示了中国在全球癌症研究中的重要地位和贡献。世易编辑团队精心整理了中国专家们的研究报告，供您参考。全体大会报告Osimertinib (osi) after definitive chemoradiotherapy (CRT) in patients (pts) with unresectable stage (stg) III epidermal growth factor receptor-mutated (EGFRm) NSCLC: Primary results of the phase 3 LAURA study. Abstract: LBA4 · Suresh S. Ramalingam教授，美国埃默里大学Winship癌症研究所· 陆舜教授，上海交通大学附属胸科医院口头报告Lung Cancer—Non-Small Cell MetastaticSacituzumab tirumotecan (SKB264/MK-2870) in combination with KL-A167 (anti-PD-L1) as first-line treatment for patients with advanced NSCLC from the phase II OptiTROP-Lung01 study. Abstract: 8502 · 方文峰教授，中山大学肿瘤防治中心 Ivonescimab combined with chemotherapy in patients with EGFR-mutant non-squamous non-small cell lung cancer who progressed on EGFR tyrosine-kinase inhibitor treatment (HARMONi-A): A randomized, double-blind, multi-center, phase 3 trial. Abstract: 8508 · 张力教授，中山大学肿瘤防治中心 Lung Cancer—Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers Adjuvant icotinib of 12 months or 6 months versus observation following adjuvant chemotherapy for resected EGFR-mutated stage II–IIIA non-small-cell lung cancer (ICTAN, GASTO1002): A randomized phase 3 trial. Abstract: 8004 ·王思愚教授，中山大学肿瘤防治中心 A phase II randomized trial evaluating consolidative nivolumab in locally advanced non-small cell lung cancer post neoadjuvant chemotherapy plus nivolumab and concurrent chemoradiotherapy (GASTO-1091). Abstract: 8008 · 刘慧教授，中山大学肿瘤防治中心 Taiwan national lung cancer early detection program for heavy smokers and non-smokers with family history of lung cancer. Abstract: 8009 · Pan-Chyr Yang, MD, PhD，台湾大学医学院 Gastrointestinal Cancer—Colorectal and Anal Neoadjuvant treatment of IBI310 (anti-CTLA-4 antibody) plus sintilimab (anti-PD-1 antibody) in patients with microsatellite instability-high/mismatch repair-deficient colorectal cancer: Results from a randomized, open-labeled, phase Ib study. Abstract: 3505 · 徐瑞华教授，中山大学肿瘤防治中心 Hematologic Malignancies—Leukemia, Myelodysplastic Syndromes, and Allotransplant Phase I study of CN201, a novel CD3xCD19 IgG4 bispecific antibody, in adult patients with relapsed or refractory B-cell acute lymphoblastic leukemia. Abstract: 6505 · 王迎教授，中国医学科学院血液病医院 Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia CLAMP: A phase II prospective study of camrelizumab combined with pegaspargase, etoposide, and high-dose methotrexate in patients with natural killer (NK)/T-cell lymphoma. Abstract: 7002 · 刘涛教授，华中科技大学同济医学院附属协和医院 Tucidinostat plus R-CHOP in previously untreated diffuse large B-cell lymphoma with double expression of MYC and BCL2: An interim analysis from the phase III DEB study. Abstract: LBA7003 · 赵维莅教授，上海交通大学医学院附属瑞金医院 Hematologic Malignancies—Plasma Cell DyscrasiaPhase 3 study results of isatuximab, bortezomib, lenalidomide, and dexamethasone (Isa-VRd) versus VRd for transplant-ineligible patients with newly diagnosed multiple myeloma (IMROZ). Abstract: 7500 ·Thierry Facon, MD，University of Lille, CHU Lille·刘卓刚教授，中国医科大学附属盛京医院Central Nervous System Tumors Efficacy and safety of the vebreltinib in patients with previously treated, secondary glioblastoma/IDH mutant glioblastoma with PTPRZ1-METFUsion GENe (FUGEN): A randomised, multicentre, open-label, phase II/III trial. Abstract: 2003 · Zhaoshi Bao, MD, PhD，首都医科大学附属北京天坛医院 High-dose almonertinib in treatment-naïve EGFR-mutated NSCLC with CNS metastases: Efficacy and biomarker analysis. Abstract: 2007 · 范云教授，浙江省肿瘤医院 SarcomaUpdated efficacy results of olverembatinib (HQP1351) in patients with tyrosine kinase inhibitor (TKI)-resistant succinate dehydrogenase (SDH)-deficient gastrointestinal stromal tumors (GIST) and paraganglioma. Abstract: 11502 · 邱海波教授，中山大学肿瘤防治中心 Sintilimab, doxorubicin and ifosfamide (AI) as first-line treatment in patients with advanced undifferentiated pleomorphic sarcoma (UPS), synovial sarcoma (SS), myxoid liposarcoma (MLPS) and de-differentiated liposarcoma (DDLPS): A single-arm phase 2 trial. Abstract: 11505 · 罗志国教授，复旦大学附属肿瘤医院 ARTEMIS-002: Phase 2 study of HS-20093 in patients with relapsed or refractory osteosarcoma. Abstract: 11507 · 谢璐教授，北京大学人民医院 Head and Neck Cancer Adjuvant PD-1 blockade with camrelizumab in high-risk locoregionally advanced nasopharyngeal carcinoma (DIPPER): A multicenter, open-label, phase 3, randomized controlled trial. Abstract: LBA6000 · 刘需教授，中山大学肿瘤防治中心 Tislelizumab versus placebo combined with induction chemotherapy followed by concurrent chemoradiotherapy and adjuvant tislelizumab or placebo for locoregionally advanced nasopharyngeal carcinoma: Interim analysis of a multicenter, randomized, placebo-controlled, double-blind, phase 3 trial. Abstract: 6001 · 陈秋燕教授，中山大学肿瘤防治中心 Endostar combined with concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone for locoregionally advanced nasopharyngeal carcinoma (LA-NPC): A phase III, prospective, randomised-controlled, multicenter clinical trial. Abstract: 6002 · 康敏教授，广西医科大学第一附属医院 Developmental Therapeutics—ImmunotherapyClaudin18.2-targeted chimeric antigen receptor T cell-therapy for patients with gastrointestinal cancers: Final results of CT041-CG4006 phase 1 trial. Abstract: 2501 · 齐长松教授，北京大学肿瘤医院 A potential best-in-class BCMA-CD19 bispecific CART with advanced safety by self-inhibiting IFNG signaling during CRS. Abstract: 2502 · Lei Xue Efficacy and safety of LM-108, an anti-CCR8 monoclonal antibody, in combination with an anti-PD-1 antibody in patients with gastric cancer: Results from phase 1/2 studies. Abstract: 2504 · Chang Liu, MD，北京大学肿瘤医院Developmental Therapeutics—Molecularly Targeted Agents and Tumor Biology Phase I/II first-in-human study to evaluate the safety and efficacy of tissue factor-ADC MRG004A in patients with solid tumors.Abstract: 3002· Wungki Park, MD, MS，美国纪念斯隆凯瑟琳癌症中心· 张剑教授，复旦大学附属肿瘤医院Updated safety and efficacy data of combined KRAS G12C inhibitor (glecirasib, JAB-21822) and SHP2 inhibitor (JAB-3312) in patients with KRAS p.G12C mutated solid tumors. Abstract: 3008 · 赵军教授，北京大学肿瘤医院快速口头摘要报告 Lung Cancer—Non-Small Cell Metastatic A multinational pivotal study of sunvozertinib in platinum pretreated non-small cell lung cancer with EGFR exon 20 insertion mutations: Primary analysis of WU-KONG1 study. Abstract: 8513 · James Chih-Hsin Yang 教授，台大肿瘤中心 Efficacy and safety of taletrectinib in patients with advanced or metastatic ROS1+ non–small cell lung cancer: The phase 2 TRUST-I study. Abstract: 8520 · 李玮教授，同济大学附属上海市肺科医院 Lung Cancer—Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers Overall survival of adebrelimab plus chemotherapy and sequential thoracic radiotherapy as first-line treatment for extensive-stage small cell lung cancer. Abstract: 8014 · 陈大卫教授，山东省肿瘤医院 Breast Cancer—Metastatic ACE-Breast-02: A pivotal phase II/III trial of ARX788, a novel anti-HER2 antibody-drug conjugate (ADC), versus lapatinib plus capecitabine for HER2+ advanced breast cancer (ABC). Abstract: 1020 · 胡夕春教授，复旦大学附属肿瘤医院 Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary Efficacy and safety of cadonilimab in combination with pulocimab and paclitaxel as second-line therapy in patients with advanced gastric or gastroesophageal junction (G/GEJ) cancer who failed immunochemotherapy: A multicenter, double-blind, randomized trial. Abstract: 4012 · 张小田教授，北京大学肿瘤医院 Phase I study of C-CAR031, a GPC3-specific TGFβRIIDN armored autologous CAR-T, in patients with advanced hepatocellular carcinoma (HCC). Abstract: 4019 · 章琦教授，浙江大学医学院附属第一医院肝胆胰外科 Gastrointestinal Cancer—Colorectal and Anal Total neoadjuvant treatment with long-course radiotherapy versus concurrent chemoradiotherapy in local advanced rectal cancer with high risk factors (TNTCRT): A multicenter, randomized, open-label, phase 3 trial. Abstract: LBA3511 · Xin Wang, MD，四川大学华西医院 Phase I trial of hypoxia-responsive CEA CAR-T cell therapy in patients with heavily pretreated solid tumor via intraperitoneal or intravenous transfusion. Abstract: 3514 · Hangyu Zhang，浙江大学医学院第一附属医院 Three-year disease-free survival after transanal vs. laparoscopic total mesorectal excision for rectal cancer (TaLaR): A randomized clinical trial. Abstract: 3516 · 康亮教授，中山大学附属第六医院 Genitourinary Cancer—Kidney and Bladder Camrelizumab plus apatinib for previously treated advanced adrenocortical carcinoma: A single-arm, open-label, phase 2 trial. Abstract: 4511 · Zhigong Wei，四川大学华西医院 Hematologic Malignancies—Leukemia, Myelodysplastic Syndromes, and Allotransplant Latest results of a phase 2 study of IMM01 combined with azacitidine (AZA) as the first-line treatment in adults with higher risk myelodysplastic syndromes (MDS). Abstract: 6510 · Wei Yang，中国医科大学附属盛京医院 Safety and efficacy of CD7-CAR-T cell in patients with relapsed/refractory T-lymphoblastic leukemia/lymphoma: Phase I dose-escalation/dose-expansion study. Abstract: 6515 · Lijuan Hu, MD, 北京大学人民医院 Hematologic Malignancies—Plasma Cell Dyscrasia OriCAR-017, a novel GPRC5D-targeting CAR-T, in patients with relapsed/refractory multiple myeloma: Long term follow-up results of phase 1 study (POLARIS). Abstract: 7511 · Shan Fu，浙江大学医学院附属第一医院 Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia Timdarpacept (IMM01) in combination with tislelizumab in prior anti-PD-1 failed classical Hodgkin lymphoma: An open label, multicenter, phase II study (IMM01-04) evaluating safety as well as preliminary anti-tumor activity. Abstract: 7017 · Zhenjiu Wang, MD Gynecologic Cancer Efficacy and safety of sintilimab plus paclitaxel and cisplatin as neoadjuvant therapy for locally advanced cervical cancer: A phase II trial. Abstract: 5512 ·刘继红教授，中山大学肿瘤防治中心 Nimotuzumab plus concurrent chemoradiotherapy for locally advanced cervical squamous cell carcinoma: The randomized, phase 3 CC3 study. Abstract: 5514 ·王俊杰教授，北京大学第三人民医院 A phase III randomized, double-blinded, placebo-controlled study of suvemcitug combined with chemotherapy for platinum-resistant ovarian cancer (SCORES). Abstract: LBA5516 · 袁光文教授，中国医学科学院肿瘤医院 Secondary cytoreduction followed by chemotherapy versus chemotherapy alone in platinum-sensitive relapsed ovarian cancer (SOC-1): A final overall survival analysis of a multicenter, open-label, randomized, phase 3 trial. Abstract: 5520 · 臧荣余教授，复旦大学附属中山医院 Head and Neck Cancer Preliminary results of phase I/II study to evaluate safety and efficacy of combination pucotenlimab with epidermal growth factor receptor-ADC (EGFR-ADC) MRG003 in patients with EGFR positive solid tumors. Abstract: 6013 · 阮丹云教授，中山大学肿瘤防治中心 Covalent FAPI PET enables accurate management of medullary thyroid carcinoma: a prospective single-arm comparative clinical trial. Abstract: LBA6018 · Ziren Kong, MD, 中国医学科学院北京协和医学院 Sarcoma A phase II study of anlotinib and an anti-PDL1 antibody in patients with alveolar soft part sarcoma: Results of expansion cohorts. Abstract: 11515 · 刘佳勇教授，北京大学肿瘤医院 Phase 1 study of NB003, a broad-spectrum KIT/PDGFRα inhibitor, in patients with advanced gastrointestinal stromal tumors (GIST). Abstract: 11518 · 李健教授，北京大学肿瘤医院 Developmental Therapeutics—Molecularly Targeted Agents and Tumor Biology Results of a phase 1/2 study of MHB088C: A novel B7H3 antibody-drug conjugate (ADC) incorporating a potent DNA topoisomerase I inhibitor in recurrent or metastatic solid tumors. Abstract: 3012 · 沈琳教授，北京大学肿瘤医院 9MW2821, a nectin-4 antibody-drug conjugate (ADC), in patients with advanced solid tumor: Results from a phase 1/2a study. Abstract: 3013 · 张剑教授，复旦大学附属肿瘤医院 Developmental Therapeutics—Immunotherapy Phase I study of GUCY2C CAR-T therapy IM96 in patients with metastatic colorectal cancer. Abstract: 2518 · 齐长松教授，北京大学肿瘤医院 Safety and preliminary efficacy results of IBI389, an anti-CLDN18.2/CD3 bispecific antibody, in patients with solid tumors and gastric or gastro-esophageal tumors: A phase 1 dose escalation and expansion study. Abstract: 2519 · 郑莉教授，四川大学华西医院 Symptom Science and Palliative Care Effect of nurse-led multi-disciplinary treatment on patients with head and neck tumors: A randomized controlled trial. Abstract: 12013 · Jingjing Wang, MD，四川大学华西医院肿瘤中心临床科学研讨会A phase 1/2 study of the TORC1/2 inhibitor onatasertib combined with toripalimab in patients with advanced solid tumors: Cervical cancer cohort. Abstract: 5509 · Hui Xie，德琪医药有限公司临床研发部 KRYSTAL-12: Phase 3 study of adagrasib versus docetaxel in patients with previously treated advanced/metastatic non-small cell lung cancer (NSCLC) harboring a KRASG12C mutation. Abstract: LBA8509 · Tony S. K. Mok 教授，香港大学 Sacituzumab tirumotecan (SKB264/MK-2870) in patients (pts) with previously treated locally recurrent or metastatic triple-negative breast cancer (TNBC): Results from the phase III OptiTROP-Breast01 study. Abstract: 104 · 樊英教授，中国医学科学院肿瘤医院 Efficacy of disitamab vedotin (RC48) plus tislelizumab and S-1 as first-line therapy for HER2-overexpressing advanced stomach or gastroesophageal junction adenocarcinoma: A multicenter, single-arm, phase II trial (RCTS). Abstract: 4009 · 刘联教授，山东大学齐鲁医院 A novel and uniquely designed bispecific antibody (LBL-024) against PD-L1 and 4-1BB in patients with advanced malignant tumors and neuroendocrine carcinoma: A report of safety and robust efficacy of LBL-024 monotherapy in phase I/II, first-in-human, open-label, multicenter, dose escalation/expansion study. Abstract: 4010 · 张盼盼医生，北京大学肿瘤医院 Safety and efficacy of IBI389, an anti-CLDN18.2/CD3 bispecific antibody, in patients with advanced pancreatic ductal adenocarcinoma: Preliminary results from a phase 1 study. Abstract: 4011 · 郝继辉教授，天津医科大学肿瘤医院 Neoadjuvant sintilimab and platinum-doublet chemotherapy followed by transoral robotic surgery for HPV-associated resectable oropharyngeal cancer: Single-arm, phase II trial. Abstract: 6011 · 宋明教授，中山大学肿瘤防治中心 BiG 十周年预告本次BiG十周年庆典，将首次分为国内和国际篇章，以原创科学和临床需求为出发点，讨论创新技术平台和创新疗法（PROTACT/分子胶、双抗/ADC、siRNA/ASO、CGT、AI制药）的重大进展和发展前景，十年一药曙光现，大浪淘沙始见金！▼报名参会会议门票：审核制(免费)；含主论坛+分论坛，不含餐；优先biotech/Pharma、临床、院校科学家共建Biomedical创新生态圈！如何加入BiG会员？

ASCO会议临床结果

2024-04-24

·生物制品圈

全球上市的ADC药物盘点，看这一篇就够了

20世纪初，Paul Ehrlich首次提出著名的“魔法子弹”理论设想，他认为可以针对病原体特殊的结构特点，寻找和研制只杀伤病原体，不影响正常组织和细胞的药物。随后，抗体-药物偶联的概念被提出，它将单克隆抗体的靶标特异性和细胞毒性分子的抗肿瘤特性结合在一起。历经几十年的尝试，直到2000年靶向CD33的ADC药物Mylotarg（Gemtuzumab Ozogamicin）出现，ADC的发展才取得了实质性的成功。目前全球已有15款ADC药物获批上市，分别是辉瑞的Mylotarg、Besponsa，罗氏的Kadcyla、Polivy，阿斯利康的Lumoxiti、Enhertu，Seagen/武田制药的Adcetris，Seagen/安塞泰来的Padcev，Seagen/Genmab的Tivdak，葛兰素史克的Blenrep，吉利德的Trodelvy，Rakuten Medical的Akalux，ADCTherapeutics的Zynlonta，荣昌生物的爱地希，以及ImmunoGen/华东医药的Elahere。治疗领域涉及淋巴瘤、白血病、乳腺癌、多发性骨髓瘤、乳腺癌、头颈癌、尿路上皮癌等。Mylotarg®（gemtuzumab ozogamicin，吉妥单抗）适应症：急性粒细胞白血病（AML）研发公司：辉瑞靶点：CD33由人源化抗CD33单克隆抗体、卡奇霉素、可切割的连接子组成。抗体与CD33抗原结合后，细胞毒素的内化和释放，从而诱导双链DNA断裂和细胞死亡。全球首款上市的ADC。2000年获FDA加速批准，用于治疗急性粒细胞白血病（AML）。由于由于连接子不稳定、细胞毒素提前释放引起严重毒性反应引发安全性问题，2010年自主撤市。随后，辉瑞补充更新了临床证据（三项临床试验研究：ALFA-0701、AML-19、MyloFrance-1），调整了规格，从原先的5mg/瓶改为4.5 mg/瓶，给药方案也进行了相应调整，推荐剂量从9mg/m2调整为3mg/m2，重新向FDA递交申请。2017年，Mylotarg®获得批准、再次上市，用于用于治疗成人新确诊的髓系细胞分化抗原（CD33）阳性的急性髓系白血病（Acute Myeloid Leukemia，AML），≥2岁儿童和成人的复发难治性髓系细胞分化抗原（CD33）阳性的AML。Adcetris®（brentuximab vedotin，维布妥昔单抗，安适利®）适应症：霍杰金淋巴瘤\系统性间变性大细胞淋巴瘤研发公司：武田和Seattle Genetics靶点：CD30一种靶向CD30的ADC，由嵌合lgG1抗体cAC10、 MMAE和蛋白酶可切割的连接子组成。内化后，蛋白水解释放MMAE，MMAE通过破坏微管系统诱导细胞周期阻滞和凋亡。由于MMAE具有旁观者效应，BV在表达CD30的组织异质性肿瘤中也有效。2011年8月被FDA批准。用于治疗霍奇金淋巴瘤（HL）和间变性大细胞淋巴瘤（sALCL）。在我国于2020年5月被NMPA批准，用于治疗复发或难治性sALCL和CD30阳性HL患者，是第二款国内获批上市的ADC。2021年获欧盟批准，可作为CD30表达的sALCL一线治疗药物，也成为全球第一个用于一线治疗的ADC。Brentuximab vedotin是第二代ADC代表药物，采用人鼠嵌合抗体、或人源化单抗代替鼠源单抗，即降低了免疫原性，又增强了肿瘤靶向性，并且采用的连接子也更加的稳定。其缺点是裸抗较多，这些未结合的单抗与偶联物竞争抗原结合位点，影响疗效。过高的药物/抗体比率（DAR），引起抗体聚集，清除加快，非特异性毒性增加等。Brentuximab平均携带4个MMAE分子，其药物/抗体比率（DAR）为4，分子量约153kDa。Kadcyla®（ado-trastuzumab emtansine，恩美曲妥珠单抗，赫赛莱®）适应症：乳腺癌研发公司：罗氏和ImmunoGen靶点：HER2一种靶向Her2的ADC，由人源化抗Her2 IgG1单抗（曲妥珠单抗）、小分子细胞毒素DM1和不可切割的连接子组成。在体循环和肿瘤微环境中能维持较高的稳定性。2013年2月22日，FDA批准Kadcyla®用于曾接受曲妥珠单抗和紫杉烷治疗的转移性Her2阳性乳腺癌患者治疗。2019年5月3日，FDA批准Kadcyla®作为单一药物用于接受新辅助曲妥珠单抗治疗后残留疾病的Her2阳性乳腺癌患者的辅助治疗。2020年1月，NMPA批准Kadcyla®用于接受了紫杉烷类联合曲妥珠单抗为基础的新辅助治疗后，仍残存侵袭性病灶的HER2阳性早期乳腺癌患者、不可切除局部晚期或转移性乳腺癌患者的辅助治疗。是我国首个上市的抗体药物偶联物（ADC），也是全球首款被批准用于实体瘤的ADC。Kadcyla®是商业化最成功的ADC。2021年全球ADC市场规模超过52亿美元，其中Kadcyla®独占半壁江山，销售额达到21.7亿美元。Kadcyla平均每个抗体上连接3.5个DM1，分子量约148,781Da。Besponsa®（inotuzumab ozogamicin，奥加伊妥珠单抗，贝博萨®）适应症：BCP-ALL研发公司：辉瑞靶点：CD22一种人源化抗CD22单克隆抗体，通过酸不稳定的腙连接子与卡奇霉素偶联。CD22是一种内吞受体，是B细胞急性淋巴细胞白血病(ALL)的特异性标志物，在90%以上的B细胞恶性肿瘤患者中表达。一旦ADC与CD22受体结合，该复合物被内化到靶细胞内，触发卡奇霉素的释放，卡奇霉素通过与DNA双螺旋的小沟结合并引起位点特异性双链DNA切割，从而诱导细胞凋亡。2017年6月获得EMA批准上市，用于治疗患有复发或难治性前体B细胞急性淋巴细胞性白血病（ALL）的成人患者。2017年8月获得美国FDA批准，治疗成人复发或难治性B细胞前体急性淋巴性白血病。这是首款获得FDA批准的靶向CD22的抗体偶联药物。2021年12月在我国上市，成为中国第四款上市的ADC。NMPA的批准基于境外临床试验B1931022数据在中国的递交，豁免中国注册临床试验。上市后，需开展上市后研究（B1931034）。Besponsa®作为辉瑞的第二款ADC、第三代ADC产品，抗体免疫原性更低，靶向性更强，细胞活性更高，连接子更稳定，小分子毒性药物的稳定性和亲水性有了进一步改善，ADC的稳定性、均一性也更好。Besponsa分子量约为160kDa，与每个抗体平均结合的6个卡奇霉素，分布范围为2~8。Lumoxiti®(Moxetumomab pasudotox，帕西妥莫单抗)适应症：复发性或难治性毛细胞白血病（HCL）的成年患者研发公司：阿斯利康靶点：CD22由抗CD22单克隆抗体共价连接到假单胞菌外毒素a(PE38)的38kDa片段上。免疫毒素的Fv部分与CD22结合，内化后，通过催化延伸因子-2(EF-2)中二苯二胺残基的ADP核糖基化诱导凋亡。2018年9月获得FDA批准上市，用于治疗复发性或难治性毛细胞白血病(HCL)成人患者。2021年2月，获EMA批准。但五个月后，同年7月EMA发布公告，撤销了它在欧盟的上市许可。然而由于临床使用非常低，阿斯利康在2023年7月将Lumoxiti永久撤出美国市场。两个撤市均为商业考量，并非安全性问题。Polivy®（polatuzumab vedotin，泊洛妥珠单抗，优罗华®）适应症：弥漫性大B细胞淋巴瘤研发公司：罗氏靶点：CD79b一种由抗CD79b单克隆抗体、蛋白酶可切割的连接子和MMAE偶联。CD79b是B细胞特异性表面蛋白，它在超过90%的B细胞非霍奇金淋巴瘤中高表达，例如：弥漫性大B细胞淋巴瘤、滤泡性淋巴瘤等，CD79b与抗体结合后被迅速内吞并递送至溶酶体内。因此，CD79b成为治疗这类淋巴瘤的理想靶点。2019年6月11日首次获得FDA加速批准上市，联合苯达莫司汀和利妥昔单抗，用于治疗至少两次以上的复发或难治性（R/R）弥漫性大B细胞淋巴瘤（DLBCL）的成年患者。随后，于2021年1月和3月，分别在欧盟、日本批准上市。2023年1月，Polivy®获得中国国家药品监督管理局（NMPA）正式批准。适应症为：联合利妥昔单抗、环磷酰胺、多柔比星和泼尼松适用于治疗既往未经治疗的弥漫性大B细胞淋巴瘤（DLBCL）成人患者；以及联合苯达莫司汀和利妥昔单抗用于不适合接受造血干细胞移植的复发或难治性弥漫性大B细胞淋巴瘤成人患者。Polivy®是20多年来国内唯一获批用于 DLBCL 一线治疗的创新靶向药物。与传统治疗方案相比，Polivy®可显著改善患者的临床结局，是20年来首个显著改善复发或难治性弥漫性大B细胞淋巴瘤的新治疗方案。因此，在美国、欧盟和日本，Polivy®被授予“孤儿药资格”，在美国还被FDA授予“突破性药物资格”，欧盟EMA则被授予“优先药物资格”。Polivy®药物/抗体比率（DAR）为3-4，分子量约150kDa。Enhertu®(fam-trastuzumab deruxtecan-nxki，德喜曲妥珠单抗，优赫得®）适应症：胃食管交界处癌，转移性胃癌，转移性乳腺癌研发公司：阿斯利康；第一三制药靶点：HER2Enhertu®是第三代ADC的代表，由靶向Her2的曲妥珠单抗、可切割的四肽连接子和细胞毒性拓扑异构酶I抑制剂组成。研究表明T-DXd对Her2高或低表达的肿瘤细胞或Her2突变的肿瘤细胞都有效，其原因可能包括：1）T-DXd的DAR值高达8，因此具有高效的有效载荷；2）释放的有效载荷具有较高的膜透性，使其能够进入邻近的肿瘤细胞，产生旁观者效应；3）新型基于四肽的连接子在血浆中具有很高的稳定性。2019年12月，Enhertu获得FDA加速批准，用于既往接受过HER2治疗的、不可切除，或转移性HER2阳性乳腺癌成年患者。2022年3月正式递交国内上市申请，并于5月被正式纳入优先审评目录，首个适应症为：治疗既往接受过一种或一种以上抗HER2药物治疗的不可切除或转移性HER2阳性成人乳腺癌患者。Enhertu®在治疗HER2阳性转移性乳腺癌等方面表现出的惊人疗效，是ADC药物研发近年来罕见的重大进展，也令HER2成为目前热度最高的ADC药物靶点。Enhertu®是全球首个且目前唯一在HER2阳性晚期乳腺癌二线治疗中，头对头对比的ADC药物，并取得了阳性结果。据Natrue子刊市场预测，Enhertu有望在2026年达到62亿美元的销售额，占据全球40%的ADC市场份额。或将取代Kadcyla，成为新一代的ADC “药王”。Padcev®（enfortumab vedotin，恩诺单抗）适应症：尿路上皮癌研发公司：Seagen；安斯泰来靶点：Nectin-4一种靶向nectin-4的ADC，由一种靶向nectin-4的人单克隆抗体、蛋白酶可切割的连接子、MMAE偶联。Nectin-4是一种细胞粘附分子，在97%的尿路上皮癌中过表达，并与肿瘤生长和增殖有关。Nectin-4在成人健康组织中表达量很低，但在多种肿瘤细胞中高表达，如：在尿路上皮癌、膀胱癌、乳腺癌、卵巢癌、胃癌、肝细胞癌和胰腺癌等组织中，具有特异性的高表达，与肿瘤的发生和转移具有密切的关系，可通过激活PI3K/AKT途径促进肿瘤细胞增殖、分化、迁移、侵袭等。因此，Nectin-4已成为许多实体瘤诊断和治疗的重要靶点。2019年12月，FDA加速批准了Padcev®用于局部晚期或转移性尿路上皮癌的成年患者，这些患者先前接受过程序性死亡受体-1(PD-1)抑制剂或程序性死亡配体受体-1(PD-L1)抑制剂以及含铂化疗药物的治疗。Padcev®是首个获批治疗尿路上皮癌的ADC，也是首个以Nectin-4为靶点的获批药物Trodelvy®（sacituzumab govitecan，戈沙妥珠单抗，拓达维®）适应症：三阴性乳腺癌研发公司：吉利德靶点：Trop-2一种靶向Trop-2的单抗，通过酸不稳定的腙可切割连接子与SN-38偶联组成。SN-38是一种拓扑异构酶-1抑制剂，是化疗药物伊立替康的活性代谢物。给药后，ADC与肿瘤细胞上的Trop-2结合，并促使SN-38释放，引发DNA损伤，随后导致细胞周期阻滞。由于SN-38的膜透性，它可以在不被内化的情况下刺激附近细胞的抗肿瘤作用，发挥旁观者效应。TROP-2，一种跨膜糖蛋白，它在乳腺癌、胃癌、非小细胞肺癌、小细胞肺癌、结肠癌、胰腺癌等多种肿瘤组织中过表达，尤其是三阴乳腺癌，表达率高达90%以上。2020年4月，Trodelvy®获得FDA加速批准用于对既往接受过两种或两种以上转移性疾病治疗的成人转移性三阴性乳腺癌的治疗。2022年6月，NMPA批准Trodelvy®用于既往至少接受过2种系统治疗，其中至少一种治疗针对转移性疾病的不可切除的局部晚期或转移性三阴乳腺癌成人患者。Blenrep®（belantamab mafodotin，玛贝妥单抗）适应症：多发性骨髓瘤研发公司：GSK靶点：BCMA一种靶向B细胞成熟抗原(BCMA)的lgG抗体，通过不可切割的马来酰亚胺基己酰(MC)连接子与MMAF偶联。BCMA是一种在恶性浆细胞上大量表达的细胞表面蛋白，是治疗多发性骨髓瘤的一个很重要的靶点。一旦belantamab maodotin与BCMA结合，该复合物内化并在溶酶体中降解，MMAF释放，诱导生长阻滞和细胞凋亡。2020年8月，FDA加速批准Blenrep®用于复发或难治性多发性骨髓瘤的成人患者，这些患者之前接受过至少四种治疗，其必须包括抗CD38单克隆抗体、免疫调节剂和蛋白酶体抑制剂。2022年11月，Blenrep®的验证性临床III期DREAMM-3试验宣告失败，这是一项“头对头”的优效性试验，研究对比了Blenrep单药与泊马度胺联合低剂量地塞米松（PomDex）的疗效。同年12月，Blenrep®撤出美国市场，也成为FDA“加速批准”来，最快退市的药物。然而，这不代表GSK停止了这款药物的开发，DREAMM系列的临床研究没有暂停，GSK正通过联合用药寻找其他获益可能。Akalux®（Cetuximab Sarotalocan Sodium，沙西妥昔单抗）适应症：头颈癌研发公司：Rakuten靶点：EGFR由靶向EGFR的抗体cetuximab与光敏物质IR700偶联而成。2020年9月，获得日本厚生劳动省正式批准，用于治疗手术无法切除的头颈部恶性肿瘤，也是全球首个光免疫疗法ADC，治疗时需要与BioBlade激光系统联合使用。Akalux®与癌细胞表面的EGFR抗体结合后，利用近红外线照射肿瘤病灶，红外线可以局部激活偶联染料并破坏已经与化学物质结合的肿瘤细胞膜，从而达到灭杀癌细胞的目的。Zynlonta®（Loncastuximab tesirine，朗妥昔单抗）适应症：LBCB研发公司：ADCTherapeutics靶点：CD19一种靶向CD19的抗体，通过可切割的酶型连接子与细胞毒性烷基化剂SG3199偶联而成。SG3199是一种合成的PBD二聚体，通过促进DNA链间交联的形成阻止细胞分裂，具有强大的细胞毒性作用。2021年4月23日，Zynlonta®获得FDA加速批准，用于弥漫性大B细胞淋巴瘤(DLBCL)患者。2022 年 12 月，Zynlonta®得到欧洲药品管理局（EMA）的附条件批准。并且CDE 官网显示，2023年7月，瓴路药业注射用泰朗妥昔单抗申报上市（受理号：JXSS2300057）。这也是国内首款申报上市的 CD19 ADC。爱地希®（Disitamab Vedotin，维迪西妥单抗）适应症：胃癌，尿路上皮癌研发公司：荣昌靶点：HER2由亲和力更高的新型人源化抗HER2抗体、可裂解连接子和微管抑制剂MMAE组成，作用机制包括抑制HER2信号通路和MMAE的细胞毒性。2021年6月和2021年12月，爱地希®获NMPA批准上市，适用于至少接受过2种系统化疗的HER2过表达局部晚期或转移性胃癌（包括胃食管结合部腺癌）患者的治疗，以及2+或3+的局部晚期或转移性尿路上皮癌的治疗。爱地希®为首家获批上市的国产ADC品种。除已获批2项适应症外，荣昌生物还开展了多项针对实体瘤的临床研究，包括乳腺癌（BC），同时还在探索对于其他HER2过表达的常见癌种的治疗，如非小细胞肺癌（NSCLC）、胆道癌（BTC）、黑色素瘤等。Tivdak®（tisotumab vedotin-tftv，替索单抗）适应症：宫颈癌研发公司：Genmab靶点：TF一种靶向组织因子(TF-011)的单克隆抗体、一种可切割的mc-VC-PABC连接子和MMAE组成。研究显示，相对正常宫颈组织，TF在宫颈癌组织中大量表达。一旦vedotin与TF结合，MMAE就会被传递到细胞中，从而阻断微管蛋白聚合并终止细胞分裂。2021年9月，美国FDA授予Tivdak加速批准，用于化疗期间或化疗后疾病进展的复发性或转移性宫颈癌成人患者。Tivdak®是首个获批用于治疗化疗期间或化疗后疾病进展的复发性或转移性宫颈癌患者的ADC。Elahere（mirvetuximab soravtansine-gynx，索米妥昔单抗）适应症：卵巢癌研发公司：ImmunoGen、华东医药靶点：FEα一款FRα靶向ADC，由IgG1亚型抗FRα人源化单抗M9346A、抗微管蛋白剂DM4（一种美登素衍生物）和连接子三部分组成。FRɑ在72%-100%的间皮瘤、35%-68%的三阴性乳腺癌、76%-89%的卵巢癌和14%-74%的非小细胞肺癌患者样本中高表达2022年11月获FDA作为一种单药疗法加速批准，用于治疗先前已接受过1-3种全身治疗方案、FRα阳性、铂耐药的上皮性卵巢癌、输卵管癌、原发性腹膜癌成人患者。结语以上就是全球上市的15款ADC药物，从原研地区来看，尽管其中只有爱地希®来自中国，确能说明中国创新药企不再是门外汉、看客，而是参与者和座上宾。虽然全球生物医药行业的寒冬还未结束，许多在原始创新道路上坚持的中国企业依旧踽踽独行。不过，最艰难的时刻已经过去，属于中国原创新药的春天已悄然来临。资料来源：1.BiG生物创新社：上市ADC系列2.全球已批准上市的15款ADC药物的包装外观图.抗体圈.2024-04-13.盘点：国内已上市ADC&双抗全景图.药渡.2023-08-174.已获批上市的ADC药物的开发回顾及未来展望.生物药搬运工.2024-04-115.2023年终盘点：ADC药物推进肿瘤治疗进程飞跃！全球上市的ADC药物概览来了.咚咚癌友圈.2023-12-236.国内上市的ADC药物(抗体药物偶联物)汇总盘点.利多卡vivi.2024-02-26识别微信二维码，添加生物制品圈小编，符合条件者即可加入生物制品微信群！请注明：姓名+研究方向！版权声明本公众号所有转载文章系出于传递更多信息之目的，且明确注明来源和作者，不希望被转载的媒体或个人可与我们联系(cbplib@163.com)，我们将立即进行删除处理。所有文章仅代表作者观点，不代表本站立场。

抗体药物偶联物上市批准临床结果多肽偶联药物

2024-04-23

·药时代

卷起来了！为什么是Claudin18.2

正文共2078字共5图预计阅读时间：8分钟早在20世纪初，“魔法子弹”靶向治疗概念就被提出，随着杂交瘤技术的诞生及人源化单克隆抗体技术的发展，ADC药物研发得以取得突破。截至目前，全球范围内获批上市的ADC药物已高达十几款，其中有半数获批于近5年。2021年，首款国产ADC药物——荣昌生物的RC48（爱地希）上市，国产ADC自此崭露头角。经过几年的技术积累，部分国内企业的ADC研发技术趋于成熟，能在国际上占得一席之地。或许是受到去年ADC领域重磅交易的激励，近期不少ADC管线忽然开始提速。据药时代团队统计，进入2024年后，接连三款Claudin18.2 ADC宣布进入III期临床阶段，并且这三款ADC药物的研发均有国内药企主导/参与。ADC：从选择一个合适的靶抗原开始ADC的结构相信大家都已经很熟知，即antibody（抗体）+linker（连接子）+payload（有效载荷）。其中，抗体负责与肿瘤上的特异性靶抗原结合，linker负责将抗体与有效载荷连接起来，有效载荷负责杀伤癌细胞。一款理想的ADC药物要兼具高特异性、稳定性、高效的细胞内载荷递送能力以及耐受性和安全性，几乎每个要素都会影响ADC的最终疗效。因此，在ADC开发之初，就必须仔细筛选所有关键组成部分，包括靶抗原、抗体、有效载荷、连接子及偶联方式等。肿瘤细胞上表达的靶抗原是 ADC 药物识别肿瘤细胞的制导方向，决定了细胞毒性有效载荷传递到癌细胞中的机制。因此，选择合适的靶抗原是ADC 的首要考虑因素。理想的靶抗原需要满足以下三点要素：为了降低脱靶毒性，靶抗原应仅表达或主要表达在肿瘤细胞中，而在正常组织中不表达或很少。靶抗原应该是非分泌的，因为在循环中分泌的抗原会导致ADC 结合到肿瘤部位之外，从而导致肿瘤靶向性降低和安全性问题。理想的目标抗原与相应的抗体结合后应该被内化，这样 ADC-抗原复合物就可以进入癌细胞，然后通过适当的细胞内运输途径和释放细胞毒性有效载荷。华金证券的一份行业研究报告显示，目前ADC研发领域排名前三的热门靶点分别为HER2、Trop-2及Claudin18.2。其中，前两者均为已经多年临床验证的成熟抗肿瘤药物靶点，相比之下claudin18.2发现晚、相应靶点单抗产品目前也仅在日本获批上市。图片来源：华金证券报告为什么是claudin18.2？1998年，日本学者S. Tsukita教授和他的团队发现了一类全新的跨膜蛋白家族，因这类蛋白在细胞间的紧密连接中起到屏障作用，于是将其命名为Claudins，源于拉丁文“claudere”，意为“关闭”。Claudin18.2是Claudins家族中的一员，由 CLDN18 基因编码。其特点是，在正常组织中，Claudin18.2仅在胃黏膜分化的上皮细胞表面低水平表达，并深埋于紧密连接复合物中。但当癌变导致细胞紧密连接被破坏，Claudin18.2表位就会暴露于肿瘤细胞表面，成为特异性靶点。凭借这种肿瘤特异性的高表达，Claudin18.2 ADC 就能精准识别并结合到肿瘤细胞表面的Claudin18.2上，且能避免对正常组织造成不必要的损伤。除此之外，Claudin18.2还表现出了强大的疾病可及性，在许多肿瘤中表达，包括胃癌、胰腺癌、食管癌、卵巢癌等。一项针对414名不同肿瘤类型患者的免疫组化分析研究中，共有 4.1% （N=17）的受试者为 Claudin18.2 阳性，包括胰腺癌（16.7%，1/6）、胃癌（14.1%，12/85）、结直肠癌（0.9%，2/203）、胆道癌（6.3%，1/16）和泌尿生殖系统/其他（2.2%，1/46）。并且除了已被证实在在原发肿瘤中高表达，Claudin18.2在转移性病变中同样呈现出表达特性。在一项研究中，胰腺导管腺癌显示 59.2% （103/174）的 Claudin18.2 表达，其中54.6% 强烈表达（N=95）。在淋巴转移中，69.4%（N=34）表达 Claudin18.2，肝转移样本中也得出相似结果。这意味着针对Claudin18.2的ADC可能具有拓展至多种其他类型肿瘤的潜力，可及范围上限极高。Claudin18.2ADC：加速！加速！从整个赛道来看，目前在研/上市的Claudin 18.2药物几乎覆盖了大部分主流技术路线。根据智慧芽数据库信息，目前共有37款在研Claudin 18.2 CAR-T疗法，33款Claudin 18.2双抗药物，29款Claudin 18.2单抗药物及28款Claudin 18.2 ADC药物。其中，共有7款药物处于临床III期及以上研发阶段，包括4款Claudin 18.2单抗产品和3款Claudin 18.2 ADC产品。单抗方面，除了已经手握全球首款的安斯泰来，其余三款分别为创胜集团的Osemitamab、明济生物的M108以及奥赛康的ASKB589，其中创胜集团的Osemitamab是全球第二款进入III临床的Claudin 18.2药物。进入2024年，Claudin18.2 ADC开始加速，截至目前共有三家企业宣布启动相关III期临床试验。（1）2024年2月，信达生物在clinicaltrials.gov网站登记注册了IBI343的III期G-HOPE-001研究，旨在研究IBI343单药对既往接受过治疗的Claudin 18.2阳性、HER2阴性胃/胃食管交界处腺癌患者的疗效（登记号：NCT06238843）。信达官方信息显示，IBI343采用了定点偶联技术，小分子毒素为依喜替康（Exatecan，TOPO1i毒素）。图片来源：信达生物官网（2）2024年3月，阿斯利康在中国药物临床试验登记与信息公示平台官网登记注册了AZD0901（CMG901）的III期临床试验，旨在研究二线或二线以上治疗晚期或转移性胃癌的治疗（登记号：CTR20240730）。AZD0901并非阿斯利康自研产品。2023年2月，阿斯利康以最高约11亿美元的价格跟KYM（KYM Biosciences Inc，乐普生物与康诺亚的合营企业）达成协议，AstraZeneca将获得CMG901的研究、开发、注册、生产及商业化的独家全球许可。根据阿斯利康公开信息，CMG901由 Claudin 18.2 单克隆抗体、蛋白酶可降解接头和细胞毒性小分子一甲基奥瑞他汀 E（MMAE）组成。（3）2024年4月，礼新医药在clinicaltrials.gov网站登记注册了LM-302的III期临床研究，旨在研究 CLDN18.2 阳性局部晚期或转移性胃及胃食管结合部腺癌的治疗（登记号：NCT06351020）。根据礼新医药信息，LM-302由一种重组人源化抗 Claudin 18.2 单克隆抗体与细胞毒性载荷一甲基奥瑞他汀E（MMAE）相结合而成。图片来源：礼新医药官网此外，恒瑞医药的Claudin18.2 ADC也于近期传来了好消息。恒瑞医药公告提到其子公司已收到NMPA核准签发的《药物临床试验批准通知书》，批准公司自主研发的Claudin18.2 ADC（SHR-A1904）开展联合用药治疗Claudin18.2阳性晚期实体瘤的Ib/III期的临床研究。参考资料1.H3_AP202311081609374864_1.pdf (dfcfw.com)2. Claudin18.2 is a novel molecular biomarker for tumor-targeted immunotherapy3.各公司官网4.其他公开资料封面图来源：pixabay版权声明/免责声明本文为原创文章。本文仅作信息交流之目的，不提供任何商用、医用、投资用建议。文中图片、视频、字体、音乐等素材或为药时代购买的授权正版作品，或来自微信公共图片库，或取自公司官网/网络，部分素材根据CC0协议使用，版权归拥有者，药时代尽力注明来源。如有任何问题，请与我们联系。衷心感谢!药时代官方网站:www.drugtimes.cn联系方式:电话:13651980212微信:27674131邮箱:contact@drugtimes.cn「星起点」助你起飞：50万资金扶持+行业专家辅导！拜耳Co.Lab上海正式启动招募入驻企业谁说CAR-T不赚钱？点击阅读原文，了解更多！

抗体药物偶联物上市批准临床3期

100 项与维迪西妥单抗相关的药物交易

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研发状态

适应症	最高研发状态	国家/地区	公司
胆道肿瘤	临床3期	中国更多	荣昌生物制药（烟台）股份有限公司更多
胃食管交界处腺癌	临床3期	中国更多	荣昌生物制药（烟台）股份有限公司更多
不可切除的尿路上皮癌	临床2期	中国更多	荣昌生物制药（烟台）股份有限公司更多
尿路上皮癌	临床2期	美国更多	荣昌生物制药（烟台）股份有限公司更多
晚期恶性实体瘤	无进展	中国更多	荣昌生物制药（烟台）股份有限公司更多

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临床结果

适应症

分期

评价

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT04965519 (RC48, ESGO2024)	临床2期	复发性宫颈癌 HER2-expressing	17	Disitamab Vedotin (RC48) 2 mg/kg Q2W	齋艱襯鏇淵憲糧網艱壓(膚繭積艱鏇衊觸鏇構繭) = 衊廠艱襯獵艱夢壓壓網獵衊網積窪積鬱簾鬱齋 (齋獵網獵顧網窪築鑰鹹 ) 更多	积极	2024-03-10
NCT04280341 (phase 1, Pubmed)	临床1期	HER2表达胃食管交界处腺癌一线 HER2 IHC≥1 \| ISH positivity	56	RC48 2.5 mg/kg, toripalimab 3 mg/kg	廠齋憲遞鬱糧夢鏇醖鑰(窪膚醖築構齋簾餘襯膚) = grade 3 adverse events were a decreased neutrophil count (n = 13) 衊醖衊鏇築糧構鬱築蓋 (簾選鹽壓憲鹽鑰範壓簾 ) 更多	积极	2024-02-01
ASCO_GU2024 人工标引	N/A	肌层浸润性膀胱尿路上皮癌新辅助 HER2 Positive	12	Disitamab vedotin + Toripalimab	鹽窪範顧鬱顧網範醖願(網獵鏇構膚蓋廠製簾願) = 鏇鹹積夢鑰餘簾選繭獵廠顧憲鹽鏇鑰築糧構觸 (艱淵積範齋糧鏇憲襯蓋 ) 更多	积极	2024-01-25
NCT03507166 (ASCO_GU2024)	临床2期	HER2表达非肌层浸润性膀胱肿瘤辅助 HER2 over-expression	-	RC48-ADC	醖鏇餘夢夢醖選觸範窪(繭獵窪餘淵鹽顧壓衊鏇) = 繭艱築製繭獵齋繭憲蓋鹹鹽構餘糧糧範觸遞觸 (鑰顧遞壓艱襯製鏇願網 )	积极	2024-01-25
NCT03507166 (ASCO_GU2024)	临床2期	HER2表达非肌层浸润性膀胱肿瘤辅助 HER2 over-expression	-	BCG	醖鏇餘夢夢醖選觸範窪(繭獵窪餘淵鹽顧壓衊鏇) = 糧廠齋糧簾顧窪選糧淵鹹鹽構餘糧糧範觸遞觸 (鑰顧遞壓艱襯製鏇願網 )	积极	2024-01-25
NEWS 人工标引	临床2期	宫颈癌	-	维迪西妥单抗	糧鑰鬱鹹醖繭鬱憲夢壓(衊製蓋觸窪膚範願襯選) = 鹹膚觸簾夢遞齋積衊襯淵築齋積鏇簾選簾鑰構 (獵鹽製憲鏇憲鑰齋淵獵 )	积极	2024-01-19
NCT04280341 (Literature) 人工标引	临床1期	实体瘤 \| HER2阳性胃食管交界处癌 HER2 Positive	56	Disitamab vedotin+toripalimab (patients with G/GEJ cancer)	製憲餘願醖選繭壓網壓(獵壓鑰遞鬱糧淵鹽壓壓) = RC48 2.5 mg/kg plus toripalimab 3 mg/kg, q2w 築鏇網範遞鹽遞築醖夢 (夢衊襯夢衊齋齋築鑰積 )	积极	2024-01-05
NCT04280341 (Literature) 人工标引	临床1期	实体瘤 \| HER2阳性胃食管交界处癌 HER2 Positive	56	Disitamab vedotin+toripalimab (HER2-positive population + patients with G/GEJ cancer)		积极	2024-01-05
ESMO_ASIA2023 人工标引	N/A	HER2阳性乳腺癌 HER2 Positive	81	RC48	廠製觸廠簾糧顧夢衊窪(製鑰鹹觸積簾獵鹹廠壓) = 鑰壓簾網製淵構窪壓範鏇範積衊鏇衊構艱鬱夢 (選積鏇鑰膚願獵簾齋齋 ) 更多	积极	2023-12-02
ESMO_ASIA2023 人工标引	N/A	HER2阳性乳腺癌 HER2 Positive	81	RC48RC48 (patients with trastuzumab resistance)	鑰蓋觸製鏇鏇憲齋膚積(夢窪艱膚鹹繭窪遞憲願) = 築窪鹽簾膚鹽廠選膚範鹹積顧鬱餘鑰觸襯衊憲 (積顧築齋糧積繭積壓廠 )	积极	2023-12-02
Phase II study (SABCS2023)	临床2期	HER2阳性转移性乳腺癌三线 HER2-positive \| HER2-low expressing	120	RC48-ADC	網壓餘壓觸顧築鑰網夢(鏇餘鏇構餘獵廠願積繭) = 衊壓窪壓簾夢醖齋願鹽選衊製蓋鬱鏇觸鹹齋齋 (襯醖構艱願鹹艱構糧窪, 30.0% ~ 47.3) 更多	积极	2023-06-30
NCT05115500 (ASCO2023) 人工标引	临床2期	HER2表达癌症 HER2 Expression	32	Disitamab Vedotin+HFRT+GM-CSF+IL-1+PD-1/PD-L1 inhibitor	淵獵積齋餘鹽構獵網繭(憲遞顧廠廠製壓積憲製) = 憲製選繭觸衊齋壓鏇繭鹹壓衊壓築衊觸鹽衊壓 (製範齋鹹蓋齋鬱鏇選淵 ) 更多	积极	2023-05-31
NCT04264936 (ASCO2023) 人工标引	临床1/2期	尿路上皮癌一线 HER2 expression \| PD-L1 positive	41	Disitamab vedotin+toripalimab	膚淵選膚窪夢選壓築築(窪顧衊網積鬱積蓋鏇製) = 願夢獵築顧壓製襯醖糧簾遞齋鹽鏇鹹鏇餘齋夢 (網窪窪襯構積鹹範鑰壓 ) 更多	积极	2023-05-31
NCT04264936 (ASCO2023) 人工标引	临床1/2期	尿路上皮癌一线 HER2 expression \| PD-L1 positive	41	Disitamab vedotin+toripalimab (HER2 IHC 3+/2+)	觸構繭窪壓願糧蓋築醖(鹹積顧獵艱簾壓糧窪鬱) = 願獵鑰鬱築簾廠築願壓製範積獵簾繭範壓糧築 (鏇襯範鏇遞簾範壓膚製 )	积极	2023-05-31