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条件性CD28共刺激剂和双重PD-L1和CTLA-4检查点抑制剂davoceticept临床试验遭遇挫折:患者死亡

2022-03-09 Allan MedSci原创

制药公司 Alpine 本周一披露, 因患者死亡,FDA 已暂停其 I 期 NEON-2试验的部分临床试验。

制药公司 Alpine 本周一披露, 因患者死亡,FDA 已暂停其 I 期 NEON-2试验的部分临床试验,该试验旨在评估 davoceticept 与默克公司的 Keytruda ( pembrolizumab )联合治疗晚期恶性肿瘤的有效性和安全性。

据 Alpine 称,该患者患有脉络膜黑色素瘤,之前接受过百时美施贵宝的 Opdivo(nivolumab)和 Yervoy(ipilimumab)治疗。在 NEON-2 试验中,该患者接受了单剂量的 davoceticept 和 Keytruda。据 Alpine 称,死亡归因于心源性休克,治疗医生认为这可能与免疫介导的心肌炎或感染有关。

Davoceticept,也称为 ALPN-202,是一种条件性 CD28 共刺激剂和双重 PD-L1 和 CTLA-4 检查点抑制剂,用于治疗癌症。去年,Alpine 表示,在 I 期 NEON-1 单药治疗研究中,61% 的患者似乎获得了临床益处,尽管大多数患者的肿瘤通常被认为对免疫疗法无反应。

Alpine 首席执行官 Mitchell Gold 在评论部分搁置时说:“鉴于 davoceticept 和 Keytruda 联合使用以使难治性患者受益的强大科学依据,我们希望在适当的安全审查后很快恢复该研究”。虽然 NEON-2 试验目前被禁止招募新患者,但已经注册的患者可能会继续接受 davoceticept 和 Keytruda。同时,FDA 的行动不影响正在进行的 NEON-1 试验。

尽管肿瘤免疫治疗取得了重大进展,但大多数接受检查点抑制剂治疗的患者要么对治疗没有反应,要么产生耐药性。最近的研究表明,免疫检查点主要通过抑制 CD28 发挥作用,CD28 是 T 细胞中一种关键的共刺激受体。Davoceticept 基于变体 CD80 细胞外结构域,通过定向进化工程改造以结合 PD-L1 以及 CD28 和 CTLA-4。Davoceticept 通过与 PD-L1 的高亲和力结合定位于肿瘤,仅在 PD-L1 存在时通过 CD28 的聚集和激动作用激活 T 细胞。

 

原始出处:

https://firstwordpharma.com/story/5519385

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    2022-12-24 jklm09
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    2022-03-11 graceoo

    双靶的风险

    0

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    2022-03-11 smartjoy
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    2022-03-11 hywen7328

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