Your browser doesn't support javascript.
loading
Evaluation of atezolizumab immunogenicity: Clinical pharmacology (part 1).
Wu, Benjamin; Sternheim, Nitzan; Agarwal, Priya; Suchomel, Julia; Vadhavkar, Shweta; Bruno, Rene; Ballinger, Marcus; Bernaards, Coen A; Chan, Phyllis; Ruppel, Jane; Jin, Jin; Girish, Sandhya; Joshi, Amita; Quarmby, Valerie.
Affiliation
  • Wu B; Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA.
  • Sternheim N; Product Development Regulatory, Genentech Inc., South San Francisco, California, USA.
  • Agarwal P; Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA.
  • Suchomel J; Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA.
  • Vadhavkar S; Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA.
  • Bruno R; Clinical Pharmacology, Genentech-Roche, Marseille, France.
  • Ballinger M; Product Development Oncology Clinical Sciences, Genentech Inc., South San Francisco, California, USA.
  • Bernaards CA; Product Development, Biostatistics, Genentech Inc., South San Francisco, California, USA.
  • Chan P; Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA.
  • Ruppel J; BioAnalytical Sciences, Genentech Inc., South San Francisco, California, USA.
  • Jin J; Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA.
  • Girish S; Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA.
  • Joshi A; Department of Clinical Pharmacology, Genentech Inc., South San Francisco, California, USA.
  • Quarmby V; BioAnalytical Sciences, Genentech Inc., South San Francisco, California, USA.
Clin Transl Sci ; 15(1): 130-140, 2022 01.
Article in En | MEDLINE | ID: mdl-34432389
Baseline patient characteristics and prognostic factors are important considerations in oncology when evaluating the impact of immunogenicity on pharmacokinetics (PK) and efficacy. Here, we assessed the impact of anti-drug antibodies (ADA) on the PK of the immune checkpoint inhibitor atezolizumab (an anti-PD-L1 monoclonal antibody). We evaluated data from ≈ 4500 patients from 12 clinical trials across different tumor types, treatment settings, and dosing regimens. In our dataset, ~ 30% of patients (range, 13-54%) developed treatment-emergent ADA, and in vitro neutralizing antibodies (NAb) were seen in ~ 50% of ADA-positive (+) patients. Pooled time course data showed a trend toward lower atezolizumab exposure in ADA+ patients, which was more pronounced in ADA+/NAb+ patients. However, the atezolizumab concentration distributions overlapped, and drug concentrations exceeded 6 µg/ml, the target concentration required for receptor saturation, in greater than 95% of patients. Patients had sufficient exposure regardless of ADA status. The dose selected to allow for dosing over effects from ADA resulted in a flat exposure-response relationship. Analysis of study results by ADA titer showed that exposure and overall survival were not affected in a clinically meaningful way. High tumor burden, low albumin, and high CRP at baseline showed the greatest association with ADA development but not with subsequent NAb development. These imbalanced factors at baseline can confound analysis of ADA impact. ADA increases atezolizumab clearance minimally (9%), and its impact on exposure based on the totality of the clinical pharmacology assessment does not appear to be clinically meaningful.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pharmacology, Clinical / Antibodies, Neutralizing / Antibodies, Monoclonal, Humanized / Immune Checkpoint Inhibitors Type of study: Prognostic_studies Limits: Humans Language: En Journal: Clin Transl Sci Year: 2022 Document type: Article Affiliation country: United States Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pharmacology, Clinical / Antibodies, Neutralizing / Antibodies, Monoclonal, Humanized / Immune Checkpoint Inhibitors Type of study: Prognostic_studies Limits: Humans Language: En Journal: Clin Transl Sci Year: 2022 Document type: Article Affiliation country: United States Country of publication: United States