Data collection and assembly: A.K.S., A.Y.K., S.S., M.R.P., R.N., A.A.C.K., S.A., J.B., K.E.M., K.H., Q.S.N., E.W.H., J.S.M., and J.G.B. (AEs), 8 (21%) serious AEs, and 15 (39%) AEs??grade 3. Anemia (Eastern Cooperative Oncology Group The study initially enrolled patients on the Q3W dose-escalation schedule (Supplementary Figure S1). During escalation, the first DLT occurred among the first three patients enrolled in the 1.8?mg/kg cohort. Consequently, an additional four patients were enrolled at 1.8?mg/kg. No further DLTs were observed at this dose level; therefore, the escalation continued to 2.4?mg/kg. At this dose and schedule, a DLT was observed in one of the first three patients, and an additional three patients were enrolled. No further DLTs were observed at the 2 2.4?mg/kg dose level. However, based on the totality of the safety data, this dose was Rabbit Polyclonal to OR52N4 determined to be the RP2D and cohort expansion occurred for this dose and schedule, enrolling 11 additional patients. Data for this dose and schedule were combined from both the dose-escalation and expansion patients (area under the concentration-time profile extrapolating to time of infinity, maximum concentration, clearance, monomethyl auristatin E, not available Immunogenicity The prevalence of ADA at baseline was 5.3% (two out of 38 evaluable patients). Post-treatment with DFRF4539A ADAs were detected in nine of 31 patients for which post-baseline data was available. These included the two patients with baseline positive signals that were not enhanced by the treatment. Therefore the overall treatment-emergent ADA incidence was 22.6% (seven out of 31). The presence of ADA appeared to have minimal impact on the ADC exposure in this study. In patients that were ADA positive, no apparent impact on safety was observed. Clinical activity Thirty-seven patients (95%) were evaluated for tumor response (Fig. ?(Fig.1).1). Two patients (5%) had a partial response, one patient (3%) had minimal response, 18 patients (46%) had ITSA-1 stable disease, and 16 patients (41%) had progressive disease (Table ?(Table4).4). The two patients with a partial response were treated at the highest dose tested, 2.4?mg/kg Q3W DFRF4539A. The duration of objective response in the two patients with PR were 22 and 66 days. Figure ?Figure11 depicts the best percent change in either serum M-protein or serum FLC levels (in patients without detectable M-protein) relative to baseline for all efficacy-evaluable patients. Open in a separate window Fig. 1 Best percent change in ITSA-1 either serum M-protein or serum free light chain levels (in patients without detectable M-protein) relative to baseline for all efficacy-evaluable patients.Two efficacy-evaluable patients are not depicted due to lack of detectable M protein or serum free light chains at baseline; both of these patients had a best response of progressive disease Table 4 Investigator-assessed best overall responses
Partial response00002 (12%)002 (5%)Minimal response01 (33%)000001 (3%)Stable disease01 (33%)1 (33%)4 (57%)9 (53%)1 (33%)2 (67%)18 (46%)Progressive disease3 (100%)1 (33%)2 (67%)3 (43%)5 ITSA-1 (29%)2 (67%)016 (41%) Open in a separate window Biomarker analysis target occupancy Two phycoerythrin-conjugated anti-FcRH5 antibody clones (anti-CD307) were used separately to stain patient samples at ITSA-1 baseline and after dosing. Clone 10A8, which consisted of the antibody in DFRF-4539A without the drug conjugate, was used to determine the occupancy of the FcRH5 receptor before and after dosing and was a competing and blocking antibody, whereas clone 7D11 was a non-competing and non-blocking antibody with respect to DFRF4539A for binding to FcRH5. The resulting fluorescence intensity units (MESF) for each antibody was plotted against each other for each patient sample at screening and found to be highly correlated (Pearson correlation coefficient?=?0.8), demonstrating comparable binding of their respective targets (data not shown). When patient samples at baseline and post-dosing were analyzed using the non-competing antibody clone 7D11, the median MESF values were similar (baseline: 8793.0; cycle 1, day 15: 7181.5), thereby equating the level of FcRH5 in the patient population at baseline vs. post-dosing (Fig. ?(Fig.2).2). When patient samples at baseline and post-dosing were analyzed using the competing antibody clone 10A8, the median MESF value at baseline.