© 2002 by Oxford University Press
Journal of the National Cancer Institute, Vol. 94, No. 19, 1484-1493,
October 2, 2002
© 2002 Oxford University Press
ARTICLE |
Molecular Imaging and Biological Evaluation of HuMV833 Anti-VEGF Antibody: Implications for Trial Design of Antiangiogenic Antibodies
For the European Organisation for Research
Treatment of Cancer (EORTC) Biological Therapeutic Development Group
Affiliations of authors: G. C. Jayson, C. Mulatero, M. Ranson, L. Broughton (Cancer Research UK Department of Medical Oncology), J. Lawrance (Department of Radiology), Christie Hospital NHS Trust, Manchester, U.K.; J. Zweit, J. Bailey, N. Smith, Cancer Research UK/University of Manchester Institute of Science and Technology, Radiochemical Targeting and Imaging Group and Manchester Positron Emission Tomography (PET) Centre, Paterson Institute for Cancer Research, and Christie Hospital NHS Trust, Manchester; A. Jackson, H. Haroon, Division of Imaging Science and Biomedical Engineering, Department of Medicine, University of Manchester, Manchester; P. Julyan, D. Hastings, Manchester PET Centre, Paterson Institute for Cancer Research, and Department of North Western Medical Physics, Christie Hospital NHS Trust; J. Wagstaff, Department of Medical Oncology, Academisch Ziekenhuis Maastricht, Maastricht, The Netherlands; L. Hakannson, Department of Medical Oncology, Linkoping University Hospital, Linkoping, Sweden; G. Groenewegen, Department of Medical Oncology, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands; T. Ward, A. T. McGown, Cancer Research UK Drug Development Group, Paterson Institute for Cancer Research; M. Tang, D. Levitt, Protein Design Labs, Inc., Fremont, CA; S. Marreaud, F. F. Lehmann, EORTC Data Centre, Brussels, Belgium; M. Herold, H. Zwierzina (Chairman), EORTC Biological Therapeutic Development Group, Innsbruck Universitaetsklinik, Department of Medicine, Innsbruck, Austria.
Correspondence to: Gordon Jayson, F.R.C.P., Ph.D., Cancer Research UK Dept. of Medical Oncology, Christie Hospital NHS Trust, Wilmslow Rd., Withington, Manchester M20 4BX, U.K. (e-mail: Gordon.Jayson{at}christie-tr.nwest.nhs.uk or GordonJayson{at}aol.com).
Background: Vascular endothelial growth factor (VEGF) is a potent angiogenic cytokine, and various inhibitory agents, including specific antibodies, have been developed to block VEGF-stimulated angiogenesis. We developed HuMV833, a humanized version of a mouse monoclonal anti-VEGF antibody (MV833) that has antitumor activity against a number of human tumor xenografts, and investigated the distribution and biologic effects of HuMV833 in patients in a phase I trial. Methods: Twenty patients with progressive solid tumors were treated with various doses of HuMV833 (0.3, 1, 3, or 10 mg/kg). Positron emission tomography with 124I-HuMV833 was used to measure the antibody distribution in and clearance from tissues. Magnetic resonance imaging was used to measure the vascular permeability surface area product with a first-pass pharmacokinetic model (kfp) to determine tumor vascular permeability. Results: The antibody was generally well tolerated, although the incremental dose, phase I study design, and pharmacodynamic endpoints could not identify the optimum biologically active dose. Antibody distribution and clearance were markedly heterogeneous between and within patients and between and within individual tumors. HuMV833 distribution to normal tissues also varied among patients, but the antibody was cleared from these tissues in a homogeneous fashion. Permeability was strongly heterogeneous between and within patients and between and within individual tumors. All tumors showed a reduction in kfp 48 hours after the first treatment (median = 44%; range = 4%–91%). Conclusions: Because of the heterogeneity in tumor biology with respect to antibody uptake and clearance, we suggest that either intrapatient dose escalation approaches or larger, more precisely defined patient cohorts would be preferable to conventional strategies in the design of phase I studies with antiangiogenic compounds like HuMV833.
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