Efficacy and Safety of BP02 (Trastuzumab Biosimilar) in HER2-Positive Metastatic Breast Cancer: A Multicenter Phase III Study.

IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY Clinical Drug Investigation Pub Date : 2024-07-01 Epub Date: 2024-06-27 DOI:10.1007/s40261-024-01374-y
M V T Krishna Mohan, Arpitkumar Prajapati, Rushabh Kothari, Srikrishna Mandal, Ranganatha Rao Srikanth, Rajnish Nagarkar, Shriram Khane, Ayyagari Santa, Disha Dadke
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Abstract

Background and objective: Trastuzumab targets human epidermal growth factor receptor 2 (HER2) receptors and is indicated for treating HER2-positive metastatic breast cancer. BP02, a recombinant IgG1 kappa humanized monoclonal antibody, is being developed as a trastuzumab biosimilar. The objective of this study was to evaluate the equivalence of BP02 with reference trastuzumab (RT: Herceptin®-EU) in patients with HER2-positive metastatic breast cancer.

Methods: This double-blinded, 1:1 randomized, parallel-group, active-controlled, phase III equivalence trial recruited women aged 18-75 years with histologically/cytologically confirmed HER2- positive, locally recurrent or metastatic breast cancer with systemic metastasis, from 59 sites in India. Patients were randomly allocated 1:1 stratified by estrogen receptor/progesterone receptor status to receive BP02/RT (8-mg/kg loading dose on day 1-cycle 1, 6 mg/kg on day 1-cycles 2-8, of each 3-week cycle) combined with docetaxel (75 mg/m2 on day 1-cycles 1-8) [induction phase]. Participants with complete or partial response, or stable disease at the end of the induction phase continued the study drug until disease progression/treatment discontinuation [maintenance phase]. The primary efficacy endpoint was the objective response rate per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1.

Results: Between 23 September, 2020 and 16 September, 2022, 690 patients were recruited (n = 345 each to BP02/RT). At the end of the induction phase (intent-to-treat population), a similar proportion of patients achieved an objective response rate with BP02 (n = 231 [67.0%], 95% confidence interval [CI] 62.0, 71.9) and RT (n = 238 [69.0%], 95% CI 64.1, 73.9). The 95% CI of risk difference (-2.03, 95% CI -9.15, 5.09) and 90% CI of risk ratio (0.97, 90% CI 0.89, 1.06) were within equivalence margins of ± 13% and (0.80, 1.25), respectively. Treatment-emergent adverse events leading to treatment withdrawal were reported in 2.9% and 3.2% patients with BP02 and RT, respectively.

Conclusions: BP02 showed an equivalent efficacy and similar safety profile to RT at the end of 24 weeks.

Clinical trial registration: CTRI Number: CTRI/2020/04/024456.

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BP02(曲妥珠单抗生物类似物)对 HER2 阳性转移性乳腺癌的疗效和安全性:多中心 III 期研究。
背景和目的曲妥珠单抗针对人类表皮生长因子受体 2(HER2)受体,适用于治疗 HER2 阳性转移性乳腺癌。BP02 是一种重组 IgG1 kappa 人源化单克隆抗体,目前正作为曲妥珠单抗的生物类似物进行开发。本研究旨在评估BP02与参考曲妥珠单抗(RT:Herceptin®-EU)在HER2阳性转移性乳腺癌患者中的等效性:这项双盲、1:1 随机、平行组、主动对照的 III 期等效试验从印度 59 个地点招募了年龄在 18-75 岁、组织学/细胞学确诊为 HER2 阳性、局部复发或转移性乳腺癌并伴有全身转移的女性患者。患者按雌激素受体/孕激素受体状态以1:1随机分配,接受BP02/RT(第1周期第1天8毫克/千克负荷剂量,第1周期第2-8天6毫克/千克负荷剂量,每个3周周期)联合多西他赛(第1周期第1-8天75毫克/平方米)[诱导阶段]。在诱导阶段结束时,获得完全或部分应答或病情稳定的参与者继续接受研究药物治疗,直至病情恶化/停止治疗[维持阶段]。主要疗效终点是根据实体瘤反应评价标准(RECIST)1.1.得出的客观反应率:2020 年 9 月 23 日至 2022 年 9 月 16 日期间,共招募了 690 名患者(BP02/RT 各为 345 人)。在诱导阶段结束时(意向治疗人群),BP02(n = 231 [67.0%],95% 置信区间 [CI] 62.0,71.9)和 RT(n = 238 [69.0%],95% CI 64.1,73.9)达到客观应答率的患者比例相似。风险差异的95% CI(-2.03,95% CI -9.15,5.09)和风险比的90% CI(0.97,90% CI 0.89,1.06)分别在± 13%和(0.80,1.25)的等效范围内。BP02和RT分别有2.9%和3.2%的患者出现导致停药的治疗突发不良事件:临床试验注册:临床试验注册:CTRI 编号临床试验注册:CTRI 编号:CTRI/2020/04/024456。
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来源期刊
CiteScore
5.90
自引率
3.10%
发文量
108
审稿时长
6-12 weeks
期刊介绍: Clinical Drug Investigation provides rapid publication of original research covering all phases of clinical drug development and therapeutic use of drugs. The Journal includes: -Clinical trials, outcomes research, clinical pharmacoeconomic studies and pharmacoepidemiology studies with a strong link to optimum prescribing practice for a drug or group of drugs. -Clinical pharmacodynamic and clinical pharmacokinetic studies with a strong link to clinical practice. -Pharmacodynamic and pharmacokinetic studies in healthy volunteers in which significant implications for clinical prescribing are discussed. -Studies focusing on the application of drug delivery technology in healthcare. -Short communications and case study reports that meet the above criteria will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Clinical Drug Investigation may be accompanied by plain language summaries to assist readers who have some knowledge, but non in-depth expertise in, the area to understand important medical advances.
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