Abstract | PURPOSE: Angiogenesis plays an important role in colorectal cancer progression. Stimulation of vascular endothelial growth factor receptor (VEGFR), a transmembrane glycoprotein, results in endothelial mitogenesis. Within this family of receptors, VEGFR 2/ kinase-insert-domain-containing receptor (KDR) appear to be principally up-regulated during tumorigenesis. A chimeric anti-KDR antibody, IMC-1C11, blocks VEGFR-KDR interaction and inhibits VEGFR-induced endothelial cell proliferation. This trial seeks to assess the safety, tolerability and feasibility of targeting an important pathway in tumorigenesis. EXPERIMENTAL DESIGN: In a dose-escalation, single-agent study of IMC-1C11, we enrolled 14 patients with colorectal carcinoma and hepatic metastases. Safety-, pharmacokinetic-, immunogenicity-, and magnetic resonance imaging-assessed alteration of vascular effects of IMC-1C11 were evaluated in this trial. IMC-1C11 was infused weekly at 0.2 mg/kg (n = 3), 0.6 mg/kg (n = 4), 2.0 mg/kg (n = 3), and 4.0 mg/kg (n = 4) for 4 weeks, which constituted a cycle. RESULTS: No grade-3 or -4 IMC-1C11-related toxicities were observed. Minor grade-1 bleeding events were observed in four patients [0.2 mg/kg (n = 1) and 0.6 mg/kg (n = 3)]. Each resolved quickly and required no intervention. The starting dose of IMC-1C11 was selected to achieve a C(max) of approximately 5 micro g/ml. This concentration prevented KDR phosphorylation in vitro. Pharmacokinetic analysis demonstrated that the plasma t(1/2) and C(max) were dose dependent with a plasma t(1/2) of 67 +/- 3 h at the 4-mg/kg dose level. Human antichimeric antibodies were detected in 7 of 14 patients. The antibodies to IMC-1C11 inhibited the circulation of the agent in two patients. One patient had prolonged stable disease for seven cycles (28 weeks). The mean changes in tumor-influx volume-transfer constant k(in) (min(-1)) and enhancement factor after 4 weeks of therapy were significantly decreased compared with pretreatment values in 11 patients. CONCLUSION:
IMC-1C11 was both safe and well tolerated. Drug levels of IMC-1C11 were reliably predicted. Further clinical investigation of anti-VEGFR/KDR agents is warranted.
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Authors | James A Posey, Thian C Ng, Baolian Yang, M B Khazaeli, Mark D Carpenter, Floyd Fox, Mike Needle, Harlan Waksal, Albert F LoBuglio |
Journal | Clinical cancer research : an official journal of the American Association for Cancer Research
(Clin Cancer Res)
Vol. 9
Issue 4
Pg. 1323-32
(Apr 2003)
ISSN: 1078-0432 [Print] United States |
PMID | 12684400
(Publication Type: Clinical Trial, Clinical Trial, Phase I, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Antibodies
- Antibodies, Monoclonal
- Antineoplastic Agents
- IMC1C11
- Intercellular Signaling Peptides and Proteins
- Vascular Endothelial Growth Factor Receptor-2
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Topics |
- Adult
- Aged
- Antibodies
(chemistry)
- Antibodies, Monoclonal
(therapeutic use)
- Antineoplastic Agents
(pharmacology)
- Carcinoma
(pathology)
- Cell Division
- Cells, Cultured
- Colorectal Neoplasms
(pathology)
- Dose-Response Relationship, Drug
- Endothelium, Vascular
(cytology)
- Female
- Humans
- Intercellular Signaling Peptides and Proteins
(metabolism)
- Kinetics
- Liver Neoplasms
(drug therapy, secondary)
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Perfusion
- Protein Structure, Tertiary
- Time Factors
- Vascular Endothelial Growth Factor Receptor-2
(antagonists & inhibitors, chemistry, immunology)
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