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First time intravesically administered trifunctional antibody catumaxomab in patients with recurrent non-muscle invasive bladder cancer indicates high tolerability and local immunological activity.

Abstract
Transurethral resection of the tumor (TUR-B) followed by adjuvant intravesical treatment with cytostatic drugs or Bacillus Calmette-Guérin (BCG) as standard therapy of non-muscle-invasive bladder cancer (NMIBC) is associated with a high recurrence rate of about 60-70%, considerable side effects and requires close monitoring. Alternative treatment options are warranted. Two patients with epithelial cell adhesion molecule (EpCAM)-positive recurrent non-muscle invasive bladder cancer were treated the first time by an intravesical administration of the trifunctional bispecific EpCAM targeting antibody catumaxomab (total dosage of 470 and 1120 µg, respectively). The binding and killing activity of catumaxomab in urine milieu was evaluated in vitro. In contrast to its previous systemic application catumaxomab was well tolerated without any obvious signs of toxicity. Relevant cytokine plasma levels were not detected and no significant systemic drug release was observed. The induction of a human anti-mouse-antibody (HAMA) reaction was either absent or untypically weak contrary to the high immunogenicity of intraperitoneal applied catumaxomab. Tumor cells that were detectable in urine patient samples disappeared after catumaxomab therapy. Endoscopically confirmed recurrence-free intervals were 32 and 25 months. Our data suggest that intravesical administration of catumaxomab in NMIBC is feasible, safe and efficacious, thus arguing for further clinical development of catumaxomab in this indication.
AuthorsPeter Ruf, Hartwig W Bauer, Alexandra Schoberth, Claudia Kellermann, Horst Lindhofer
JournalCancer immunology, immunotherapy : CII (Cancer Immunol Immunother) Vol. 70 Issue 9 Pg. 2727-2735 (Sep 2021) ISSN: 1432-0851 [Electronic] Germany
PMID33837852 (Publication Type: Journal Article)
Copyright© 2021. The Author(s).
Chemical References
  • Antibodies, Bispecific
  • Antineoplastic Agents, Immunological
  • catumaxomab
Topics
  • Aged
  • Antibodies, Bispecific (administration & dosage, adverse effects, therapeutic use)
  • Antineoplastic Agents, Immunological (administration & dosage, adverse effects, therapeutic use)
  • Cell Line, Tumor
  • Cell Survival (drug effects)
  • Cystoscopy
  • Dose-Response Relationship, Drug
  • Drug Resistance, Neoplasm
  • Female
  • Humans
  • Male
  • Neoplasm Staging
  • Protein Binding
  • Retreatment
  • Treatment Outcome
  • Tumor Microenvironment (drug effects, immunology)
  • Urinary Bladder Neoplasms (diagnosis, drug therapy, immunology)

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