This is a phase I study of an agonistic CD40 antibody (mitazalimab) injected intratumorally at the time of surgical IRE in patients with locally advanced pancreatic cancer. Intratumoral delivery has potential to be more effective than systemic (intravenous) delivery while decreasing the systemic side effects of immunotherapy. We hypothesize that local delivery of mitazalimab at the time of IRE in patients with locally advanced pancreatic cancer will be safe, augment the immune effects of IRE, and decrease the risk of recurrence.

开始日期2024-06-25

申办/合作机构

University of California San Diego

[+2]

NCT04888312

/ Active, not recruiting临床1/2期

An Open-label Phase 1b/2 Study Assessing the Safety and Efficacy of Mitazalimab in Combination with Chemotherapy in Patients with Metastatic Pancreatic Ductal Adenocarcinoma

Phase 1b/2 study to assess the safety and efficacy of mitazalimab in combination with chemotherapy in patients with metastatic pancreatic ductal adenocarcinoma.

开始日期2021-09-17

申办/合作机构

Alligator Bioscience AB

[+2]

NCT02829099

/ Completed临床1期

A Phase 1, Open-Label Study of the Safety, Pharmacokinetics and Pharmacodynamics of JNJ-64457107, an Agonistic Human Monoclonal Antibody Targeting CD40 in Patients With Advanced Stage Solid Tumors

The primary purpose of the study is to determine the recommended Phase 2 dose (RP2D) and schedule of JNJ-64457107 when administered intravenously (IV) to participants with advanced stage solid tumors in Part 1 and to further characterize the safety of JNJ-64457107 when administered IV to participants with non-small cell lung cancer (NSCLC), pancreatic cancer and cutaneous melanoma in Part 2.

开始日期2016-09-21

申办/合作机构

Janssen Research & Development LLC

100 项与米佐利单抗相关的临床结果

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100 项与米佐利单抗相关的转化医学

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100 项与米佐利单抗相关的专利（医药）

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项与米佐利单抗相关的文献（医药）

2024-07-01·LANCET ONCOLOGY

Combining CD40 agonist mitazalimab with mFOLFIRINOX in previously untreated metastatic pancreatic ductal adenocarcinoma (OPTIMIZE-1): a single-arm, multicentre phase 1b/2 study

Article

作者: Batlle, Jaime Feliu ; Prenen, Hans ; Gallego, Inmaculada ; Cassier, Philippe Alexandre ; Pilla, Lorenzo ; Pazo-Cid, Roberto Antonio ; Blanc, Jean-Frédéric ; Garrote, Mercedes Rodriguez ; Van Laethem, Jean-Luc ; Borbath, Ivan ; Pico de Coaña, Yago ; Ellmark, Peter ; Smith, Karin Enell ; Mitry, Emmanuel ; Ambarkhane, Sumeet Vijay ; Macarulla, Teresa ; Geboes, Karen Paula ; Lambert, Aurélien

BACKGROUND:

Current systemic therapies for metastatic pancreatic ductal adenocarcinoma are associated with poor outcomes with a 5-year overall survival rate under 5%. We aimed to assess the safety and antitumour activity of mitazalimab, a human CD40 agonistic IgG1 antibody, with modified FOLFIRINOX (mFOLFIRINOX; fluorouracil, leucovorin, oxaliplatin, and irinotecan), in chemotherapy-naive patients with metastatic pancreatic ductal adenocarcinoma.

METHODS:

OPTIMIZE-1 was a single-arm, multicentre, phase 1b/2 study which enrolled adults with histologically-confirmed metastatic pancreatic ductal adenocarcinoma and European Cooperative Oncology Group performance status 0 or 1 in 14 university hospitals in Belgium, France, and Spain. The primary endpoint of phase 1b was to determine the recommended phase 2 dose of intravenous mitazalimab (450 μg/kg or 900 μg/kg) when combined with intravenous mFOLFIRINOX (oxaliplatin 85 mg/m², leucovorin 400 mg/m², irinotecan 150 mg/m², fluorouracil 2400 mg/m²). In the first 21-day treatment cycle, mitazalimab was administered on days 1 and 10, and mFOLFIRINOX on day 8. In subsequent 14-day cycles mitazalimab was administered 2 days after mFOLFIRINOX. The phase 2 primary endpoint was objective response rate. Activity and safety analyses were conducted on the full analysis set (all patients who received the combination of mitazalimab at the recommended phase 2 dose and mFOLFIRINOX for at least two treatment cycles) and safety set (all patients who received any study treatment), respectively. Enrolment is complete, and data represents a primary analysis of the ongoing trial. The trial is registered at Clinicaltrials.gov (NCT04888312).

FINDINGS:

Between Sept 29, 2021, and March 28, 2023, 88 patients were screened and 70 patients were enrolled (40 [57%] were female and 30 [43%] were male). In phase 1b, 900 μg/kg mitazalimab was determined as the recommended phase 2 dose. Overall, five patients received 450 μg/kg mitazalimab; 65 received 900 μg/kg mitazalimab. No dose-limiting toxicities were observed at 450 μg/kg, and one dose-limiting toxicity was observed at 900 μg/kg. 57 patients were evaluated for activity, and all 70 patients were included in the safety set. At data cutoff on Nov 14, 2023, median follow-up was 12·7 months (95% CI 11·1-15·7). Of the 57 patients, 29 (51%) remained on study and 18 (32%) remained on treatment. The primary endpoint (objective response rate >30%) was met (objective response rates in 23 [40%]; one-sided 90% CI ≥32 of 57 patients). The most common grade 3 or worse adverse events were neutropenia (18 [26%] of 70 patients), hypokalaemia (11 patients [16%]), and anaemia and thrombocytopenia (eight patients [11%]). Serious adverse events were reported in 29 (41%) of 70 patients, the most common being vomiting (five [7%] of 70 patients), decreased appetite (four [6%]), and diarrhoea and cholangitis (three [4%] of 70 patients for each), none considered related to mitazalimab. No treatment-related deaths were reported.

INTERPRETATION:

Mitazalimab with mFOLFIRINOX demonstrated manageable safety and encouraging activity, warranting continued development in a phase 3, randomised, controlled trial. The results from OPTIMIZE-1 pave the way for further exploration and confirmation of a novel immunotherapy treatment regimen for metastatic pancreatic ductal adenocarcinoma, which is a complex and aggressive cancer with very low survival rates and restricted treatment options.

FUNDING:

Alligator Bioscience.

2024-02-01·Cytokine & growth factor reviews

Harnessing the potential of CD40 agonism in cancer therapy

Review

作者: Richmond, Ann ; Zhou, Yang ; Yan, Chi

CD40 is a member of the tumor necrosis factor (TNF) receptor superfamily of receptors expressed on a variety of cell types. The CD40-CD40L interaction gives rise to many immune events, including the licensing of dendritic cells to activate CD8⁺ effector T cells, as well as the facilitation of B cell activation, proliferation, and differentiation. In malignant cells, the expression of CD40 varies among cancer types, mediating cellular proliferation, apoptosis, survival and the secretion of cytokines and chemokines. Agonistic human anti-CD40 antibodies are emerging as an option for cancer treatment, and early-phase clinical trials explored its monotherapy or combination with radiotherapy, chemotherapy, immune checkpoint blockade, and other immunomodulatory approaches. In this review, we present the current understanding of the mechanism of action for CD40, along with results from the clinical development of agonistic human CD40 antibodies in cancer treatment (selicrelumab, CDX-1140, APX005M, mitazalimab, 2141-V11, SEA-CD40, LVGN7409, and bispecific antibodies). This review also examines the safety profile of CD40 agonists in both preclinical and clinical settings, highlighting optimized dosage levels, potential adverse effects, and strategies to mitigate them.

2023-02-01·Investigational new drugs

A phase 1 study of intravenous mitazalimab, a CD40 agonistic monoclonal antibody, in patients with advanced solid tumors

Article

作者: Hellemans, Peter ; Peretz-Yablonski, Tamar ; Girgis, Suzette ; Calvo, Emiliano ; Xia, Qi ; Pendás, Natalia ; Guo, Yue ; Perets, Ruth ; Fourneau, Nele ; Verona, Raluca ; Moreno, Victor ; Geva, Ravit

Mitazalimab is an agonistic human monoclonal antibody targeting CD40, a target for anti-tumor immunotherapy. This phase 1, dose-escalation study evaluated the safety, dose-limiting toxicities (DLTs), pharmacokinetic and pharmacodynamic profile of mitazalimab. Adults with advanced solid malignancies received mitazalimab intravenously once every-2-weeks. Dose-escalation was pursued with and without pre-infusion corticosteroids for mitigation of infusion-related reactions (IRRs). In all, 95 patients were enrolled in 7 cohorts (n = 50, 75-2000 µg/kg) with corticosteroids and in 5 cohorts (n = 45, 75-1200 µg/kg) without corticosteroids. Two patients experienced DLTs (transient Grade-3 headache; Grade-3 drug-induced liver injury [Hy's law]). The most frequently reported (≥ 25%) treatment-emergent adverse events were fatigue (44.2%), pyrexia (38.9%), pruritus (38.9%), chills (27.4%), and headache (26.3%). IRRs were reported in 51.6% of patients; pruritus (30.5%; with corticosteroids [36.0%], without corticosteroids [24.4%]) was the most frequent. Following the first infusions of 600 μg/kg and 2000 μg/kg, mitazalimab was rapidly cleared from the systemic circulation with mean terminal half-life of 11.9 and 24.1 h, respectively. Pharmacokinetics appeared to exhibit target-mediated drug disposition at the tested doses. Mitazalimab treatment induced higher levels of selected chemokines and transient reduction of B-cells, T-cells, and NK cells. One patient (renal cell carcinoma) displayed partial response lasting 5.6 months. Stable disease was reported by 35 (36.8%) patients, persisting for ≥ 6 months in 9 patients. Mitazalimab has a manageable safety profile with acceptable pharmacokinetic and pharmacodynamic properties. Future clinical development will evaluate combination with existing treatment options. Trial registration NCT02829099 (ClinicalTrials.gov; July 7, 2016).

项与米佐利单抗相关的新闻（医药）

2025-04-22

·小药说药

靶向CD40激动剂的癌症治疗研究进展

-01-引言目前，肿瘤免疫治疗已成为第三代肿瘤治疗中最活跃的研究领域。以PD-1、CTLA-4和PD-L1为靶点的免疫检查点抑制（ICI）疗法在多种癌症的治疗中显示出卓越的效果，并且ICI的免疫疗法随着新的免疫检查点的开发（如TIM-3、LAG-3和TIGIT）而继续扩大。然而，ICI治疗的主要目的是维持先前已建立的抗肿瘤活性。相比之下，刺激性免疫治疗靶点，如CD40、ICOS、CD27、GITR、OX40和4-1BB则用激动剂来激活免疫，主要集中在免疫反应的早期阶段。这些分子最先起作用的很可能是CD40，因为它在抗原呈递过程中起着关键作用，间接地激活T细胞。最新研究显示，CD40激动剂不仅可直接激活树突状细胞（DC）、B细胞等免疫“指挥官”，还能重塑肿瘤微环境（TME），甚至让“冷肿瘤”变得对免疫治疗敏感。CD40激动剂在癌症免疫治疗中正展现出巨大的潜力。-02-一、CD40/CD40L的表达为了获得强大而特异的免疫反应，固有免疫系统和适应性免疫系统需要在多个环节上进行协调。免疫反应的许多关键阶段是由肿瘤坏死因子超家族（TNFSF）的配体及其受体介导的，包括CD40/CD40L。抗原特异性T细胞的有效抗原识别关键取决于特异性抗原呈递细胞（APC）的存在和功能，如B细胞和DC细胞。这些APC通常在细胞表面表达共刺激表面受体CD40（TNFRSF5）。CD40是一种48kda大小的Ⅰ型跨膜蛋白，是连接固有免疫和适应性免疫的重要免疫细胞通讯介质。CD40存在于血小板、B细胞和髓系细胞，但也存在于非造血细胞，如内皮细胞、成纤维细胞、平滑肌细胞甚至某些类型的肿瘤细胞。CD40的同源配体是CD154（TNFSF5/CD40L），一种39kda的II型跨膜蛋白。CD40L的表达通常可诱导并局限于造血系统的细胞，如血小板、粒细胞、活化T细胞、活化B细胞和活化自然杀伤细胞（NK）细胞，但内皮细胞和平滑肌细胞也有弱表达。-03- 二、CD40/CD40L的结构、组成及信号通路TNFRSF信号传导的结构已经比较明确，需要恰当的三维受体聚集和三聚体化。虽然TNFSF配体天然以三价功能单位存在，但受体通常分散分布在细胞表面。TNFSF配体以同源三聚体的形式自然地聚集在细胞表面，其中三个受体结合位点位于相邻单体之间的三个完全相同的缝隙处。关键的是，受体组装成功能性的三聚体复合物是通过天然配体单元的结合发生的。这些三聚体TNFSF配体与在其他细胞表面表达的相应受体的相互作用导致了非常精确的受体聚集。配体对细胞外受体的指令传递给邻近的受体细胞内结构域，然后是细胞内信号复合物的有序组装。TNFSF配体的三聚体结构和由此产生的受体簇是信号传递到细胞的前提。由于这种特殊的要求，一价和二价的结构在体内通常被证明是极低效的。与TNFRSF的其他成员一样，CD40是一种膜结合分子，可以通过细胞间直接接触被膜结合配体激活，也可以被溶液中的可溶性配体激活。多种下游分子和细胞反应进程已被证明受到CD40结合的调节。同源配体连接受体可诱导形成空间上明确的三聚体信号复合物，促进TNF受体相关因子（TRAFs）和NFκB激活剂-1（Act1）的招募。信号复合物的特定组成，主要取决于细胞类型，触发各种途径。例如，与TRAF6的结合主要激活JAK/Stat3通路，TRAF1/2诱导MKK/p38/ERK1/2信号传导，Act1在NFkB通路、JNK和PI3K信号传导中具有多种功能，并与TRAF3一起放大MKK/p38/ERK1/2信号。此外，根据特定的环境，CD40结合可以激活“经典”和非典型的NFkB通路。-04-三、CD40/CD40L的生物学作用CD40在单核细胞及其子代巨噬细胞和DC细胞以及B细胞上的表达在发挥免疫细胞的功能中起着重要作用。单核细胞是固有免疫前体细胞，具有很高的可塑性。它们具有分化为多种细胞类型的能力，如巨噬细胞、髓源性抑制细胞（MDSC）和DC细胞。CD40信号是单核细胞成熟过程的重要触发因素，主要驱动分化为M1谱系的巨噬细胞和DC细胞。CD40与DC细胞表面的结合促进了细胞因子和趋化因子的产生，诱导共刺激分子的表达，并促进抗原的交叉呈递。CD40L的主要功能之一是通过激活DC细胞来增强抗原对T细胞的提呈。这一步称为“许可”，通过上调表面蛋白如CD54和CD86，增加DC与T细胞的相互作用，从而激活后者。B细胞也是CD40L活性的靶点。在胸腺中，T细胞和B细胞之间广泛的串扰使之必须维持表达CD40的B细胞，从而保持自体反应性T细胞对B细胞的阴性选择。B细胞与CD4+T细胞的直接相互作用诱导T细胞表达CD40L，进而保护B细胞不受凋亡的影响。在这个功能中，CD40L通过激活PI3K/Akt提供一个生存信号，使活化的B细胞维持寿命并向浆细胞分化。抗原特异性B细胞通过CD40的稳态增殖和生存机制是通过抗凋亡成员Bcl-2家族的上调来维持的。事实上，CD40/CD40L系统的缺陷与B细胞的抗体类别转换以及细胞超突变的缺陷（hyper-IgM综合征）有关。B细胞与活化的表达CD40L的T细胞的相互作用也增加了MHC-II和CD80或CD86等共刺激分子的表达，并诱导B细胞中的Ig类别转换。活化的B细胞迁移到淋巴器官，在那里向T细胞呈递抗原，CD40激活的DC和B细胞通过释放免疫刺激性细胞因子和趋化因子如IL-6、IL-12p70、IFNγ、CXCL10和TNFα来支持免疫应答。此外，CD40活化的B细胞能够通过促进TNFα和IFNγ等细胞因子的分泌来诱导抗原特异性CD8+T细胞。一些研究证明，体外活化的表达CD40的B细胞是完全功能性抗原提呈的B细胞，随后用这些细胞进行过继细胞转移（ACT）治疗可提高抗肿瘤的疗效。-05-四、CD40/CD40L与肿瘤免疫数十年来，CD40/CD40L信号传导同步免疫反应的固有、细胞和体液分支的非凡能力激发了基础和临床研究的灵感。鉴于CD40的一般表达谱和生物学活性，人们已经做了许多尝试来探索CD40/CD40L信号在抗肿瘤免疫中的作用。CD40激活的DC细胞可用于癌症和传染性疾病（如结核病）的疫苗治疗。CD40信号的另一个有趣结果是表型从“另类活化”的M2型向抗肿瘤或“经典活化”的M1型的转变。这种M1/M2型的命名与肿瘤相关巨噬细胞（TAM）在肿瘤免疫治疗中特别相关。所谓的M1型的“经典活化”巨噬细胞产生于对GM-CSF以及IFNγ和LPS等刺激物的反应，通常被认为具有促炎性免疫反应和抗原交叉呈递的作用。M1型巨噬细胞主要与良好的抗肿瘤免疫反应相关。“另类活化”的M2型巨噬细胞是由于暴露于M-CSF和细胞因子（如IL-4和IL-10）而产生的，并参与组织修复和消除炎症状态。肿瘤相关的M2型被认为是癌症进展和转移的关键驱动因素。肿瘤和浸润性巨噬细胞的紧密相互作用强烈地塑造了肿瘤微环境，从而建立了炎症或促肿瘤的局部条件。有人提出，改善肿瘤内M2/M1谱系的平衡可以通过促进细胞毒性T细胞的浸润和激活来提高抗肿瘤免疫反应。这一点已经在多个模型中进行了描述，例如胰腺癌和小鼠异种移植胶质母细胞瘤模型。巨噬细胞复极化与CD40活化诱导CD206下调和CD54表达增加一致，表明巨噬细胞迁移能力的改变和有效激活。有趣的是，尽管CD40在许多组织中广泛表达，肿瘤细胞似乎更易受膜结合CD40L诱导的CD40杀伤。在B16黑色素瘤小鼠模型中，DC细胞上表达的膜结合CD40L可直接诱导CD40阳性肿瘤细胞凋亡，而非T细胞依赖的的细胞生长抑制活性则源于CD40刺激的IFNγ激活的巨噬细胞。这一现象的部分原因可能不是CD40信号的直接作用，而是对易感细胞类型死亡受体的二次上调。然而，抗CD40抗体Lucatumumab和dacetuzumab对B细胞恶性肿瘤有一定的临床效果，这可能归因于抗体介导的巨噬细胞吞噬和抗体依赖性细胞毒性（ADCC）的作用。结合CD40后，肿瘤细胞显示出DNA损伤的迹象，分泌促血管生成因子，如VEGF和IL-8，并且通常表现出衰老相关分泌表型（SASP）的状态，这是由于CD40诱导的NFκB通路的激活。-06-五、CD40激动剂的药物开发现状基于其独特的受体聚集模式，从TNFRSF产生的下游信号依赖于具有非常精确的结构和三维组成的激动剂化合物。由于CD40在抗肿瘤免疫反应中发挥关键作用，诱导CD40信号的各种策略已经被广泛地研究探索。大致可分为基于激动剂抗体的方法或基于CD40L的方法。目前，临床开发中有9种激动性人抗CD40抗体：4种IgG1抗体（APX005M、mitazalimab、2141-V11、SEA-CD40），2种IgG2抗体（selicrelumab和CDX-1140），1种IgG突变抗体（LVGN7409）和2种双特异性抗体（RO7300490、ABBV-428）。SelicrelumabSelicrelumab（也称为CP-870893，RO7009789）是一种完全人IgG2抗体，不依赖于通过Fc结构域交联来激活CD40。selicrelumab是临床试验中研究最广泛的CD40激动剂。最近，一项1期研究评估了selicrelumab在胰腺导管腺癌（PDAC）患者手术前使用或不使用化疗（nab-紫杉醇和吉西他滨）的新辅助治疗（NCT02588443）。接受selicrelumab单药治疗的患者的1年OS率（中位数+SE）分别为81.8%+11.8%，接受selicreumab联合化疗的患者为100%。Selicrelumab耐受性良好，相关不良事件（AE）大多较轻。此外，发现了selicrelumab诱导TME调节的证据，包括T细胞浸润、DC成熟、巨噬细胞复极化和肿瘤基质密度降低。CDX-1140CDX-140是一种人IgG2单克隆抗体，可驱动NF-kB激活。它结合CD40L结合位点之外的结构域，其激活机制独立于FcR交联。来自评估CDX-1140与抗PD-1治疗（pembrolizumab）联合使用或不使用的I期试验的数据显示，1.5 mg/kg CDX-1140联合200 mg pembrolizumab的剂量具有良好的安全性。观察到临床益处，尤其是在非小细胞肺癌（NSCLC）患者中，有80%的可评估患者具有稳定疾病（SD），而所有患者在之前的基于抗PD-1/L1的治疗中都经历了进展性疾病（PD）（NCT03329950）。APX005MAPX005M是一种人源化IgG1单克隆CD40抗体。通过Fc结构域中的点突变，APX005M增强了与FcγRIIb的结合亲和力，促进了CD40的交联并介导了ADCC。多个早期临床试验评估了APX005M与免疫疗法的联合应用。一项II期研究评估了APX005M与化疗（nab-paclitaxel和吉西他滨）联合使用或不使用抗PD-1（nivolumab）治疗转移性胰腺癌患者的疗效。研究表明，APX005并没有显著改善OS：在105名患者中，nivo/化疗达到了1年总生存期（OS）的主要终点，但APX005M/化疗或APX005M/Cnivo/化学均未达到。然而，APX005M/化疗后的存活率与更显著的肿瘤内CD4+T细胞浸润、循环分化的CD4+T细胞和APCs相关（NCT03214250）。最近，在随后的一项II期研究中，研究了APX005M与纳武单抗联合治疗抗PD-1疾病进展后的转移性黑色素瘤患者。客观反应率（ORR）为15%，中位反应持续时间至少为26个月。MitazalimabMitazalimab（也称为ADC-1013和JNJ-64457107）是一种靶向CD40的人IgG1单克隆抗体。它被设计为以FcγR依赖的方式与CD40结合，具有高效力和亲和力，这有利于肿瘤内给药，以减少剂量和不良免疫相关事件。在一项针对晚期实体瘤患者的I期研究中，静脉注射0.075-2mg/kg的Mitazalimab显示出可控的安全性。 2141-V112141-V11是一种完全人IgG1 CD40抗体，是selicrelumab的Fc优化版本，其中人IgG1 Fc经过5位点突变改造，可增强Fc与FcγRIIB的结合。一项I期研究评估了2141-V11在皮肤转移的实体瘤患者中的作用，在局部和远处病变中显示出抗肿瘤活性的迹象（NCT04059588）。另一项I期研究调查了2141-V11单药治疗对标准治疗无效的非肌肉浸润性癌症（NMIBC）患者的安全性和剂量（NCT05126472）。局部膀胱内给药用于减轻全身毒性。此外，在复发性胶质母细胞瘤患者的I期研究中，通过增强递送（CED）将2141-V11与免疫毒素（D2C7-IT）联合用于肿瘤内给药是安全且有一定疗效的：在入组的5名患者中，一名0.70 mg剂量的患者和两名2.0 mg剂量的患者观察到肿瘤响应的早期迹象。SEA-CD40SEA-CD40是一种全人源的非岩藻糖基化IgG1单克隆CD40抗体。非岩藻糖基化抗体增强了与FcγRIIIa受体的结合，可能提高了激动疗效。一项首次人体I期试验评估了晚期实体瘤和淋巴瘤患者的静脉注射SEA-CD40单一疗法。然而，SEA-CD40的抗肿瘤作用很小，在基底细胞癌患者中有1.8%（1/56）的部分反应，在滤泡性淋巴瘤患者中有1.8%（1/56）的完全反应。另一项研究检查了SEA-CD40联合化疗（nab紫杉醇和吉西他滨）和pembrolizumab治疗转移性PDAC患者的疗效。在10μg/kg和30μg/kg的剂量组中，分别有48%和38%的患者观察到了客观响应。两个剂量组的中位反应持续时间均为5.7个月（NCT02376699）。LVGN7409LVGN7409是一种IgG突变重组单克隆CD40抗体，具有工程Fc片段，可选择性结合FcγRIIB。LVGN7409以FcγRIIB交联依赖的方式激活CD40，因此在富含CD40和FcγRIIB的TME中发挥最佳作用。目前，有两项LVGN7409的I期研究。LVGN7409的第一项人体I期研究是在有或没有抗PD-1抗体（LVGN3616）和/或CD137激动剂抗体（LVGD6051）的情况下评估LVGN7407。静脉注射LVGN7409单药治疗在2 mg/kg以下具有良好的耐受性（NCT04635995）。RO7300490RO7300490是一种针对CD40和成纤维细胞激活蛋白（FAP）的新型双特异性抗体，后者在肿瘤组织中经常过表达，在健康组织中表达较低。因此，RO7300490能够直接重塑TME，同时可能避免与全身CD40激活相关的毒性。目前，一项I期研究正在评估RO7300490在晚期实体瘤患者中使用或不使用atezolizumab的疗效（NCT04857138）。ABBV-428ABBV-428是另一种双特异性抗体，旨在通过与肿瘤抗原间皮素相互作用实现CD40的局部激活。第一项人体I期研究评估了ABBV-428在晚期实体瘤患者中使用或不使用纳武单抗的情况（NCT02955251）。根据接受ABBV-428单药治疗的患者的中期数据，36%的患者在推荐的II期剂量（3.6 mg/kg）下的最佳临床反应为SD。未观察到CD40激动剂的毒性。然而，ABBV-428产生的临床活性很小，这可以用肿瘤细胞上间皮素的低表达来解释，这将限制肿瘤的可及性和ABBV-428对CD40的交联。-07-结语增强抗肿瘤免疫应答的策略是肿瘤学最有希望的新进展之一，而TNFRSF成员，如CD40，是其中重要的靶点。由于产生高效TNF-R-SF信号的独特要求，激动剂分子必须产生非常精确的受体结构和三维结构。虽然已经探索了诱导CD40信号的各种策略，但是20年来有限的临床成功表明需要探索新的方法，这种信号通路激动剂的真正威力尚未在临床开发中充分释放出来。目前CD40激动剂临床疗效有限的原因归咎于抗体的结构和功能特性，包括每个分子只有两个靶结合位点，不适合刺激TNFRSF。由于这一信号通路具有广泛的靶向性，因此也可与其他药物和疗法联合应用。相信不久的将来会产生更多令人鼓舞的临床数据，提高治疗效果，并拓宽更多癌症患者的治疗选择。参考资料：1.Concepts for agonistic targeting of CD40 in immuno-oncology. Hum Vaccin Immunother. 2020;16(2):377-387.2. Harnessing the Potential of CD40 Agonism in Cancer Therapy. Cytokine Growth Factor Rev. 2023 Dec 4;75:40–56公众号内回复“ADC”或扫描下方图片中的二维码免费下载《抗体偶联药物：从基础到临床》的PDF格式电子书！公众号已建立“小药说药专业交流群”微信行业交流群以及读者交流群，扫描下方小编二维码加入，入行业群请主动告知姓名、工作单位和职务。

免疫疗法

2025-02-27

·SYNAPSE

2025年2月27日全球新药进展早知道

1. Keytruda获FDA优先审评资格，针对头颈部鳞癌 2月25日，默沙东（MSD）宣布，美国FDA已接受该公司为重磅免疫疗法Keytruda递交的补充生物制品许可申请（sBLA），寻求批准Keytruda作为手术前的新辅助疗法，用于治疗可切除局部晚期头颈部鳞状细胞癌（LA-HNSCC）患者，随后联合标准放疗（有或无顺铂）作为辅助治疗，然后再作为单药进行辅助治疗。FDA同时授予这一申请优先审评资格，预计在今年6月23日之前完成审评。该sBLA基于3期临床试验KEYNOTE-689的积极数据，预先设定的首次中期分析结果将在即将召开的医学会议上公布。结果显示，在可切除LA-HNSCC患者中，包含Keytruda的围手术期治疗方案与单独采用辅助放疗（有或无顺铂）相比，在无事件生存期（EFS）方面具有统计学显著且临床意义重大的改善。 2. 阿斯利康下一代口服SERD一线乳腺癌III期研究成功 2月26日，阿斯利康宣布III期SERENA-6研究积极的中期分析结果，口服选择性雌激素受体降解剂（SERD）camizestrant联合CDK4/6抑制剂（palbociclib、ribociclib或abemaciclib）在无进展生存期（PFS）的主要终点方面显示出具有统计学意义和临床意义的改善。这意味着，camizestrant成为了首个也是唯一一个证明与已获批的CDK4/6抑制剂联用时具有一线治疗获益的新一代口服SERD和完全ER拮抗剂。SERENA-6研究评估了在一线治疗HR阳性、HER2阴性且具有ESR1突变晚期乳腺癌患者中，改用camizestrant组合疗法与继续使用芳香化酶抑制剂（阿那曲唑或来曲唑）联合CDK4/6抑制剂这一标准护理治疗的疗效与安全性比较。 3. 一周一次创新抗菌药在中国申报上市 2月26日，中国国家药监局药品审评中心（CDE）官网最新公示，由萌蒂制药（Mundipharma）申报的5.1类新药注射用醋酸瑞扎芬净的新药上市申请已获得受理。公开资料显示，瑞扎芬净（rezafungin）是一种环肽药物，是一种创新、一周一次的棘球白素（echinocandin），其已经于2023年3月获得美国FDA批准，用于治疗没有替代治疗选择或选择有限的念珠菌血症与侵袭性念珠菌病患者。瑞扎芬净最初由Cidara Therapeutics开发，萌蒂制药此前通过合作拥有rezafungin在美国和日本以外的商业权利。2024年4月，Cidara Therapeutics宣布将rezafungin的所有权利剥离给萌蒂制药。 4. Alligator更新CD40抗体胰腺癌2期临床数据，股价大涨90% 2月26日，Alligator Bioscience报告了CD40激动型抗体药物MITAZALIMAB（Mitazalimab，米佐利单抗）在胰腺癌的二期临床OPTIMIZE-1研究的最新结果。OPTIMIZE-1是一项开放标签、单臂、多中心的1b/2期临床试验，旨在评估Mitazalimab联合mFOLFIRINOX（改良FOLFIRINOX方案）作为一线治疗方案在转移性胰腺导管腺癌（mPDAC）患者中的疗效和安全性。数据显示，接受MITAZALIMAB单抗联用mFOLFIRINOX治疗的患者的24个月生存率为29.4%，中位总生存期 (mOS) 为14.9个月，显著优于FOLFIRINOX和最近的NALIRIFOX。基于这些结果和已确认的监管途径，Alligator Bioscience 仍在推进MITAZALIMAB单抗单抗进入确认性临床试验。受此消息推动，Alligator股价一度大涨100%以上。 5. 恒瑞ADC新药NSCLC研究结果荣登《柳叶刀·肿瘤学》 2月25日，由上海交通大学附属胸科医院陆舜教授以及李子明教授团队牵头开展的HORIZON-Lung研究II期阶段主要结果发表于国际肿瘤学领域顶级期刊《柳叶刀·肿瘤学》《The Lancet Oncology》（IF:41.6）。该研究结果显示，瑞康曲妥珠单抗（研发代号：SHR-A1811）单药用于既往经治HER2突变晚期非小细胞肺癌患者，表现出了令人鼓舞的抗肿瘤疗效及良好的安全性。HORIZON-Lung研究是一项开放性、多中心、剂量递增/拓展的I/II期临床试验。I期阶段旨在评估瑞康曲妥珠单抗在治疗HER2过表达、扩增或者突变的非小细胞肺癌（NSCLC）受试者中的安全性、耐受性、PK特征及有效性，II期阶段作为关键单臂研究，旨在评估瑞康曲妥珠单抗单药对HER2突变的晚期NSCLC受试者的抗肿瘤疗效和安全性，主要研究结果已于2024年9月递交上市申请且已被纳入优先审评。 6. Arrowhead公布ALK7 siRNA临床前结果，可增强替尔泊肽疗效 2月25日，Arrowhead Pharmaceuticals 公布了ARO-ALK7的临床前结果，这是一种靶向激活素受体样激酶7（ALK7）的在研RNA干扰（RNAi）疗法，有望成为治疗肥胖症的潜在疗法。ARO-ALK7是首个直接靶向脂肪组织中表达基因的RNAi疗法，目前已在新西兰启动ARO-ALK7的1/2a期临床试验，Arrowhead预计将于2025年第二季度开始给药。在啮齿动物和非人灵长类动物的临床前研究中，ARO-ALK7显示出脂肪组织中ALK7 mRNA表达的剂量依赖性和持久性降低。在饮食诱导的肥胖小鼠模型中的药理学研究表明，脂肪组织中ALK7的沉默导致身体成分改善，脂肪量减少约50%，同时保留了瘦体重。此外，GLP-1/GIP受体共激动剂替尔泊肽与ALK7 siRNA的联合治疗增强了治疗效果，与替尔泊肽单药治疗相比，在减轻体重和脂肪量方面具有叠加效应，同时缓解了替尔泊肽单药治疗相关的瘦体重显著减少。 1. 3.95亿美元！和铂医药就一款抗体新药达成授权合作 2月26日，和铂医药宣布，由其孵化的创新型生物技术公司HBM Alpha Therapeutics宣布与一家业务合作伙伴达成战略合作与许可协议，共同推进针对多种疾病的新型促肾上腺皮质激素释放激素（CRH）靶向疗法。根据协议，该合作伙伴获得在大中华区（包括中国大陆、中国台湾、中国香港和中国澳门地区）以外的全球市场开发和商业化HAT001（一款强效且选择性靶向CRH的中和抗体，和铂医药内部代号为HBM9013）的独家权利。HBMAT将获得高达3.95亿美元的总付款，包括首付款和开发、监管及商业里程碑付款，以及基于未来产品净销售额的分级特许权使用费。此外，HBMAT还有权获得认股权证以获取合作伙伴的少数股权。内容来源于网络，如有侵权，请联系删除。

优先审批临床结果临床成功

2024-12-17

·Business Wire

CD40 Targeted Therapies Clinical Trials, Therapeutic Approaches & Market Opportunity Insight Report 2025 - First CD40 Targeted Therapy Approval Expected By 2027 - ResearchAndMarkets.com

DUBLIN--( BUSINESS WIRE )--The "CD40 Targeted Therapies Clinical Trials, Therapeutic Approaches & Market Opportunity Insight 2025" report has been added to ResearchAndMarkets.com's offering. CD40 targeted therapies have become a focal point in immunotherapy research, with growing attention on harnessing the potential of the CD40 receptor to treat a variety of diseases. While no CD40 targeted therapies have yet been approved for clinical use, some promising candidates are currently undergoing late stage clinical development. Moreover, additional candidates are slated to enter late-stage trials within the next year, expanding the pool of CD40 targeted therapies in clinical development. These ongoing research and clinical trials suggest that CD40 targeted therapies could become a vital treatment option for patients with prevalent diseases in the coming years. Global CD40 Targeted Therapies Clinical Trials, Therapeutic Approaches & Market Opportunity Insight 2025 Report Highlights: First CD40 Targeted Therapy Approval Expected By 2027 CD40 Targeted Therapies In Clinical Trials: > 20 Therapies CD40 Inhibitors Clinical Trials Insight By Company, Country, Indication & Phase CD40 Targeted Therapy Research & Development Trends By Indication CD40 Targeted Therapy Market Trend Analysis By Region CD40 Targeted Therapies Proprietary Technologies By Company Historically, the primary focus of CD40 targeted therapies has been on autoimmune and inflammatory diseases. However, there is an increasing interest in exploring their potential for treating cancer and other conditions. More recent studies have expanded the scope of CD40 targeting to include infectious diseases, such as HIV and COVID-19, as well as neurodegenerative diseases like Alzheimer's and Parkinson's disease. Some research has also suggested that CD40 targeted therapies might be beneficial for diseases like cardiovascular conditions, where CD40's signaling pathway, although not directly involved in disease initiation, plays a role in disease progression and inflammation. Over the years, various strategies have been employed to target the CD40 receptor and its ligand. These include traditional monoclonal antibodies as well as next-generation molecular therapeutics such as small interfering RNA (siRNA). While antibodies are developed either as CD40 agonists or as antagonists, CD40 targeted siRNAs aim to reduce CD40 protein expression by degrading CD40 mRNA. Several other conventional and next-generation approaches are undergoing active research and clinical trials to assess their safety and efficacy. Nonetheless, antibody therapies remain the dominant approach in CD40 targeted research. Among the most advanced CD40/CD40L targeted antibodies are those for autoimmune and inflammatory diseases, with some entering phase 3 clinical trials. For example, Sanofi's Frexalimab, a promising anti CD40 antibody, is currently in phase 3 trials for autoimmune conditions. In the cancer domain, CD40 targeted antibodies are also making significant strides, with companies like Alligator Bioscience preparing to initiate phase 3 clinical trials for its lead candidate, mitazalimab, an anti-CD40 antibody for pancreatic ductal adenocarcinoma (PDA) and pancreatic cancer. The development of CD40 targeted therapies has been greatly facilitated by the advent of proprietary technologies and platforms. One notable example is GenMab's DuoBody platform, which enables the creation of bispecific antibodies that can target two different antigens simultaneously. This technology has been leveraged to develop several promising immunotherapies, including its CD40 targeted therapy, GEN1042/BNT312, currently in phase 2 trial for malignant solid tumors. As the field of CD40 targeted therapies evolves, the competitive landscape is becoming increasingly crowded, with many major pharmaceutical companies entering the arena. Notable players include Amgen, Sanofi, GenMab, BioNTech, and Biogen, all of which are investing heavily in this space. Collaborations between pharmaceutical companies and academic institutions have been essential in advancing the scientific understanding of CD40 targeted therapies, combining cutting edge research with clinical expertise to bring these therapies closer to market. In conclusion, while CD40 targeted therapies have not yet been approved for clinical use, they represent a promising and rapidly developing area of research across a wide range of diseases. As more therapies enter clinical trials and the competitive landscape intensifies, it is clear that CD40 targeted therapies could become a cornerstone of treatment for cancer, autoimmune diseases, infectious diseases, and beyond in the near future. Key Topics Covered: Introduction To CD40 Targeted Therapies Considering CD40 As Drug Target Over Other CD Markers History & Evolution Of CD40 Targeting Therapies CD40 Targeted Therapies - Mechanism Of Action Agonist Mediated Activation Of CD40 Signaling Antagonist-Mediated Inhibition Of CD40 Signaling CD40 Targeted Therapeutic Approaches Antibody Formats Fusion Proteins Peptides Nucleic Acids CD40 Targeted Therapy Research & Development Trends By Indication Cancer Neurological Diseases Autoimmune & Inflammatory Disorders Transplant Rejection Microbial Infections Global CD40 Targeted Therapy Market Outlook Current Market Trends & Developments Future Market Opportunities CD40 Targeted Therapy Market Trend Analysis By Region US Europe China Japan Australia CD40 Targeted Therapies Clinical Trials Insight By Company, Country, Indication & Phase Research Preclinical Phase I Phase I/II Phase II Phase III CD40 Targeted Therapies - Proprietary Technologies By Company Alligator Bioscience - FIND Technology & Neo-X-Prime Aprilbio - SAFA Platform Biocytogen - RenMice EnnoDC - Unnamed Platform Genmab - DuoBody Harbour BioMed - Harbour Mice & HBICE Kyowa Kirin - REGULGENT Strike Pharma - ADAC Technology Platform Global CD40 Targeted Therapy Market Dynamics Competitive Landscape Alligator Bioscience Amgen Biogen BioNTech Eledon Pharmaceuticals EnnoDC Genmab Innovent Bio Novartis Sanofi Tonix Pharmaceuticals UCB For more information about this report visit https://www.researchandmarkets.com/r/46sm5e About ResearchAndMarkets.com ResearchAndMarkets.com is the world's leading source for international market research reports and market data. We provide you with the latest data on international and regional markets, key industries, the top companies, new products and the latest trends.

免疫疗法临床3期临床2期

100 项与米佐利单抗相关的药物交易

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KEGG	Wiki	ATC	Drug Bank
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研发状态

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适应症	最高研发状态	国家/地区	公司	日期
转移性胰腺导管腺癌	临床2期	比利时	Alligator Bioscience AB	2021-09-17
转移性胰腺导管腺癌	临床2期	法国	Alligator Bioscience AB	2021-09-17
转移性胰腺导管腺癌	临床2期	西班牙	Alligator Bioscience AB	2021-09-17
晚期恶性实体瘤	临床1期	丹麦	Alligator Bioscience AB	2015-04-01
晚期恶性实体瘤	临床1期	瑞典	Alligator Bioscience AB	2015-04-01
晚期恶性实体瘤	临床1期	英国	Alligator Bioscience AB	2015-04-01

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临床结果

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT04888312 (OPTIMIZE-1, NEWS) 人工标引	临床1/2期	转移性胰腺导管腺癌一线	-	MITAZALIMAB + mFOLFIRINOX	衊顧遞構淵夢願鏇壓構(餘醖齋選觸蓋積繭繭鹹) = 壓淵憲醖淵願淵衊鹹鏇膚願顧構鏇齋憲襯襯鑰 (選衊鹹膚鏇選選襯齋醖 ) 更多	积极	2025-02-26
NCT04888312 (OPTIMIZE-1, NEWS) 人工标引	临床1/2期	转移性胰腺导管腺癌一线	-	mFOLFIRINOX	衊顧遞構淵夢願鏇壓構(餘醖齋選觸蓋積繭繭鹹) = 範鹽鏇築膚鹹範衊網製膚願顧構鏇齋憲襯襯鑰 (選衊鹹膚鏇選選襯齋醖 ) 更多	积极	2025-02-26
NCT04888312 (OPTIMIZE-1, Pubmed)	临床1/2期	转移性胰腺导管腺癌	70	Mitazalimab 900 μg/kg	膚壓蓋觸淵齋艱窪蓋淵(製鹽顧糧憲艱憲鹹壓簾) = eight patients [11%] 製齋糧餘顧鹽構醖淵餘 (簾膚餘觸艱糧繭鬱齋夢 ) 更多	积极	2024-07-01
NCT04888312 (OPTIMIZE-1, ASCO2024) 人工标引	临床2期	转移性胰腺导管腺癌一线	-	mitazalimab+FOLFIRINOX	艱鹹觸築膚齋醖鹽衊廠(蓋遞廠範觸構夢膚艱遞) = associated with an expansion in the frequency of effector CD4 T cells (p < 0.0001) at day 8 after receiving mitazalimab. 簾選窪鹽淵製鬱壓夢願 (齋製鏇鏇繭鏇構遞齋鑰 )	积极	2024-05-24
NCT04888312 (OPTIMIZE-1, ASCO2024) 人工标引	临床1/2期	转移性胰腺导管腺癌一线 KRAS G12D \| KRAS G12R \| KRAS G12V	57	Mitazalimab + mFOLFIRINOX	蓋鏇艱憲艱衊鏇憲憲繭(願齋觸淵繭構夢廠築膚) = 鹹遞廠蓋壓齋壓簾獵鬱壓醖顧構襯願壓網觸艱 (鑰積遞願衊選衊繭鏇觸, 29.4 ~ 52.1) 更多	积极	2024-05-24
NCT04888312 (OPTIMIZE-1, PRNewswire) 人工标引	临床2期	胰腺癌一线	57	Mitazalimab	糧窪顧窪觸淵艱夢衊築(餘憲積構鏇壓齋壓齋襯) = 襯醖積鹽鹹顧鑰窪觸簾鑰夢夢鏇鬱衊簾製廠醖 (窪鹹鬱築艱願簾簾蓋選 ) 更多	积极	2023-07-01
NCT04888312 (OPTIMIZE-1, ASCO2023) 人工标引	临床1/2期	转移性胰腺导管腺癌	43	Mitazalimab + mFOLFIRINOX	繭艱顧鹹憲觸鹽製廠廠(淵築夢觸衊鏇簾憲窪鹹) = 觸繭齋顧襯壓憲廠壓構遞壓願鏇膚艱齋壓夢範 (蓋齋壓蓋膚鬱願蓋簾選 ) 更多	积极	2023-05-31
NCT04888312 (OPTIMIZE-1, PipelineReview) 人工标引	临床2期	转移性胰腺癌一线	23	mFOLFIRINOX+Mitazalimab	膚壓壓齋鹹醖艱夢觸鏇(壓鹽鹹憲餘觸夢襯廠醖) = 艱遞糧餘餘鏇夢齋築顧鏇獵憲願獵壓餘觸鹹鏇 (築齋繭夢顧夢遞壓淵網 ) 更多	积极	2023-01-02
NCT02829099 (Pubmed)	临床1期	晚期恶性实体瘤	95	Mitazalimab	夢艱蓋鑰餘蓋願觸鬱積(夢鹹窪窪製襯顧蓋築遞) = 遞鬱鑰壓膚衊鹽顧廠蓋構構艱範簾憲願鹽遞繭 (顧獵膚鬱鹹齋鏇艱餘膚 ) 更多	-	2022-12-20
NCT04888312 (OPTIMIZE-1, AACR2022) 人工标引	临床1/2期	转移性胰腺导管腺癌一线	11	Mitazalimab+mFOLFIRINOX	艱衊遞積齋製襯鑰選顧(選憲範齋鹹簾願鑰衊蓋) = 餘夢鹹窪夢鹽壓獵獵艱製淵構餘鬱淵願齋夢夢 (鏇憲積壓醖憲築範觸積 ) 更多	积极	2022-11-15
NCT04888312 (OPTIMIZE-1, ASCO2022) 人工标引	临床1期	转移性胰腺导管腺癌	5	mFOLFIRINOX+Mitazalimab	蓋鬱窪築襯憲顧範蓋夢(廠夢淵觸齋構獵鏇網餘) = 淵鬱糧顧範選餘糧製衊簾糧繭繭築憲廠醖窪鏇 (顧糧網憲積醖鹽築窪淵 ) 更多	积极	2022-06-02