Journal of Clinical Oncology · 2014 · 361 citations · 38 references
MedicineOncologyPharmacologyCancer ImmunologyClinical ImmunologyImmunotherapyCancer ImmunotherapyChemokine NetworksCutaneous LymphomaCytotoxic T Lymphocyte ResponsesPharmacodynamics Of ImmunotherapiesPharmacokinetics Of Monoclonal AntibodiesAntibody-dependent Cell-mediated CytotoxicityAntibody-dependent Cellular CytotoxicityCd4+ Tumor-infiltrating LymphocytesComplete Response AssessmentCutaneous T-cell Lymphoma TreatmentCytotoxic T Lymphocyte - Associated Protein 4 PathwayCytotoxic T-lymphocyte-associated Protein 4 InhibitorsLymphoma Treatment Response
PURPOSE: CC chemokine receptor 4 (CCR4) is expressed by peripheral T-cell lymphomas (PTCLs) and is associated with poor outcomes. Mogamulizumab (KW-0761) is a defucosylated humanized anti-CCR4 antibody engineered to exert potent antibody-dependent cellular cytotoxicity. This multicenter phase II study evaluated the efficacy and safety of mogamulizumab in patients with relapsed PTCL and cutaneous T-cell lymphoma (CTCL). PATIENTS AND METHODS: Mogamulizumab (1.0 mg/kg) was administered intravenously once per week for 8 weeks to patients with relapsed CCR4-positive PTCL or CTCL. The primary end point was the overall response rate, and the secondary end points included safety, progression-free survival (PFS), and overall survival (OS). RESULTS: A total of 38 patients were enrolled, and 37 patients received mogamulizumab. Objective responses were noted for 13 of 37 patients (35%; 95% CI, 20% to 53%), including five patients (14%) with complete response. The median PFS was 3.0 months (95% CI, 1.6 to 4.9 months), and the median OS was not calculated. The mean maximum and trough mogamulizumab concentrations (± standard deviation) after the eighth infusion were 45.9 ± 9.3 and 29.0 ± 13.3 μg/mL, respectively. The most common adverse events were hematologic events, pyrexia, and skin disorders, all of which were reversible and manageable. CONCLUSION: Mogamulizumab exhibited clinically meaningful antitumor activity in patients with relapsed PTCL and CTCL, with an acceptable toxicity profile. Further investigation of mogamulizumab for treatment of T-cell lymphoma is warranted.
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